EVALUATION OF KNOWLEDGE, ATTITUDE AND PRACTICE OF INHALATION SEDATION IN CHILDREN AMONGST PEDODONTISTS AND GENERAL DENTAL PRACTITIONERS IN MANGALORE, INDIA

Inhalation sedation is a minimally depressed level of consciousness that retains the patient's ability to maintain an airway independently and continuously and respond to stimulation and command. Found to be safe for use in dentistry with positive outcomes, it is used to manage anxiety in pediatric patients during procedures. Aim of our study was to determine the frequency of usage of inhalation sedation as adjunctive management technique in children by Dentists. A Cross sectional study was conducted with pre-structured questionnaire given to Pedodontists and General dental practitioners in various Dental colleges and clinics in and around Mangalore. Total sample size was 72. Data was collected and analyzed using SPSS version 17.0 with the Test of Proportions. 32 out of 72 participants were trained in usage of Inhalation Sedation, out of which 14 used it regularly. Out of the 80.56% dentists not using it, majority said that expensive equipment, increased cost of treatment and potential complications were the main reasons for not using it. 59.72% of participants wanted to gain information, knowledge and undergo training in the usage of Inhalation Sedation.58.33% agreed to use it in their future dental career. 70.83% believed that knowledge and training to use Inhalation Sedation is integral part of dental curriculum for undergraduates. This study showed willingness of the dentists to provide Inhalation Sedation as a behavior management technique to their patients. The lack of training, costly equipment, increased cost of treatment are the main barriers to providing such services to the patients.

Trends in Dental Sedation of Korean Children and Adolescents

The purpose of this study was to investigate trends in dental sedation of Korean children and adolescents. A retrospective study was conducted on patients under 20 years of age who received dental treatment under sedation using National Health Insurance Service-National Sample Cohort Database from 2002 to 2015. Based on the 1 million standard data, there were 436 cases of dental treatment under sedation in 2002, but 4002 cases in 2015, showing a trend increasing every year. The 3 - 5 year old group accounted for the largest portion (54.2%), while the 6 - 8 year old group increased recently. Nitrous oxide inhalation sedation is the most commonly used, accounting for 45.9% in 2002, but increased to 89.5% in 2015. Combination of nitrous oxide inhalation sedation, chloralhydrate and hydroxyzine was the most common, accounting for 5.7% in 2002, but decreased to 2.9% in 2015. There is a trend to use the sedation method more safely and in a way that reduces side effects.

Managing paediatric dental anxiety

Sabrina Pahal explores the role of dental nurses in delivery of inhalation sedation to paediatric patients

An alternative sedation option for special care patients: combined inhalation sedation with nitrous oxide and oxygen and intravenous sedation with midazolam

This article highlights an alternative sedation technique by providing inhalation sedation with nitrous oxide and oxygen alongside intravenous sedation with midazolam as an additional option for patients within special care dentistry. Two case reports are described, as well as a short overview of the available literature on this technique and the indications, advantages and disadvantages. This technique should be considered alongside other sedation techniques. As with all treatment for which sedation is provided, each case needs to be considered on an individual basis and the most appropriate option selected following discussion with the patient. CPD/Clinical Relevance: Although single sedation techniques provide a good level of sedation to facilitate dental treatment for the majority of patients, it is desirable to have an awareness of alternative sedation options that may be available for patients.

Inhalation sedation in the spotlight

Janet Pickles discusses the effects of Covid-19 on the provision of inhalation sedation

Efficacy and Safety of Inhalation Sedation during Office Probing for Congenital Nasolacrimal Duct Obstruction

We compared the effectiveness of inhaled sevoflurane versus physical restraint during probing in children with congenital nasolacrimal duct obstruction (CNLDO). We performed a retrospective review of children with CNLDO who underwent office probing procedures by a single surgeon under sedation or restraint. Patients’ characteristics at the time of probing, including age, sex, laterality, previous non-surgical treatment, presence of dacryocystitis, outcomes of probing, and complications were compared between the sedation and restraint groups. A multivariable logistic regression analysis was performed to investigate the prognostic factors associated with the success of probing. A subgroup analysis by 12 months of age was also conducted. The overall success rate was 88.6% in 202 eyes of 180 consecutive children (mean age, 15.1 ± 7.7 months). The sedation group had a marginally higher success rates than the restraint group (93.8% vs. 85.1%, p = 0.056). The success rate was not significantly different between the two groups in children aged <12 months (90.9% vs. 93.1%, p = 0.739), but it was significantly higher in the sedation group (94.7% vs. 77.8%. p = 0.006) in children aged ≥12 months. Inhalation sedation was the most potent factor associated with success (adjusted odds ratio = 5.56, 95% confidence interval = 1.33–23.13, p = 0.018) in children aged ≥12 months. There were no surgical or sedation-related complications intra- and postoperatively. Inhaled sevoflurane sedation resulted in more successful, controlled, painless probing, particularly in children aged ≥12 months. It represents a safe, efficient alternative to general anesthesia.