Behavioral Modifications in Children after Repeated Sedation with Nitrous Oxide for Dental Treatment: A Retrospective Study (original) (raw)
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European Archives of Paediatric Dentistry
Purpose Conscious sedation by inhalation of a mixture of nitrous oxide and oxygen (CS) is a technique used in dental care for anxious, handicapped or uncooperative patients. The very special objective of this cohort study is to compare the behaviour of young patients during dental care under CS in two hospitals using different gas distribution systems. Methods Young patients were divided into four categories: young child (YC), phobic anxiety (PA), mental disorder (MD), occasional indication (OI). Differences in behaviour scale at various time points according to the sedation system used were established and compared using Mann-Whitney tests. Results This study showed that there is no difference in behaviour during dental care in YC after sedation. In PA, a significant difference in behaviour is only observed during local anaesthesia (p = 0.024). Conclusion No significant differences detected in children's behaviour under conscious sedation using different gas administration systems. The delicate stage of local anaesthesia in PA patients can be facilitated with repeated sessions of dental care under conscious sedation.
Interventions in Pediatric Dentistry Open Access Journal, 2020
Purpose: To show the different dental treatment responses and outcomes of different pediatric age groups under nitrous oxide (N₂O), based on the experiences of a private practice, to show that N₂O inhalation is an effective tool for all young patients if used in conjunction with behavior management techniques, and to show that N₂O is an outstanding tool for decreasing the dentist risk and stress when using pre-medication or general anesthesia. Methods: A total of 826 middle-and upper-class children 394 males and 432 females, ranging in age from < 2 to 13 years old, participated in this study using the rapid induction method. All patients were treated over a total of 1,924 appointments (average, 2-3 visits per patient). The PDCC (Pediatric Dental Consulting Center) created criteria for each child's evaluation at the first visit prior to categorization, according to which behavioral rating scale he or she belonged. Moreover, these categorizations were based on McDonald and Frankel's Behavior Rating Scale with Wright's Modification, in conjunction with the PDCC criteria. During the first visit, we enhanced the parents-child-dentist relationship. The child was familiarized with the dental environment by a skillful dental team, while the parents were educated about several behavior management techniques and the use of N₂O sedation. Results: N₂O worked effectively when combined with basic behavior management techniques. The child's first visit to the dental clinic should only include familiarization, acclimatization and enhancement of the parent-child-dentist relationship, as well as education. It was observed that, patients 4-6 years old responded best including children with bad experience and different personalities. Conclusion: Behavior management and N₂O constitute an excellent combination. If both applied and used properly, pediatric patients can be treated successfully. The pediatric dentist should master his or her communication skills with children and parents. Based on this study, children with moderate to severe anxiety can be managed with proper application of behavior management and with the use of N₂O sedation (with a high success rate of 91%).
Journal of Clinical Pediatric Dentistry, 2020
Objective: Sedation using 50% nitrous oxide (N2O) concentration is common in pediatric dentistry. The aim to assess sedation and cooperation levels following sedation with 60% and 70% N2O concentrations in children whose dental treatment failed using 50% N2O concentration. Study design: Children (n=51) aged 5–10 years were included. Sedation started with N2O concentration of 50%; when appropriate cooperation and sedation were not achieved, N2O concentration was increased to 60%, and subsequently to 70% during the same session. Sedation and cooperation levels were the primary outcomes. Adverse events were defined as secondary outcomes. Results: At 50% N2O concentration, five children reached adequate sedation and cooperation and completed their dental treatment, where 32 children completed the treatment at 60% N2O concentration. Fourteen children required a concentration of 70% to complete treatment. For ten of the latter, treatment was successfully completed, while for four, treatme...
BioMed Research International, 2016
Aim. To evaluate the effectiveness and the tolerability of the nitrous oxide sedation for dental treatment on a large pediatric sample constituting precooperative, fearful, and disabled patients.Methods. 472 noncooperating patients (aged 4 to 17) were treated under conscious sedation. The following data were calculated: average age; gender distribution; success/failure; adverse effects; number of treatments; kind of dental procedure undertaken; number of dental procedures for each working session; number of working sessions for each patient; differences between males and females and between healthy and disabled patients in relation to success; success in relation to age; and level of cooperation using Venham score.Results. 688 conscious sedations were carried out. The success was 86.3%. Adverse effects occurred in 2.5%. 1317 dental procedures were performed. In relation to the success, there was a statistically significant difference between healthy and disabled patients. Sex and ag...
International Journal of Applied Dental Sciences, 2021
Aim: To Compare patient and parental preference between nitrous oxide sedation and conventional behaviour management technique for dental treatment.Material and Methods: This cross-over split mouth study design was performed on 30 children (6-12 years old) who require a bilateral treatment involving inferior alveolar nerve block. 15 children were enrolled in a group A & 15 children in a group B. Thereafter, the outcome of preference of technique was assessed by parent and child after both techniques were performed. Results: The collected data was statistically analysed. The majority of children and parents preferred nitrous oxide inhalation sedation to conventional behaviour management techniques. Conclusion: Study concludes that nitrous oxide was preferred by both children and their parents over conventional behavior management techniques.
Conscious Inhalation Sedation with Nitrous Oxide and Oxygen in Children: A Retrospective Study
Applied Sciences
Dental anxiety is a common problem in younger children, especially those who have had traumatic or perceived traumatic dental treatments. Nitrous oxide (N2O) and oxygen (O2) have been recommended by the American Academy of Pediatric Dentistry as the optimal approach for uncooperative or anxious patients. The study aimed to evaluate the cooperation of children treated on deciduous teeth without local anesthesia and with rubber dam. A retrospective study was conducted from January 2019 to December 2020 in a private dental practice on children aged 4–10 years who had previously reported cases of dental anxiety during dental procedures or refused to undergo them. After an initial cognitive examination, the children underwent conservative treatment lasting a maximum of 30 min. Initially, 100% O2 was administered, then N2O dose was gradually increased to 35%. At the end of the treatment, 100% pure O2 was administered for 5 min. Children’s cooperation was assessed by Venham score before tr...
Saudi Journal of Oral and Dental Research
To evaluate the management of patients initially refusing care and their treatment under conscious sedation by the inhalation of Equimolar Mixture of Oxygen-Nitrous Oxide in the Department of Paediatric Dentistry at the Faculty of dental medicine in Monastir. Settings and Design: A 5 years retrospective study. Methods and Material: Dental session's treatment under conscious sedation were done once a week. Data for only one operator was collected. Data entry was performed using SPSS statistical software. Quantitative variables were expressed by their mean and standard deviation and categorical variables by their number and frequency. Differences with P-value < 0.05 were recorded as statistically significant. Results: The sample represents 161 patients (226 care sessions), the majority of patients treated under conscious sedation are aged between 3 and 30 years. The mean age is 8.02 years with a standard deviation of 4.591 years. The most represented age group is that of 5-14 years with 74% of the total number. The category of the most treated patients in our study were disabled patients with 49%, then young children with 36% and anxious patients with 13%. The category of occasional indications related to the act represents only 3%. Recruitment was mostly performed within the Department of Paediatric Dentistry. Extractions represent 40%, no serious side-effects were observed. The success rate was 93.2%. Conclusions: Since it is carried out in a Paediatric Dentistry department, this study provides a vision of conscious sedation benefits with young patients requiring this specific treatment. Keywords: Conscious sedation, Inhalation of equimolar mixture of oxygen and nitrous oxide, Paediatric Dentistry. Key Messages: Nitrous oxide inhalation sedation (N2O/O2) can improve cooperation for pediatric dental procedures, and the clinical efficacy of this technique is sufficient and predictable in most cases. Nitrous oxide inhalation sedation (N2O/O2) can be considered safe, practical and effective both for pediatric very young and fearful patients with low pain tolerance and for patients with intellectual disability.
Journal of Clinical Psychopharmacology, 2006
In various medical domains, inhalation of nitrous oxide (N 2 O) in oxygen (O 2) is indicated to alleviate pain and anxiety during routine treatment. Repeat treatment may often be indicated. Little data are available, however, to evaluate the long-term efficacy and side effects of reiterated N 2 O/O 2 sedation. The aim of this study was to compare behavior during dental treatment under a premix of 50% N 2 O/O 2 between first experience and repeat experiences of sedation in a cohort of uncooperative patients. Five hundred forty-three patients (age range, 1-94 years; mean, 17 ± 16 years) experiencing conscious sedation for dental treatment for the first time were recruited at a special care unit during 3 years. A modified Venham scale was used to evaluate patient behavior at 5 steps during each session. Completion of planned treatment and occurrence of adverse MATERIALS AND METHODS This prospective longitudinal study was designed in accordance with the process of good clinical practice. 14 It was conducted at the special care dental unit of the university hospital of Clermont-Ferrand. Approval was obtained from the local ethical committee (CCPPRB Auvergne, project AU 402). Informed written consent for participation in the trial was obtained from all patients and/or their legal guardians.
Pediatric dentistry
This study evaluated and compared the effect of three different sedation combinations on the young dental patient: hydroxyzine alone, hydroxyzine with nitrous oxide, and nitrous oxide alone. Nineteen uncooperative children with mean age of 37 months needing at least three restorative visits were selected for this study. Crying, alertness, and general behavior were evaluated during the dental procedure. The combination of hydroxyzine and nitrous oxide was more effective than the others for the majority of the sessions in terms of controlling crying and alertness. The results in the present study indicate that the sedative effect of hydroxyzine on children's behavior is enhanced by the addition of nitrous oxide.
International Journal of Clinical Pediatric Dentistry
Delivery of dental care without causing adverse psychological impact upon the child is a challenge that all pediatric dentists face. One of the primary responsibilities of the dentist is to eliminate the anxiety and fear of the patient. Dental fear and anxiety (DFA) is experienced by many patients, which results in a considerable amount of stress in dentists who are under an obligation to treat such patients. 1-3 In patients with severe DFA, the non-pharmacological methods may not work. Pharmacological methodologies which include sedation and general anesthesia (GA) may be the only way forward with such patients. 4 'Sedation and analgesia' is a continuum of states and it ranges from minimal sedation (anxiolysis) through general anesthesia. The states have been defined by the American Dental anesthesia. 5 In GA the patient's cooperation is not essential for its success. The patient is unconscious, is amnesia is present and there is no response to pain, and it may be the only technique that will prove successful for certain patients, such as medically compromised children. The disadvantages that limit its use are the depression of the vital signs and the protective reflexes (can cause laryngospasm). Also, the patient is unconscious which may not be the ideal requirement in certain situations. For administrating general anesthesia, special equipment, advanced training, and an 'anesthesia team' are required. Due to greater risks involved in elective GA procedures, laboratory tests, chest X-rays, and ECG are