ISSN : 0376-4672
Inhalation sedation has may advantageous properties that make it a suitable choice for sedation in pediatric, disabled and many patients, either alone or in conjunction with other agents. We need review of Guideline on use of nitrous oxide for dental patients that make minimizing complication of sedation for safe and effective sedation. Conventionally, nitric oxide is used for inhalation sedation, nowadays sevoflurane can also be used due to easily titratable for controllable effect and less failure of sedation. Recently sevoflurane can be used to provide sedation as a sole agent in air or oxygen or in combination with nitrous oxide in dentistry.
Sedation is frequently required to relieve anxiety in the field of dentistry. Among sedation techniques, oral sedation has been widely used because it is easy for administration and has a wide acceptability for dentists. This article discuss the pharmacology of oral sedatives and therapeutic considerations of these drugs, and finally how to manage apprehensive patients using oral sedation. Also, we recommend how pertinent drugs should be used to maintain an adequate level of sedation, not deep sedation
많은 환자는 치과 진료 중 불안과 공포를 경험하게되고 이러한 불안과 공포는 치과 진료를 기피하게 하는 주된 원인이 된다1). 치과 진료를 위한 진정이 필요한 환자의 평가와 투약, 환자감시, 회복에 관여하는모든 의료인들은 환자의 안전을 최우선으로 진료를 해야 한다.시술 시 진정 및 진통(Procedural sedation and analgesia, PSA)의 목적은 환자의 공포,불안, 고통을 감소시키고 육체적인 불편함과 고통,정신적 외상을 최소화하며 환자의 안전에 가해지는 위협을 예방하고 안전하게 퇴원할 수 있는 상태로 환자를회복시키는 것이다.
Apprehension and phobia regarding dental procedures are represent the most common deterrents in patients seeking dental care and very common. For these individuals, and others who cannot cooperateduring care, procedural sedation may permit completion of intraoralprocedures. In mostcases, the level of sedation may be kept at minimal to moderate levels permitting patient maintenance of their airway patency and ventilation. Unlike many medical procedures, the majority of dental procedures, no matter the depth of sedation, are performed in the presence ofcomplete analgesia provided by local anesthesia. Therefore, the goal of procedural sedation is to primarily suppress patient fear and apprehensionand gain cooperation. Any issues regarding actual pain are usually limited to that produced by the local anesthetic injections or, rarely, theextent of the procedure. For the extremely phobic patient, however, allaying apprehension may be very challenging. Intravenous titration of sedative drugs is the most effective route of administration to achieve this goal but requires advanced training beyond that provided in undergraduate training.
Pediatric and adolescent dental anxiety and fear have been researched in the connection with behavior modification for a long time and this dental anxiety can persist until the adulthoods resulting in extreme fear of and avoidance of dental treatments and causes oral health deterioration. However, the domestic researches regarding adolescent dental anxiety and fear are insufficient. For this reason,this study aims to examine the level of fear and the influential factors affecting their dental fear and to utilize the result as the basic materials in the dental management. The subjects were the students from a middle school located in Gyeonggi-Do. The school was selected by convenient sampling and self-answered questionnaire was filled in by the students. The distribution of responses in each category of fear was examined by frequency analysis. The analysis was conducted using cross tabulation in order to examine the difference between male students and female students and using independent sample t-test in order to compare the fear score of each category. The study results showed the fear score of female students for the category ‘causing irritation during the dental treatments’was significantly higher in statistics(p<0.05). Therefore, these results should be reflected to the dental care environments in order for the adolescent to reduce the dental anxiety and fear.
