Oral sedation in pediatric outpatient dentistry

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THE AIM OF THE STUDY

Was to improve the quality of treatment in pediatric outpatient dentistry with the effective use of oral sedation.

MATERIALS AND METHODS

The study comprised 60 children aged 3—12 years who were undergoing therapeutic/surgical dental treatment. All children’s somatic state was assessed as ASAI—II. All children met a number of psychological, anamnestic and procedural criteria. Midazolam and chloropyramine in a dose calculated for the patient’s body weight were used as components of oral sedation. The estimated sedation depth was Ramsay II—III. The study included an analysis of objective (the time of comfortable treatment, the amount of treated or removed teeth per visit, the possibility of treatment without anesthesia during further visits) and subjective (the possibility of contact with the child during treatment, behavioral reactions at home and on further visits) criteria. Negative behavioral reactions and dental effects were also assessed.

RESULTS

The treatment features correlated with the age category and gender of the patient. In the older age group of 7—12 years, the amount of comfortable treatment time was higher, the possibility of contact with the child reached 100% (which is twice as much as in the younger one), and also a larger number of patients were treated during further visits without an anesthetic aid. At the same time, in the younger age group of 3—6 years, the volume of treatment per visit was higher, since it takes less time to treat a primary tooth than for a permanent one. Side effects (visual hallucinations, diplopia, hyperactivity, tearfulness and aggressiveness) were more often recorded in the younger age group, but emotional instability was equally manifested in both groups.

CONCLUSION

In order to maximize the effectiveness of using oral sedation as a method, it is necessary to take into account the duration and traumatism of the proposed procedure, the peculiarities of age psychology and the peculiarities of the psychological development of boys and girls.

Keywords:

pediatric dentistry

oral sedation

midazolam

fear

anxiety

dentophobia

Authors:

Shavlokhova E.A.

Central Research Institute of Dentistry and Maxillofacial Surgery;
Russian Medical Academy Postgraduate Education

ORCID: 0009-0008-4015-6444

Ostreikov I.F.

Russian Medical Academy Postgraduate Education

ORCID: 0000-0002-4863-1958

Babaev B.D.

Central Research Institute of Dentistry and Maxillofacial Surgery

ORCID: 0000-0002-2063-0240

Korolenkova M.V.

Central Research Institute of Dentistry and Maxillofacial Surgery

ORCID: 0000-0001-7705-462X

Dobrodeev A.S.

Central Research Institute of Dentistry and Maxillofacial Surgery

ORCID: 0000-0001-8437-3602

Mamedli O.R.

Centre for Excellence in Emotionally Focused Therapy

ORCID: 0009-0004-8880-9396

Received:

04.02.2024

Accepted:

01.03.2024

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