Assessment of Patients' Awareness and Factors Influencing Patients' Demands for Sedation in Endodontics

Huh, Yoo Kyeom; Montagnese, Thomas A.; Harding, Jarrod; Aminoshariae, Anita; Mickel, Andre

doi:10.1016/j.joen.2014.10.009

Cited by 16 publications

(10 citation statements)

References 24 publications

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“…Many of these people will need root canal treatment to relieve their pain, but such treatment is known to induce high levels of anxiety in some individuals. A survey of dental patients has shown that the fear of pain, the fear of needles, difficulty in achieving anaesthesia and anxiety are major problems for them . Numerous investigations have been performed to increase dentists’ abilities to manage pain during root canal treatment .…”

Section: Introductionmentioning

confidence: 99%

Strategies for managing pain during endodontic treatment

Abbott

Parirokh

2018

Aust Endodontic J

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Many patients associate root canal treatment with pain. Unfortunately, local anaesthetic techniques such as infiltrations and inferior alveolar nerve blocks are not very effective as single injections for acute irreversible pulpitis. This review discusses strategies for more effective pain management for such situations. Pain control before, during and after treatment is essential for effective patient management. Adequate pain control during treatment also reduces post-operative pain. Effective pain management begins with a thorough understanding of the conditions being treated and an accurate diagnosis. In some cases, premedication with non-steroidal anti-inflammatory drugs can help reduce intra-operative pain. Pain management during treatment involves standard local anaesthetic solutions and injection techniques plus increased volumes and supplementary injections. Once anaesthesia is achieved, treatment can be commenced and the root canal system can be medicated to relieve pain. These should be followed by flexible post-operative pain management strategies for the individual patient and specific condition.

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Section: Introductionmentioning

confidence: 99%

Strategies for managing pain during endodontic treatment

Abbott

Parirokh

2018

Aust Endodontic J

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“…Studies have found that anxiolytic drugs provided before dental treatment can be effective in controlling fear and intra‐operative pain, with mild adverse effects encountered (Milgrom et al, 1994; Nutt et al, 2009). However, there is a low level of awareness amongst patients regarding options for sedation (Huh et al, 2015) and a lack of training amongst dentists on administration (Yehia et al, 2018). In a local context where patients are generally more hesitant to take medication, sedation for dental procedures is seldom utilized, with none of the patients in this study receiving pre‐medication prior to surgery.…”

Section: Discussionmentioning

confidence: 99%

Psycho‐social perspectives of nonsurgical versus surgical endodontic interventions in persistent endodontic disease

et al. 2022

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Introduction: Patients' experiences related to dental treatment could influence care-seeking behaviour and engender personal bias. Although endodontic retreatment and apical surgery are procedures often performed to manage previously treated teeth with persistent disease, there is lack of information regarding psychosocial perspectives of patients who undergo these treatments. Our aim was to compare experiences of patients who received these two treatment modalities using a qualitative approach.Methods: A purposive sample of patients was taken from our previous study utilizing the Oral Health Impact Profile to compare oral health-related quality of life of 150 patients who received retreatment and apical surgery. Patients who reported impact and no impact were invited to participate in focus group discussions (FGDs).Eighteen patients from the retreatment group and 15 patients from the surgical group participated in six FGDs. Thematic analysis was conducted to identify key themes.Results: Four themes emerged: (1) psycho-social disability associated with dental procedures, (2) physical disability associated with dental problems, (3) reliance on dentist's advice for treatment and (4) self-management to preserve treated teeth.Patients undergoing endodontic retreatment reported significant time loss from work and were less informed of alternative treatment options. However, they were pleased with the aesthetics of their teeth, especially if new crowns were made. Patients undergoing surgery experienced anxiety related to loss of control during surgery and apprehension on visualizing the wound post-surgery. They reported more impact on their diet, social interaction and sleep quality and some felt self-conscious due to post-treatment gingival recession. Patients in both groups placed great trust in professional advice and expressed a clear desire to maintain their natural dentition.There was low awareness regarding long-term care and future sequelae of their treated tooth. Conclusions:Patients reported different psycho-social and physical impacts following endodontic retreatment and apical surgery. Patients undergoing endodontic retreatment were more satisfied with aesthetic outcomes but experienced greater impact related to complexities and length of time taken for treatment. Patients undergoing surgery were better informed of treatment options but experienced greater How to cite this article:

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“…The survey for the program directors was based on a literature review of questionnaires concerning IV‐sedation coverage in dental schools 14 – 17 and residency programs 5 , 9 , 13 , 18 . The draft survey was pilot tested with the program director of the Endodontic Graduate Program at the University of Michigan School of Dentistry.…”

Section: Methodsmentioning

confidence: 99%

“…These percentages were even higher when patients with high dental fear were surveyed. Considering that 35% of patients in a study by Wong and Lytle categorized root canal therapy as the most unpleasant treatment and named it in the high anxiety category, 4 it is not surprising that Huh et al found that over half of the patients who presented to a Graduate Endodontic Clinic for an endodontic consultation would have elected to receive intravenous (IV) sedation for their endodontic treatment if the option was available 5 . This service is even more advantageous for certain groups of patients such as those with high dental fear and/or a history of a bad dental experience, patients with special medical considerations or mental and developmental conditions, and patients with reflex difficulties 6 .…”

mentioning

confidence: 99%

Should Endodontic Residents Be Educated About IV‐Sedation? Endodontics Program Directors’ and Endodontists’ Perspectives

Yehia

McDonald

Aronovich

et al. 2018

Journal of Dental Education

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The aims of the two studies reported here were to assess endodontic postgraduate program directors' educational efforts and attitudes related to educating residents about intravenous (IV) sedation (Study 1) and to assess endodontists' educational experiences and attitudes concerning IV-sedation (Study 2). Directors of all 56 U.S. endodontic residency programs and a sample of 2,173 endodontists in the U.S. were invited to participate in the surveys in 2016 and 2017; 31 directors completed the survey (response rate 55%), as did 616 endodontists (response rate 28.3%). Of the participating programs, 18 did not and 13 did offer IV-sedation education. Most directors of programs without this education agreed/strongly agreed that other programs in their institutions offered IV-sedation (83%) and that none of their faculty were trained to teach it (83%). Most directors of programs with this education were satisfied/very satisfied with their classroom-based education about IV-sedation (64%) and this education in general (54%). Directors of programs with IV-sedation education agreed more strongly than directors of programs without IV-sedation education that there is a need for IV-sedation in endodontics (on five-point scale with 1=disagree strongly: 4.08 vs. 3.39; p=0.05), that postgraduate programs should offer it (3.50 vs. 2.71; p=0.04), and that many patients inquire about it (2.75 vs.1.83; p=0.04). Most of the endodontists disagreed/disagreed strongly that they had received adequate training in IV-sedation in their postgraduate program (87%) and were not satisfied with their IV-sedation training (71%); half (51%) reported not feeling competent answering patients' questions about IV-sedation. While most of the endodontists were dissatisfied with their IV-sedation related postgraduate education, most of the program directors did not offer IV-sedation education in their programs. A discussion of the need to educate future endodontists about IV-sedation is needed.

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Assessment of Patients' Awareness and Factors Influencing Patients' Demands for Sedation in Endodontics

Cited by 16 publications

References 24 publications

Strategies for managing pain during endodontic treatment

Strategies for managing pain during endodontic treatment

Psycho‐social perspectives of nonsurgical versus surgical endodontic interventions in persistent endodontic disease

Should Endodontic Residents Be Educated About IV‐Sedation? Endodontics Program Directors’ and Endodontists’ Perspectives

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