Conscious sedation for the management of dental anxiety in third molar extraction surgery: a systematic review

Abstract

Background: Dental anxiety is a condition associated with avoidance of dental treatment and increased medical and surgical risks. This systematic review aims to summarize available evidence on conscious sedation techniques used for the management of Dental anxiety in patients scheduled for third molar extraction surgery, to identify best approaches and knowledge gaps. Methods: A comprehensive search was conducted including MEDLINE/Pubmed, EMBASE, SCOPUS, clinicaltrials.gov and the Cochrane Database of Systematic Reviews through March 2019. Only randomized controlled trials were included. PRISMA guidelines were followed. Risk of bias was appraised as reported in the Cochrane Handbook for Systematic Reviews of Interventions. Results: Seventeen RCTs with a total of 1788 patients were included. Some aspects limited the feasibility of a meaningful meta-analysis, thus a narrative synthesis was conducted. Conscious sedation was associated with improvement in Dental anxiety in six studies. One study reported lower cortisol levels with midazolam vs. placebo, while another study found significant variation in perioperative renin levels with remifentanil vs. placebo. Conclusions: This review found inconclusive and conflicting findings about the role of Conscious sedation in managing Dental anxiety during third molar extraction surgery. Relevant questions remain unanswered due to the lack of consistent, standardized outcome measures. Future research may benefit from addressing these limitations in study design.

Efficacy of continuous intravenous remimazolam versus midazolam in the extraction of impacted wisdom teeth: protocol of a randomised controlled trial

“… 10 Intravenous sedation is a commonly used technique in conscious sedation. 11 Once venous access is established, administration is convenient, the onset of therapeutic effects is rapid and the degree of sedation is easily adjusted. Unlike many other outpatient operations, dental surgery is performed in the oral cavity and often requires irrigation with water.…”

Kinesiology Taping as an Innovative Measure against Post-Operative Complications after Third Molar Extraction—Systematic Review

“…This significantly reduces the quality of life of patients [ 1 ]. Due to the inconvenience from which patients have to suffer, various methods of alleviating the effects are offered, such as pharmacotherapy [ 3 ], local compresses for postoperative sites [ 4 ], laser applications [ 5 ], or recently, kinesiology taping. Traditionally, practitioners are trying to increase patients’ well-being with the use of pharmacotherapy, such as steroid application pharmacotherapy (e.g., steroid application and painkiller prescriptions).…”

Estimating the Need for Sedation in Patients with Dental Anxiety and Medical Complexities Reporting to Tertiary Care Dental Hospital Using the IOSN Tool

“…More the complexity of dental procedure, more is the need for sedation. That is why we see that in minor oral surgical procedures such as third molar surgery, many of the dentists prefer sedation [ 25 ]. Many methods for sedation are being used for third molar impactions.…”