Current state of sedation/analgesia care in dentistry

Leitch, Jason; Macpherson, Avril

doi:10.1097/aco.0b013e32825ea2a4

Cited by 14 publications

(9 citation statements)

References 31 publications

(28 reference statements)

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“…Nevertheless, the results of this study highlight the importance of anxiety management in ITM surgery. Anxiety about dental procedures is a worldwide problem, presenting a significant barrier to dental care and an attendance obstacle for people of all ages (10, 13). As shown in this study, the perioperative anxiety of ITM surgery patients as measured with the DAS system was typically ‘high’ meaning that the patient is emotionally stressed or in a nervous state.…”

Section: Discussionmentioning

confidence: 99%

Independent predictors of satisfaction in impacted third molar surgery patients

Kim

Myoung

2010

Comm Dent Oral Epid

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This study demonstrates that the patients who undergo ITM surgery often have severe anxiety that seriously impacts patient satisfaction and resultant treatment outcomes. In addition, patient satisfaction directly depends on the occurrence of some postoperative complications. Appreciation of these predictive factors and increasing patient satisfaction may help clinicians to provide optimal care for ITM surgery patients.

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Section: Discussionmentioning

confidence: 99%

Independent predictors of satisfaction in impacted third molar surgery patients

Kim

Myoung

2010

Comm Dent Oral Epid

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“…Even the implementation of a single strategy that calms a small proportion of tense patients may therefore yield benefits for patients and practitioners alike. Dental anxiety management techniques currently include pharmacological interventions (Leitch and Macpherson 2007), behavioral and distraction techniques (Pawlicki 1991), or a combination of both (Dworkin 1986; Hmud and Walsh 2007). Pharmacological interventions like sedative drugs, anesthesia, sedation or local analgesia, inherently carry some risk (Haas 2002), and require special knowledge and equipment.…”

Section: Introductionmentioning

confidence: 99%

Effects of Pleasant Ambient Fragrances on Dental Fear: Comparing Apples and Oranges

et al. 2010

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Previous studies showed that orange odor reduces the anticipatory anxiety and improves the mood of patients waiting for scheduled appointments in small dental practices. We replicated these previous studies in the setting of three large dental clinics. In addition, we investigated whether another pleasant fruity smell (apple odor) is similarly associated with reduced anxiety. We included 219 patients (117 males, 102 females) between the ages of 18 and 81 in this study. While they were waiting for dental treatment, the participants were either exposed to the ambient odor of orange (N = 81) or apple (N = 69), or they received no stimulation. State anxiety, mood, and perceived level of pain of the participants were assessed using questionnaires. Statistical analysis showed no significant difference between the responses of patients in each of the three experimental groups. We therefore conclude that orange and apple odors have no effect on the anticipatory anxiety or mood of patients waiting for scheduled appointments in large dental clinics.

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“…P ain and anxiety management has always been an integral part of dentistry. 1 Dentists generally use local anesthetic for painful procedures. Some procedures, however, require greater levels of pain and anxiety management than can be provided by local anesthetics alone.…”

mentioning

confidence: 99%

Analysis of Oxygen Saturations Recorded During Dental Intravenous Sedations: A Retrospective Quality Assurance of 3500 Cases

Viljoen¹,

Coombs

Mahoney

et al. 2011

Anesthesia Progress

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The death of a patient under sedation in New South Wales, Australia, in 2002 has again raised the question of the safety of dental sedation. This study sought answers to 2 questions: Can safe oxygen saturation levels ($94%) be consistently maintained by a single operator/sedationist ? Does the additional use of propofol, in subanesthetic doses, increase the risk of exposure to hypoxemia ? Three thousand five hundred cases generated between 1996 and 2006 were randomly examined and divided into 2 subcohorts: 1750 patients were sedated with midazolam and fentanyl, and 1750 patients received propofol, in subanesthetic increments, in addition to midazolam and fentanyl. Initial sedation was established using midazolam and fentanyl in both subcohorts. The second subcohort received propofol during times of noxious stimulation. Patient exposure to 2 or more oxygen desaturations below 94% was uncommon. The variables that were significantly associated with low saturations were age, gender, and weight. Neither the dose of midazolam nor the additional use of propofol was a significant risk factor. ASA classification ( I or II) was not a determinant of risk. The data, within the limitations of the study, showed that a single operator/sedationist, supported by a well-trained team of nurses, can consistently maintain safe oxygen saturation levels. The additional use of propofol did not increase exposure to hypoxemia.

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Current state of sedation/analgesia care in dentistry

Cited by 14 publications

References 31 publications

Independent predictors of satisfaction in impacted third molar surgery patients

Independent predictors of satisfaction in impacted third molar surgery patients

Effects of Pleasant Ambient Fragrances on Dental Fear: Comparing Apples and Oranges

Analysis of Oxygen Saturations Recorded During Dental Intravenous Sedations: A Retrospective Quality Assurance of 3500 Cases

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