Theoretical concepts and practical applications of hypnosis in the treatment of children and adolescents with dental fear and anxiety

Shaw, A. J.; Niven, Neil

doi:10.1038/sj.bdj.4808950

Cited by 12 publications

(9 citation statements)

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“…However, in the adolescent population, success is sometimes compromised where patients present with severe dental anxiety and/or complex dental treatment (Shaw and Niven 1996) and these patients may require alternative sedation or general anaesthesia. For those adolescent patients who are anxious, it is preferable to carefully select the most appropriate pharmacological technique for the individual patient to avoid progressing through a range of techniques that may possibly fail based on their clinical and dental need (SDCEP 2017).…”

Section: Introductionmentioning

confidence: 99%

Acceptability of intravenous propofol sedation for adolescent dental care

Dixon

Aspinall

Rolfe

et al. 2019

Eur Arch Paediatr Dent

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Purpose Propofol is an intravenous anaesthetic agent commonly utilised in general anaesthesia, however in sub-anaesthetic concentrations can be utilised to provide sedation through automated dosing of target-controlled infusion (TCI). TCI has been shown to provide accurate and stable predicted plasma and effect-site concentrations of propofol. A four-part mixedmethod prospective study was undertaken to evaluate the safety and patient acceptability of intravenous propofol sedation in adolescent patients requiring dental care. There is a paucity in the literature on patient-reported outcomes and patient safety in the management of adolescent patients for dental treatment. Methods Demographics were recorded including age, gender, ASA Classification and Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) completed pre-operatively. Behaviour ratings of the Frankl and Houpt scales were recorded followed by post-operative questionnaire and telephone consultation. Consultation was completed following the procedure to determine patient satisfaction, memory of the procedure and any reported side effects of treatment. Qualitative thematic analysis was utilised. Results 55 patients were recruited for the study, of which 49 (mean age 14.67 years) completed the sedation study and were treated safely with no post-operative complications. The mean lowest oxygen saturation was 98.12% SpO 2 (SD 2.6). Thematic analysis demonstrated positive patient-reported outcomes to IV sedation. Conclusion Propofol TCI sedation is an effective treatment modality for the management of dentally anxious adolescents as a safe alternative to general anaesthesia, allowing the opportunity for increased provision of treatment per visit on those patients with a high dental need. Further randomised controlled trials comparing propofol TCI to other pharmacological managements are required.

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Section: Introductionmentioning

confidence: 99%

Acceptability of intravenous propofol sedation for adolescent dental care

Dixon

Aspinall

Rolfe

et al. 2019

Eur Arch Paediatr Dent

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“…There is evidence that behavioural interventions, such as cognitive behavioural therapy, can considerably help adults with dental anxiety or phobia. [16][17][18][19][20] The different sedation techniques are associated with different qualifying criteria. The importance of thorough history taking as well as clinical examination cannot be overemphasised.…”

Section: The Practice Of Conscious Sedationmentioning

confidence: 99%

“…As discussed above, alternatives such as behavioural interventions do play a definite role and should be explored in each case. [17][18][19] Furthermore, treatment under sedation is not an alternative for GA when providing treatment under GA is definitely warranted.…”

Section: 61215mentioning

confidence: 99%

The use of anaesthetic agents to provide anxiolysis and sedation in dentistry and oral surgery

O'Halloran¹

2013

AMJ

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Throughout the world there is considerable variation in the techniques used to manage anxious dental patients requiring treatment. Traditionally anxious or phobic dental patients may have been sent for general anaesthesia to allow dental treatment be undertaken. While this is still the case for the more invasive oral surgical procedures, such as wisdom teeth extraction, sedation in general dentistry is becoming more popular. Various sedation techniques using many different anaesthetic agents have gained considerable popularity over the past 30 years. While the practice of sedating patients for dental procedures is invaluable in the management of suitably assessed patients, patient safety must always be the primary concern. Medical, dental and psychosocial considerations must be taken into account when evaluating the patient need and the patient suitability for sedation or general anaesthesia. The regulations that govern the practice of dental sedation vary throughout the world, in particular regarding the techniques used and the training necessary for dental practitioners to sedate patients. It is necessary for medical and dental practitioners to be up to date on current practice to ensure standards of practice, competence and safety throughout our profession. This article, the first in a two-part series, will provide information to practitioners on the practice of sedation in dentistry, the circumstances where it may be appropriate instead of general anaesthesia and the risks involved with sedation. It will also discuss the specific training and qualifications required for dental practitioners to provide sedation. The second article in this series will outline the different techniques used to administer inhalation, oral and intravenous sedation in dentistry and will focus on specific methods that are practiced.

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“…Der Zustand einer hypnotischen Trance lässt sich als natürlicher [1], temporä-rer [33],eingeengter [26],subjektiv erlebbarer und objektiv messbarer Zustand veränderten Erlebens und Verhaltens [9] mit intensivierter Aufmerksamkeit [12] und Konzentration [32] verstehen,in dem die entsprechende Person in eigene Erfahrungen, wie Gefühle und Vorstellungen,versunken ist [31].Trance wird schlafähnlich wahrgenommen [26] und entweder durch Kommunikation mit einer anderen Person [33] oder seltener durch selbst gegebene Instruktionen [32] hervorgerufen.…”

Section: Tranceunclassified