Oral sedation in dentistry

This review of oral sedation in dentistry will examine the objectives, indications, advantages and disadvantages of oral sedation and will present some of the basic guidelines for its safe use. It will also review the properties, precautions and contraindications (both absolute and relative) of some of the currently popular sedative agents.     

Pharmacologic sedation in dentistry: an overview

The primary purpose of pharmacological fear management is to reduce or block the anxiety reflex. Conscious sedation is a viable tool for both dentist and patient to overcome anxiety without having to turn to general anesthesia. This article reviews the current use of oral sedatives in dentistry, taking into account their availability and pointing out advantages and disadvantages in daily practice. Rapid onset and short half-life benzodiazepines can be considered the gold standard, always taking into account possible adverse effects. Moreover this article provides the different guidelines of international organizations such as AAPD, EAPD and EFAAD regarding the educational requirements dentists should meet to deliver safe and effective pharmacologic oral sedation.     

General anaesthesia, sedation and resuscitation in dentistry.

In the eyes of the public there is a traditional link between general anaesthesia and dental practice. After 150 years' experience the link may be broken by Government's acceptance of the Poswillo Report and its major recommendations.     

Sickle cell disease, dentistry and conscious sedation

The features of sickle cell disease (SCD) are described. Two case reports of patients treated in a Dental Institute are presented and the dental management of patients with SCD discussed. Since infection is one of the major risk factors for sickle cell crisis, the prevention of oral disease and infection is vital for this group of patients and there is no contra-indication to the delivery of dental treatment under local anaesthetic with inhalational sedation if required in the primary care setting. Since patients with sickle cell disease are particularly vulnerable to the effects of periods of hypoxia, which may produce significant morbidity, and because of the additional practical challenges in sedating this group of patients, intravenous sedation should be undertaken in a specialist unit. CLINICAL RELEVANCE: The increasing prevalence of sickle cell disease highlights the importance of dentists practising in multi-cultural communities having an understanding of this condition and its implications on their clinical practice. This will facilitate the safe management of patients with sickle cell disease.     

咪达唑仑口服镇静术在不同年龄段儿童口腔治疗中的效果评价

目的 总结咪达唑仑口服镇静术对口腔诊疗不配合的儿童患者的临床效果,探讨年龄因素对咪达唑仑治疗效果和安全性的影响.方法 选取109例对口腔诊疗不配合的儿童患者,在门诊环境下实施咪达唑仑口服镇静术辅助诊疗,给药剂量为0.50～0.75 mg/kg,记录各项评价指标并对≤3岁组(40例)和＞3岁组(69例)的治疗效果和安全性进行分析、比较.结果 镇静治疗总成功率为71%(77/109),≤3岁组治疗成功率[58%(23/40)]显著低于3岁以上组[78%(54/69)](x2=5.26,P＜0.05);总不良反应发生率为17%(19/109),≤3岁组不良反应发生率[28%(11/40)]显著高于3岁以上组[12%(8/69)],x2=4.24,P＜0.05.结论 咪达唑仑口服镇静术对3岁以上患者治疗效果好,不良反应相对少;口服咪达唑仑0.50～0.75 mg/kg的剂量范围安全有效.     

Basic techniques and materials for conservative dentistry: I cavity preparation

This series of articles presents a review of current techniques and materials for basic conservative dentistry. The importance of correct diagnosis and the formulation of a sound treatment plan is stressed. Areas where there has been a change of emphasis in treatment are presented in detail. This includes the development of the ‘conservative’ cavity for amalgam and the management of the deep carious lesion.