J Korean Dent Soc Anesthesiol.  2007 Dec;7(2):114-119. 10.17245/jkdsa.2007.7.2.114.

Sedation for Dental Treatment of Patients with Disabilities

Affiliations
  • 1Division of Oral and Maxillofacial Surgery/Department of Dentistry, College of Medicine, Hanyang University, Seoul, Korea. ksshim@hanyang.ac.kr
  • 2Department of Dental Anesthesiology, Seoul National University College of Dentistry, Seoul, Korea.

Abstract

BACKGROUND
Dental disabilities mean the poor cooperation for dental treatment because of patient's inherent disability, severe fear and anxiety, and communication problem. Sedation and general anesthesia are usually used for behavioral control in dentally disabled patients. In particular, sedation (conscious and deep) can help them to tolerate the proper dental treatment effectively and safely.
METHODS
From March 2002 to September 2007, total 35 sedation were carried out in 33 patients (male : female = 20 : 13) with dental disabilities at Seoul National University Dental Hospital and Hanyang University Medical Center. Patients' dental charts and sedation records were retrospectively reviewed.
RESULTS
Tooth extraction (19 cases) was the most common dental treatment performed under intravenous sedation (30 cases). Occasionally, inhalation sedation using Sevoflurane 1-2% was adapted (5 cases). Deep sedation (28 cases) was carried out using midazolam 2-3 mg bolus injection and propofol infusion via TCI (4.2 ± 0.9 mg/kg/h), and conscious sedation (7 cases) was carried out using midazolam bolus onlywithout severe complications. The duration of dental treatment was 25.5 ± 12.3 min and that of sedation was 43.2 ± 9.7 min.
CONCLUSION
Sedation for dentally disabledpatients should be selected for effective behavioral control in conjunction with general anesthesia, considering the duration and pain-evoking potentials of dental treatment, the type and severity of patients' disabilities, and the experience of dental anesthesiologists altogether.

Keyword

Conscious sedation; Deep sedation; Dental; Disabled person; Intravenous infusion; Midazolam; Propofol; Retrospective studies
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