CURRENT SEDATION APPROACHES FOR MANAGING PEDIATRIC DENTAL ANXIETY
Keywords:
Pediatric Sedation, Dental Anxiety, Procedural SedationAbstract
This article examines procedural sedation in pediatric dentistry, focusing on the difficulties associated with dental anxiety and behavioral control in young children. Despite the prevalent use of sedation to aid dental treatments, there are still information deficiencies regarding the most effective approaches for juvenile patients outside the surgical environment. This narrative review evaluates progress in sedative techniques, emphasizing pharmacological and non-pharmacological therapies, including behavior management technology (BMT). An analysis of various sedative drugs, such as midazolam, ketamine, and nitrous oxide, along with their distinct delivery routes (oral, intranasal, and intravenous), is conducted. Research indicates that the integration of pharmacologic and non-pharmacologic approaches diminishes necessary medication dosages and adverse effects while improving patient compliance. BMT is recognized for its efficacy in decreasing preprocedural agitation and facilitating smoother transitions to sedation. The research indicates that choosing customized sedative methods according to specific patient characteristics might markedly enhance safety and results in juvenile dentistry treatment. Future study must enhance sedation techniques and investigate long-term neurocognitive consequences to guarantee safer and more effective sedation practices in kid dentistry. This study offers insights into enhancing pediatric sedation methods, promoting a comprehensive strategy to successfully address dental fear and ensure procedural compliance.
References
1. American Academy of Pediatric Dentistry. (2019). Guidelines on behavior guidance for the pediatric dental patient. Pediatric Dentistry, 41(4), 259-260.
2. Coté, C. J., & Wilson, S. (2019). Guidelines for monitoring and management of pediatric patients before, during, and after sedation for diagnostic and therapeutic procedures. Pediatric Dentistry, 41(4), 259-260.
3. Goettems, M. L., et al. (2017). Nonpharmacologic intervention on the prevention of pain and anxiety during pediatric dental care: a systematic review. Academic Pediatrics, 17(2), 110-119.
4. Patel, M., et al. (2016). Parental attitudes toward advanced behavior guidance techniques used in pediatric dentistry. Pediatric Dentistry, 38(1), 30-36.
5. Nelson, T., & Nelson, G. (2013). The role of sedation in contemporary pediatric dentistry. Dental Clinics of North America, 57(1), 145-161.
6. Sebastiani, F. R., et al. (2016). Oral sedation in the dental office. Dental Clinics of North America, 60(2), 295-307.
7. Mason, K. P. (2014). Challenges in pediatric procedural sedation: political, economic, and clinical aspects. British Journal of Anaesthesia, 113(Suppl 2), ii48-ii62.
8. Borland, M., et al. (2007). A randomized controlled trial comparing intranasal fentanyl to intravenous morphine for managing acute pain in children in the emergency department. Annals of Emergency Medicine, 49(3), 335-340.
9. Chopra, R., et al. (2013). Buccal midazolam spray as an alternative to intranasal route for conscious sedation in pediatric dentistry. Journal of Clinical Pediatric Dentistry, 38(2), 171-173.
10. Fein, J. A., et al. (2012). Relief of pain and anxiety in pediatric patients in emergency medical systems. Pediatrics, 130(5), e1391-e1405.
11. Krauss, B., & Green, S. M. (2006). Procedural sedation and analgesia in children.
The Lancet, 367(9512), 766-780.
12. Green, S. M., et al. (2019). Unscheduled procedural sedation: a multidisciplinary consensus practice guideline. Annals of Emergency Medicine, 73(2), e51-e65.
13. Wathen, N. C., & Chambers, C. T. (2008). Non-pharmacologic management of pain and anxiety in children. Pediatrics, 121(5), e1040-e1050.
14. Wathen, N. C., & Chambers, C. T. (2010). Managing anxiety in children. Canadian Family Physician, 56(8), 847-852.
15. Hagan, J. F., Shaw, J. S., & Duncan, P. M. (2010). Cultural competency in pediatric health care. Pediatrics, 125(1), 168-173.
