General anesthesia and sedation in pediatric dentistry. How and When?
DOI:
https://doi.org/10.47990/006n9036Keywords:
Conscious sedation, Deep sedation, general anesthesia, pediatric dentistryAbstract
Introduction: The possibility of offering dental care under sedation or general anesthesia is increasingly requested by parents or guardians, particularly in pediatric or special needs patients, due to difficulties in communication and poor cooperation with treatment. Objectives: This narrative literature review was conducted with the aim of determining the indications for sedation and/or general anesthesia for dental treatment in children, as well as describing the different options for sedation or general anesthesia, and establishing criteria for the discharge of patients treated under sedation or general anesthesia. Methods: A literature search was conducted in the PubMed database using the keywords "pediatric dentistry," "conscious sedation," and "general anesthesia," with the filter "published in the last 10 years." Relevant publications on the subject, including review articles or observational or cross-sectional studies, were included. Publications on adult patients, as well as case reports, were excluded. Results: Twenty-nine publications were included in this review. Conclusions: The indication for a specific degree of sedation or general anesthesia will depend on the patient's level of cooperation, medical history, and the extent of the dental treatment required. The main risks of these procedures include respiratory alterations and allergic reactions, among others. After the procedure, the patient will be monitored until discharge criteria are met before discontinuing observation.
References
Dentistry AA of P. Use of nitrous oxide for pediatric dental patients. 2021:338–43.
Vasakova J, Duskova J, Lunackova J, Drapalova K, Zuzankova L, Starka L, et al. Midazolam and its effect on vital signs and behavior in children under conscious sedation in dentistry 2020;69:S305–14. https://doi.org/10.33549/physiolres.934511.
Salinas Salmeron KS, Kim HJ, Seo K-S. Effects site concentrations of propofol using target-controlled infusion in dental treatment under deep sedation among different intellectual disability types 2019;19:217–26. https://doi.org/10.17245/jdapm.2019.19.4.217.
Hicks CG, Jones JE, Saxen MA, Maupome G, Sanders BJ, Walker LA, et al. Demand in pediatric dentistry for sedation and general anesthesia by dentist anesthesiologists: a survey of directors of dentist anesthesiologist and pediatric dentistry residencies 2012;59:3–11. https://doi.org/10.2344/11-17.1.
Al-Ogayyel S, Al-Haj Ali S. Comparison of dental treatment performed under general anesthesia between healthy children and children with special health care needs in a hospital setting, Saudi Arabia 2018;10:e963–9. https://doi.org/10.4317/jced.55060.
Vanhee T, Lachiri F, Van Den Steen E, Bottenberg P, Vanden Abbeele A. Child behaviour during dental care under nitrous oxide sedation: a cohort study using two different gas distribution systems 2021;22:409–15. https://doi.org/10.1007/s40368-020-00569-z.
Salerno C, Cirio S, Zambon G, D’Avola V, Parcianello RG, Maspero C, et al. Conscious Sedation for Dental Treatments in Subjects with Intellectual Disability: A Systematic Review and Meta-Analysis 2023;20:1779. doi: 10.3390/ijerph20031779. https://doi.org/10.3390/ijerph20031779.
Messieha Z. Risks of general anesthesia for the special needs dental patient 2009;29:21–5; quiz 67–8. https://doi.org/10.1111/j.1754-4505.2008.00058.x.
Ashley P, Anand P, Andersson K. Best clinical practice guidance for conscious sedation of children undergoing dental treatment: an EAPD policy document 2021;22:989–1002. https://doi.org/10.1007/s40368-021-00660-z.
Coke JM, Edwards MD. Minimal and moderate oral sedation in the adult special needs patient 2009;53:221–30, viii. https://doi.org/10.1016/j.cden.2008.12.005.
Shokouhi B, Kerr B. A review of the indicator of sedation need (IOSN): what is it and how can it be improved? 2018;224:183–8. https://doi.org/10.1038/sj.bdj.2018.74.
Akpinar H. Evaluation of general anesthesia and sedation during dental treatment in patients with special needs: A retrospective study 2019;19:191–9. https://doi.org/10.17245/jdapm.2019.19.4.191.
Gordon SM, Dionne RA, Snyder J. Dental fear and anxiety as a barrier to accessing oral health care among patients with special health care needs 1998;18:88–92. https://doi.org/10.1111/j.1754-4505.1998.tb00910.x.
Geddis-Regan AR, Gray D, Buckingham S, Misra U, Boyle C, Health BS for D and O. The use of general anaesthesia in special care dentistry: A clinical guideline from the British Society for Disability and Oral Health 2022;42:3–32. https://doi.org/10.1111/scd.12652.
Coté CJ, Wilson S. Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures 2019;41:259–60.
Abdo M, Al Halabi M, Hussein I, Salami A, Khamis AH, Kowash M. Characteristics of Pediatric Dental Treatment Provided under General Anesthesia in Dubai, United Arab Emirates: A Retrospective Analysis 2022;2022:9900775. https://doi.org/10.1155/2022/9900775.
Abbas B, Maqsood A, Rahat Geelani SR, Sattar M, Rahim M, Khurshid Z. Estimating the Need for Sedation in Patients with Dental Anxiety and Medical Complexities Reporting to Tertiary Care Dental Hospital Using the IOSN Tool 2022;2022:5824429. https://doi.org/10.1155/2022/5824429.
Azevedo ID, Ferreira MAF, da Costa APS, Bosco VL, Moritz RD. Efficacy and safety of midazolam for sedation in pediatric dentistry: a controlled clinical trial 2013;80:133–8.
SEOP. Protocolo de sedación en odontopediatría.
Yang R, Zhao R, Chaudry F, Wang T, Brunton P, Khurshid Z, et al. Modern sedative agents and techniques used in dentistry for patients with special needs: A review 2023;19:153–63. https://doi.org/10.1016/j.jtumed.2023.10.004.
Aikaterini L, Andreas A, Maria BG, Athanasia T, Sotiria G. Long-term outcome of oral health in uncooperative children with caries treated under general anesthesia 2023;47:64–70. https://doi.org/10.22514/jocpd.2023.024.
Caputo AC. Providing deep sedation and general anesthesia for patients with special needs in the dental office-based setting 2009;29:26–30. https://doi.org/10.1111/j.1754-4505.2008.00059.x.
Jackson DL, Johnson BS. Conscious sedation for dentistry: risk management and patient selection 2002;46:767–80. https://doi.org/10.1016/s0011-8532(02)00034-4.
Marinho MA, Ramos FCT, Cardoso AL, Silva-Junior GO, Faria MDB, Bastos LF, et al. Dental Treatment under General Anesthesia in Patients with Special Needs Provided by Private and Public Healthcare Services-A Retrospective, Comparative Study 2022;10:1147. doi: 10.3390/healthcare10061147. https://doi.org/10.3390/healthcare10061147.
Al Zoubi L, Schmoeckel J, Mustafa Ali M, Splieth CH. Parental acceptance of advanced behaviour management techniques in paediatric dentistry in families with different cultural background 2021;22:707–13. https://doi.org/10.1007/s40368-021-00607-4.
Glassman P, Caputo A, Dougherty N, Lyons R, Messieha Z, Miller C, et al. Special Care Dentistry Association consensus statement on sedation, anesthesia, and alternative techniques for people with special needs 2009;29:2–8; quiz 67–8. https://doi.org/10.1111/j.1754-4505.2008.00055.x.
Lim MAWT, Borromeo GL. The use of general anesthesia to facilitate dental treatment in adult patients with special needs 2017;17:91–103. https://doi.org/10.17245/jdapm.2017.17.2.91.
Kim J, Kim H, Seo K-S, Kim HJ. Analysis of sedation and general anesthesia in patients with special needs in dentistry using the Korean healthcare big data 2022;22:205–16. https://doi.org/10.17245/jdapm.2022.22.3.205.
Ashley PF, Williams CECS, Moles DR, Parry J. Sedation versus general anaesthesia for provision of dental treatment to patients younger than 18 years 2015;2015:CD006334. https://doi.org/10.1002/14651858.CD006334.pub4.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Latin American Pediatric Dentistry Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
How to Cite
