Pediatric dentistry patients are those who are less than 18 years of age. In these patients, options that facilitate timely treatment are sometimes required, such as conscious sedation.
Conscious sedation is defined as a technique in which the use of one or more drugs produces a state of depression of the central nervous system that allows the proposed treatment to be carried out and during which verbal contact with the patient is maintained throughout the sedation period.
The techniques and drugs used to provide conscious sedation for dental treatment must have a sufficiently wide margin of safety so that a loss of consciousness cannot occur. It is essential that the level of sedation is such that the patient remains conscious and is able to understand and respond to verbal commands.
Sedation in pediatric dentistry
The ear sedationpediatric dentistry Its purpose is to consider the needs of both the patient and the specialist, the pediatric dentist. As for children, it is intended to reduce fear and the perception of pain during treatment, to facilitate adaptation to treatment and prevent the development of dental phobia and anxiety. As for the dentist, facilitate the achievement of dental procedures, reduce stress and uncomfortable sensations and prevent the syndrome of the burn-out (the syndrome of burn by profession).
Conscious sedation should not be interpreted as a concept of light or mild general anesthesia, since in conscious sedation, verbal contact is maintained and protective reflexes are lost, whereas in general anesthesia they are lost.
Types of conscious sedation in pediatric dentistry
Conscious sedation in pediatric dentistry can be classified as inhalation, intravenous, or oral sedation.
In the inhalation conscious sedation nitrous oxide or protoxide is used. Nitrous oxide is a gas with anxiolytic and sedative properties that accompany analgesic and muscle relaxation effects to a lesser degree. It has a fast effect and a fast recovery. Use of the pulse oximeter or basic clinical monitoring is required.
In the intravenous and oral sedation benzodiazepines are commonly used. They have anxiolytic, sedative, hypnosis, musculoskeletal relaxation, anterograde amnesia, respiratory depression and anticonvulsant effects, but they do not have analgesic effects. Still, there is not enough scientific evidence to support the routine use of IV sedation in dentistry for children under 16 years of age.
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