Research Update - Pain Management
An analysis of moderate sedation protocols used in dental specialty programs: a retrospective observational study
ABSTRACT:
This study analyzed the sedation protocols used in three dental specialty programs at the Case Western Reserve University School of Dental Medicine, Cleveland, OH. A retrospective analysis was performed using dental school records of patients receiving moderate sedation in the graduate endodontic, periodontic, and oral surgery programs. Information was gathered and the data compiled regarding the reasons for sedation, age, sex, pertinent medical conditions, ASA physical status classifications, routes of administration, drugs, dosages, failures, complications, etc. RESULTS: The reasons for the use of moderate sedation were anxiety (54%), local anesthesia failures (15%), fear of needles (15%), severe gag reflex (8%), and claustrophobia with rubber dam (8%). The most common medical conditions were hypertension (17%), asthma (15%), and bipolar disorder (8%). Most patients were classified as ASA class II. The most common tooth treated in the endodontic program was the mandibular molar. CONCLUSIONS: There are differences in the moderate sedation protocols used in the endodontic, periodontic, and oral surgery programs regarding monitoring, drugs used, and recordkeeping.
The local anaesthetic effect of a dental laser prior to cavity preparation: a pilot volunteer study
ABSTRACT:
This study aimed to assess the response of dental pulp to laser preconditioning. METHODS: The effects of laser preconditioning, sham laser (negative control), and composite curing light (positive control) on the response of the dental pulp to electric pulp testing was investigated in this double-blind crossover trial with six volunteers. The Er,Cr:YSGG laser or curing light was shone on a premolar tooth in a sweeping motion for 30 seconds (in the sham treatment, the laser was not activated) in blindfolded volunteers subjected to a consistent aural stimulus. Treatment method at each visit was randomized and performed by a researcher not involved in pulp testing. Teeth were pulp tested twice initially by another member of the research team to get baseline readings, immediately following the treatment, and thereafter every 2 minutes for 10 minutes. Results were analyzed using analysis of variance and an independent-sample t-test. RESULTS: There were no significant differences in pulpal response between treatments (P > 0.05). CONCLUSION: Laser preconditioning did not affect pulpal response as measured by an electronic pulp tester. Laser preconditioning did not result in any pain or noticeable symptoms for both teeth and soft tissues.
Educating parents of children receiving comprehensive dental care under general anesthesia with visual aids
ABSTRACT:
The purpose of this study was to determine if educating parents with visual aids after their child’s treatment under general anesthesia would improve attendance at follow-up appointments, oral health outcomes, and treatment satisfaction. METHODS: Fifty-four parent-child dyads were recruited and randomly assigned to two groups. The control group received verbal education, and the intervention group received verbal and visual education. Oral health was measured using the gingival index and the simplified oral hygiene index (OHI-S) before and after the treatment. RESULTS: Seventy-eight percent of the intervention group and 52% of the control group returned for follow-up appointments (P = 0.04). The plaque index decreased (P < 0.01); the reported brushing frequency increased for all children from baseline to follow-up visit (P = 0.02). The satisfaction increased only for parents in the intervention group over time (P = 0.04). CONCLUSIONS: Using visual aids had a positive impact on patient attendance at follow-up and parents’ treatment satisfaction. There was an improvement in oral hygiene, as measured by the OHI-S, and an increase in brushing frequency for all children, regardless of whether their parents were educated with or without a visual aid.
