Abstract
Abstract
Background
Due to fear and/or behaviour management problems, some children are unable to cooperate for dental treatment using local anaesthesia and psychological support alone. Sedation is required for these patients in order for dentists to be able to deliver high quality, pain-free dental care.
The aim of this guideline is to evaluate the efficacy and relative efficacy of conscious sedation agents and dosages for behaviour management in paediatric dentistry and to provide guidance as to which sedative agents should be used.
Methods
These guidelines were developed using a multi-step approach adapted from that outlined by the National Institute for Clinical Excellence (NICE (2020) Developing NICE Guidelines: the manual. https://www.nice.org.uk/process/pmg20/chapter/introduction#main-stages-of-guideline-development. Accessed 7 Oct 2020). Evidence for this guideline was provided from a pre-existing Cochrane review (Ashley et al. Cochrane Database Syst Rev 12:CD003877, 2018) supplemented by an updated search and data extraction up to May 2020.
Results
Studies were from 18 different countries and had recruited 4131 participants overall with an average of 70 participants per study. Ages ranged from 0 to 16 years with an average age of 5.6 years across all included studies. A wide variety of drugs or combinations of drugs (n = 38) were used and delivered orally, intranasally, intravenously, rectally, intramuscularly, submucosally, transmucosally or by inhalation sedation. Twenty-four different outcome measures for behaviour were used. The wide range of drug combinations and outcome measures used greatly complicated description and analysis of the data.
Conclusion
Oral midazolam is recommended for conscious dental sedation. Midazolam delivered via other methods or nitrous oxide/oxygen sedation could be considered, but the evidence for both was very low.
Publisher
Springer Science and Business Media LLC
Subject
Dentistry (miscellaneous),Pediatrics, Perinatology and Child Health
Reference29 articles.
1. American Academy of Pediatric Dentistry (AAPD). Use of Nitrous oxide for pediatric dental patients. 2018. https://www.aapd.org/media/Policies_Guidelines/BP_UseofNitrous.pdf. Accessed 20 Jan 2021.
2. American Society for Anesthesiologists. New classification of physical status. Anesthesiology. 1963;24:111.
3. Ashley PF, Chaudhary M, Lourenço-Matharu L. Sedation of children undergoing dental treatment. Cochrane Database Syst Rev. 2018;12:CD003877. https://doi.org/10.1002/14651858.CD003877.pub5.
4. Dental Sedation Teachers Group . DSTG Logbook of clinical experience in conscious sedation. 2015. Available online at https://www.dstg.co.uk/index.php/documents/document/sedationlogbook-doc. Accessed Apr 2020.
5. European Association of Paediatric Dentistry. Curriculum guidelines for education and training in paediatric dentistry. Int J Paediatr Dent. 1997;7:273–81.
Cited by
7 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献