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What is the primary purpose of using nitrous oxide in dentistry?
What is the primary purpose of using nitrous oxide in dentistry?
- To completely sedate the patient.
- To induce general anesthesia.
- To achieve relative analgesia and maintain verbal contact. (correct)
- To replace local anesthesia in all situations.
Which factor is crucial for the success of inhalation sedation with nitrous oxide?
Which factor is crucial for the success of inhalation sedation with nitrous oxide?
- Patient selection. (correct)
- Type of dental procedure.
- Patient age.
- Duration of treatment.
Which of the following is a contraindication for the use of inhalation sedation?
Which of the following is a contraindication for the use of inhalation sedation?
- Inability to communicate. (correct)
- Needle phobia.
- Prolonged treatment.
- Mild anxiety.
What percentage of success in treatment under nitrous oxide was reported by Blain Lyrazopoulos in 2003?
What percentage of success in treatment under nitrous oxide was reported by Blain Lyrazopoulos in 2003?
What is one of the indications for using nitrous oxide in dental treatment?
What is one of the indications for using nitrous oxide in dental treatment?
What advantage does nitrous oxide provide compared to general anesthesia?
What advantage does nitrous oxide provide compared to general anesthesia?
Which statement about the history of nitrous oxide is correct?
Which statement about the history of nitrous oxide is correct?
How are patient behaviors affected by the use of nitrous oxide during dental procedures?
How are patient behaviors affected by the use of nitrous oxide during dental procedures?
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Study Notes
Inhalation Sedation
- Definition: A technique using drugs that depress the central nervous system to allow for treatment while maintaining verbal contact with the patient. Aims to avoid loss of consciousness.
- History:
- 1771-72: Joseph Priestley discovered oxygen and nitrous oxide (N2O).
- 1778: Humphrey Davy relieved his pericoronitis pain using N2O.
- 1799: Public demonstrations of N2O effects.
- 1844: Horace Wells used N2O in dentistry.
- 1845: Public demonstrations of N2O use in dentistry.
- Evidence of Success:
- Useful alternative to general anesthesia (GA), but patient selection is crucial.
- Can improve cooperation and confidence when used with behavioral management/semi-hypnotic suggestion.
- Cost-effective alternative to GA, but more expensive than local anesthesia (LA) alone.
- Successful treatment of 221 out of 265 children needing extractions (Blain & Hill 1998).
- Success rates quoted between 83-97% (Blain & Lyrazopoulos 2003).
- Preferred to GA for anxious children needing elective orthodontic extractions (BSPD Guidelines 2002, Shepherd & Hill 2000).
- Less post-operative distress in children undergoing extraction with inhalation sedation compared to GA (Arch et al 2001).
- Cochrane Review showed positive behavioral changes with N2O use.
- Assume all patients have fear and anxiety.
- Indications:
- Mild to moderate anxiety.
- Needle phobia.
- When profound LA can't be achieved (e.g., acute pulpitis).
- Prominent gag reflex.
- Prolonged or unpleasant procedures (e.g., surgical extractions).
- Hypoplastic teeth to reduce sensitivity.
- Alternative to GA for specific needs/medically compromised patients.
- Emergency treatment (dental trauma, but not maxillofacial injuries).
- Contraindications:
- Balance the risks of sedation against the risks of GA.
- Consult the patient's doctor or specialist if unsure.
- Inability to communicate effectively.
- Terminology:
- Relative Analgesia: A term used to describe inhalation sedation.
- Conscious Sedation: The current preferred terminology by the European Federation for the Advancement of Anaesthesia in Dentistry ( EFAAD).
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