Inhalation Sedation in Dentistry PDF

The Use of Inhalation Sedation In Dentistry Dr Salwa Al-Habsi BDS MClinDent FARCDS Baldus - Nitrous oxide  Inhalation Sedation with Nitrous Oxide and Oxygen “Relative analgesia “ by Dr Harry Langa The European Federation for the Advancement of Anaesthesia in Dentistry (E...

The Use of Inhalation Sedation In Dentistry Dr Salwa Al-Habsi BDS MClinDent FARCDS Baldus - Nitrous oxide  Inhalation Sedation with Nitrous Oxide and Oxygen “Relative analgesia “ by Dr Harry Langa The European Federation for the Advancement of Anaesthesia in Dentistry (EFAAD) EFAAD promote the term “ conscious sedation “  Definition of Conscious Sedation “A technique in which the use of a drug or drugs produces a state of depression of the Central Nervous System enabling treatment to be carries out but during which verbal contact with the patient is maintained throughout the period of sedation. The drugs and techniques used to provide conscious sedation for dental treatment should carry loss of consciousness unlikely “  N2O in History 1771-72 Joseph Priestley O2 and N2O 1778 Humphrey Davy suffered pericoronitis and found relieve from pain with N2O 1799 Audience demonstration on affects of N2O 1844 Horace Wells used it in dentistry 1845 Public demonstration of its use  Evidence of success Useful alternative to GA- patient selection is very important for success In conjunction with BM/ semi hypnotic suggestion can build confidence and improve cooperation Cost effective alternative to GA more expensive than LA alone  Evidence for success Blain and Hill 1998 successfully treated 221 of 265 children who required extractions 57% of these were directly referred for treatment under GA Success quoted between 83-97% ( Blain Lyrazopoulos 2003) Preferred to GA for anxious children undergoing elective orthodontic ( Premolar) extractions ( BSPD Guidelines 2002, Shepherd and Hill 2000) Children who have extraction with IS exhibit less post operative distress compared to children treated under GA ( Arch et al 2001) Conchrane Review showed favorable changes in behavior when N2O is used Assume all your patient have fear and anxiety  Indications Mild to moderate anxiety Needle phobia Where profound LA cannot be obtained, e.g acute pulpits Prominent gaga reflex Prolonged or unpleasant treatment , e.g Surgical extractions Hypoplastic teeth to reduce sensitivity An alternative to GA for some special needs/ Medically compromised patients Emergency treatment ( Dental trauma cases but not maxillofacial injuries)  Contraindications Balance between the risk of giving sedation against risk of GA If in doubt seek patients doctor or specialist advice Inability to communicate Very young children (