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KMID : 0980220070070020114
Journal of the Korean Dental Society of Anesthesiology
2007 Volume.7 No. 2 p.114 ~ p.119
Sedation for Dental Treatment of Patients with Disabilities
Bing Jung-Ho

Hwang Kyung-Gyun
Yeom Kwang-Won
Shim Kwang-Sub
Park Chang-Joo
Kim Hyun-Jeong
Seo Kwang-Suk
Jung Se-Hwa
Jeon Jae-Yun
Abstract
Background: Dental disabilities mean the poor cooperation for dental treatment because of patient¡¯s inherent disability, severe fear and anxiety, and communication problem. Sedation and general anesthesia are usually used for behavioral control in dentally disabled patients. In particular, sedation (conscious and deep) can help them to tolerate the proper dental treatment effectively and safely.

Methods: From March 2002 to September 2007, total 35 sedation were carried out in 33 patients (male : female = 20 : 13) with dental disabilities at Seoul National University Dental Hospital and Hanyang University Medical Center. Patients¡¯ dental charts and sedation records were retrospectively reviewed.

Results: Tooth extraction (19 cases) was the most common dental treatment performed under intravenous sedation (30 cases). Occasionally, inhalation sedation using Sevoflurane 1-2% was adapted (5 cases). Deep sedation (28 cases) was carried out using midazolam 2-3 mg bolus injection and propofol infusion via TCI (4.2 0.9 mg/kg/h), and conscious sedation (7 cases) was carried out using midazolam bolus onlywithout severe complications. The duration of dental treatment was 25.5 12.3 min and that of sedation was 43.2 9.7 min.

Conclusion: Sedation for dentally disabledpatients should be selected for effective behavioral control in conjunction with general anesthesia, considering the duration and pain-evoking potentials of dental treatment, the type and severity of patients¡¯ disabilities, and the experience of dental anesthesiologists altogether.
KEYWORD
Conscious sedation, Deep sedation, Dental, Disabled person, Intravenous infusion, Midazolam, Propofol, Retrospective studies
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