Analysis of changes and trends in the use of sedatives in dental sedation using data from the National Health Insurance in Korea

Abstract

Background Although dental sedation helps control anxiety and pain, side effects and serious complications related to sedation are gradually increasing. Due to the introduction of new drugs and sedation methods, insurance rates, legal regulations, drugs, and methods used for dental sedation are inevitably changed. In the Republic of Korea, National Health Insurance is applied to all citizens, and this study investigated changes in the use of sedatives using this big data. Methods This study used customized health information data provided by the Healthcare Insurance Review & Assessment Service of Korea. Among patients with a record of use of at least one of eight types of sedatives for dental sedation between January 2007 and September 2019 were selected; the data of their overall insurance claims for dental treatment were then analyzed. Results The number of patients who received dental sedation was 786,003, and the number of dental sedation cases was 1,649,688. Inhalational sedation using nitrous oxide (N 2 O) accounted for 86.8% of all sedatives that could be claimed for drugs and treatment. In particular, it was confirmed that the number of requests for sedation using N 2 O sharply increased each year. Midazolam showed an increasing trend, and in the case of chloral hydrate, it gradually decreased. Conclusion According to our analysis, the use of N 2 O and midazolam gradually increased, while the use of chloral hydrate gradually decreased.

Primary tooth aspiration during conscious sedation with N2O: foreign body removal with rigid bronchoscopy

“…According to statistics, 87% of conscious sedation cases are performed using N 2 O [ 3 ]. Several agents are typically used in dental clinics for sedation, including chloral hydrate, hydroxyzine, midazolam, propofol, dexmedetomidine, and sevoflurane.…”

“…Although easy to administer, the prevalence of sedation with chloral hydrate has decreased. This is because its texture and taste irritate children, and its safety has not been proven [ 3 ].…”

“…Among these, nitrous oxide gas is frequently employed because of its perceived safety profile and minimal associated risks [ 2 ]. In the Republic of Korea, the prevalence of conscious sedation in dental clinics has increased, and 87% of sedation procedures were performed with N 2 O between January 2007 and September 2019 [ 3 ]. In Korean pediatric dental practice, a typical mixture consists of 50% N 2 O and 50% O 2 , with the maximum N 2 O concentration not exceeding 50%.…”