Conscious sedation for anxious children

Abstract

When treating children for dental health problems, it is often necessary to use behavioural management techniques to calm any fears. Rubya Adamji, Isabelle Holroyd and Paul Ashley describe the use of pharmacological methods for these purposes.

Predictable sedation: Safe administration of oral Midazolam and nitrous oxide gas for paediatric patients in the general dental practice

“…9,21 Many different drugs have been employed to effectively sedate paediatric patients during dental care treatment. 9 One of the more favourable sedation techniques used by paediatric dentists is the combined use of the inhalation of nitrous oxide (N 2 O) and oxygen (O 2 ), as a sedation alone or, in combination with Midazolam. 22 Moderate sedation can be successfully administered in the clinical management of a paediatric dental patient, with both intranasal and oral sedation using Midazolam in combination with nitrous oxide gas.…”

“…Those in Classes III to V should be treated in a hospital environment. 9 Should the child have a history of recent respiratory illnesses or common infections, then the airway, weight and vital signs should be assessed before general anaesthesia is administered.…”

“…Examples of behaviour management techniques are tell-show-do, positive reinforcement, modelling, behaviour shaping, desensitisation and alternative techniques (flexible control, distraction and memory restructuring). 9 Techniques used to improve communication with young children include distraction, non-verbal communication, voice control, tell-show-do, positive reinforcement, parental presence/absence, and protective stabilisation. 7,10 To encourage the child to act in a more suitable manner in the dental clinic, the sole use of behavioural management techniques is preferred.…”