Conscious sedation vs general anesthesia in pediatric dentistry - a review

Abstract

INTRODUCTION: Performing dental treatments on pediatric patients who present behavioral problems is usually a great clinical challenge. Depending on the patients' emotional maturity and their physical, psychological and mental skills, the usual behavior control techniques may not offer adequate efficacy and safety when dental procedures are being carried out. In these circumstances, alternative and more invasive methods such as conscious sedation and general anesthesia may become necessary. OBJECTIVE: To compare the indications and contraindications of conscious sedation and general anesthesia in pediatric dentistry. METHOD: Literature research undertaken through the MEDLINE/Pubmed, Science Direct and B-on search engines between April and June 2013 using a 5 year time frame and the following keywords: conscious sedation, general anesthesia, pediatric dentistry and guidelines. RESULTS: Conscious sedation is recommended to anxious patients who have dental and needle phobia, to patients that present an increased vomiting reflex and also to patients with special needs but capable of communicating. General anesthesia is indicated for non-cooperating patients under the age of four, in mouth breathers, in children ASA III or higher and in pediatric patients who do not communicate. CONCLUSIONS: Each technique must be selected according to the characteristics showed by patient. Although conscious sedation and general anesthesia introduce benefits to pediatric dentistry, they should not be regarded as priority intervention techniques for behavior control. The pediatric dentist's previous knowledge of these techniques provides a better level of dental care quality as well as more safety and less discomfort for their patients.

William-Beuren Syndrome: Comprehensive Dental Care in Child Patient

“…1 General anesthesia could be applied to patients who are considered non-cooperative due to physical, mental, or medical disorders, young patients, patients with cognitive or emotional immaturity who tend to have extreme anxiety ad requires extensive rehabilitation, non-cooperative behaviors, patients requiring extensive treatment, patients who need tooth restoration or surgery that should be performed simultaneously. 11,15,16 GIC restorations (Figure 4) were chosen because of the simple handling technique and fluor release (the ion exchanges between glass-ionomer cement and dentine facilitate the remineralization of caries-affected dentine into fluorapatite that provides a caries-resistant). Root canal treatment was not recommended in this case due to the high incidence of chronic infections.…”

Care under general anesthesia of patients with autistic spectrum

“…However, in this case, it was possible to show that treatments can be performed in the operating room safely for the team and for the patient. These treatment options must be disseminated in order to bring this possibility to the patient and the professionals to understand how it works so that it is more and more widespread [20].…”

“…People with autism often have serious health problems, which increases their anesthetic risk [9]. Therefore, the choice of anesthetic is of great importance and responsibility, it must present fast and smooth anesthesia, safely recovering its effects, having a wide safety margin and not having side effects [10]. Isofl uorane is the most widely used anesthetic, as it has low toxicity and is poorly metabolized [11].…”

Atendimento odontológico para pacientes com necessidades especiais: uma revisão de literatura

“…Research, Society and Development, v. 9, n. 8, e288985405, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i8.5405 A sedação é uma técnica realizada apenas em pacientes saudáveis ou com comprometimento sistêmico leve (Cavalcante et al, 2011). Indivíduos com retardo mental severo, comprometimento sistêmico profundo ou transtornos psiquiátricos significativos geralmente devem ser submetidos à anestesia geral que é realizada em ambiente hospitalar (Silva et al, 2015). Para realizar essas técnicas de contenção, é obrigatório o consentimento dos pais ou cuidadores, informados na ficha do paciente antes de iniciar o procedimento (AAPD, 2015).…”