Behavioral Modifications in Children after Repeated Sedation with Nitrous Oxide for Dental Treatment: A Retrospective Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Subjects
2.2. Sedation Procedure
2.3. Data Collection
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Collado, V.; Hennequin, M.; Faulks, D.; Mazille, M.N.; Nicolas, E.; Koscielny, S.; Onody, P. Modification of behavior with 50% nitrous oxide/oxygen conscious sedation over repeated visits for dental treatment a 3-year prospective study. J. Clin. Psychopharmacol. 2006, 26, 474–481. [Google Scholar] [CrossRef] [PubMed]
- Hennequin, M.; Manière, M.C.; Albecker-Grappe, S.; Faulks, D.; Berthet, A.; Tardieu, C.; Droz, D.; Wolikow, M.; Koscielny, S.; Onody, P. A prospective multicentric trial for effectiveness and tolerance of a N2O/O2 premix used as a sedative drug. J. Clin. Psychopharmacol. 2004, 24, 552–554. [Google Scholar] [CrossRef] [PubMed]
- Sivakumar, P.; Gurunathan, D. Behavior of Children toward Various Dental Procedures. Int. J. Clin. Pediatr. Dent. 2019, 12, 379–384. [Google Scholar] [CrossRef] [PubMed]
- Balian, A.; Cirio, S.; Salerno, C.; Wolf, T.G.; Campus, G.; Cagetti, M.G. Is Visual Pedagogy Effective in Improving Cooperation Towards Oral Hygiene and Dental Care in Children with Autism Spectrum Disorder? A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health 2021, 18, 789. [Google Scholar] [CrossRef] [PubMed]
- Salerno, C.; Cirio, S.; Zambon, G.; D’Avola, V.; Parcianello, R.G.; Maspero, C.; Campus, G.; Cagetti, M.G. Conscious Sedation for Dental Treatments in Subjects with Intellectual Disability: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health 2023, 20, 1779. [Google Scholar] [CrossRef] [PubMed]
- Corridore, D.; Zumbo, G.; Corvino, I.; Guaragna, M.; Bossù, M.; Polimeni, A.; Vozza, I. Prevalence of oral disease and treatment types proposed to children affected by Autistic Spectrum Disorder in Pediatric Dentistry: A Systematic Review. Clin. Ter. 2020, 171, e275–e282. [Google Scholar] [CrossRef] [PubMed]
- Reighard, C.; Junaid, S.; Jackson, W.M.; Arif, A.; Waddington, H.; Whitehouse, A.J.O.; Ing, C. Anesthetic Exposure During Childhood and Neurodevelopmental Outcomes: A Systematic Review and Meta-analysis. JAMA Netw. Open 2022, 5, e2217427. [Google Scholar] [CrossRef]
- Graff, V.; Gabutti, L.; Treglia, G.; Pascale, M.; Anselmi, L.; Cafarotti, S.; La Regina, D.; Mongelli, F.; Saporito, A. Perioperative costs of local or regional anesthesia versus general anesthesia in the outpatient setting: A systematic review of recent literature. Braz. J. Anesthesiol. 2021; in press. [Google Scholar] [CrossRef]
- Istituto Superiore di Sanità. Linea Guida: La sedazione cosciente in odontoiatria, National Guidelines System (SNLG) 1st ed. 28th May 2021, Rome, Italy. Available online: https://snlg.iss.it/?cat=6 (accessed on 8 February 2023).
- Shaat, M.A.; Bakry, N.S.; Elshafie, A.M.; Talaat, D.M. Intranasal versus sublingual route of dexmedetomidine sedation in paediatric dentistry: A randomized controlled clinical trial. Int. J. Paediatr. Dent. 2022, 32, 232–239. [Google Scholar] [CrossRef]
- Arch, L.M.; Humphris, G.M.; Lee, G.T. Children choosing between general anaesthesia or inhalation sedation for dental extractions: The effect on dental anxiety. Int. J. Paediatr. Dent. 2001, 11, 41–48. [Google Scholar] [CrossRef]
- Ryu, J.H.; Kim, P.J.; Kim, H.G.; Koo, Y.S.; Shin, T.J. Investigating the effects of nitrous oxide sedation on frontal-parietal interactions. Neurosci. Lett. 2017, 651, 9–15. [Google Scholar] [CrossRef]
- Hennequin, M.; Collado, V.; Faulks, D.; Koscielny, S.; Onody, P.; Nicolas, E. A clinical trial of efficacy and safety of inhalation sedation with a 50% nitrous oxide/oxygen premix (Kalinox™) in general practice. Clin. Oral Investig. 2012, 16, 633–642. [Google Scholar] [CrossRef] [PubMed]
- Venham, L.L.; Gaulin-Kremer, E.; Munster, E.; Bengston-Audia, D.; Cohan, J. Interval rating scales for children’s dental anxiety and uncooperative behavior. Pediatr. Dent. 1980, 2, 195–202. [Google Scholar]
- Moura, L.D.; Costa, P.S.; Costa, L.R. How Do Observational Scales Correlate the Ratings of C’ildren's Behavior during Pediatric Procedural Sedation? Biomed Res. Int. 2016, 2016, 5248271. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Pasarón, R.; Burnweit, C.; Zerpa, J.; Malvezzi, L.; Knight, C.; Shapiro, T.; Ramos-Irizarry, C.; Velis, E. Nitrous oxide procedural sedation in non-fasting pediatric patients undergoing minor surgery: A 12-year experience with 1058 patients. Pediatr. Surg. Int. 2015, 31, 173–180. [Google Scholar] [CrossRef] [PubMed]
- Galeotti, A.; Garret-Bernardin, A.; D’Antò, V.; Ferrazzano, G.F.; Gentile, T.; Viarani, V.; Cassabgi, G.; Cantile, T. Inhalation Conscious Sedation with Nitrous Oxide and Oxygen as Alternative to General Anesthesia in Precooperative, Fearful, and Disabled Pediatric Dental Patients: A Large Survey on 688 Working Sessions. Biomed Res. Int. 2016, 2016, 7289310. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Mourad, M.S.; Santamaria, R.M.; Splieth, C.H.; Schwahn, C.; Midani, R.; Schmoeckel, J. Impact of operators’ experience and patients’ age on the success of nitrous oxide sedation for dental treatment in children. Eur. J. Paediatr. Dent. 2022, 23, 183–188. [Google Scholar] [CrossRef] [PubMed]
- Kharouba, J.; Somri, M.; Hadjittofi, C.; Hasan, J.; Blumer, S. Effectiveness and Safety of Nitrous Oxide as a Sedative Agent at 60% and 70% Compared to 50% Concentration in Pediatric Dentistry Setting. J. Clin. Pediatr. Dent. 2020, 44, 60–65. [Google Scholar] [CrossRef] [PubMed]
- Zier, J.L.; Liu, M. Safety of high-concentration nitrous oxide by nasal mask for pediatric procedural sedation: Experience with 7802 cases. Pediatr. Emerg. Care 2011, 27, 1107–1112. [Google Scholar] [CrossRef] [PubMed]
- Houpt, M.I.; Sheskin, R.B.; Koenigsberg, S.R.; Desjardins, P.J.; Shey, Z. Assessing chloral hydrate dosage for young children. ASDC J. Dent. Child. 1985, 52, 364–369. [Google Scholar]
- Frankl, S.N.; Shiere, F.R.; Fogels, H.R. Should the parent remain with the child in the dental operatory? J. Dent. Child 1962, 29, 150–163. [Google Scholar]
- Vanhee, T.; Lachiri, F.; Van Den Steen, E.; Bottenberg, P.; Vanden Abbeele, A. Child behaviour during dental care under nitrous oxide sedation: A cohort study using two different gas distribution systems. Eur. Arch. Paediatr. Dent. 2021, 22, 409–415. [Google Scholar] [CrossRef] [PubMed]
- Bangash, M.; Mustafa, L.; Irshad, M.; Omer, Q.; Alam, M.K. Short Term Effects of Inhalation Sedation on Child Dental Fear and Anxiety. Curr. Pediatr. Rev. 2022. [Google Scholar] [CrossRef] [PubMed]
- Faulks, D.; Hennequin, M.; Albecker-Grappe, S.; Manière, M.C.; Tardieu, C.; Berthet, A.; Wolikow, M.; Droz, D.; Koscielny, S.; Onody, P. Sedation with 50% nitrous oxide/oxygen for outpatient dental treatment in individuals with intellectual disability. Dev. Med. Child Neurol. 2007, 49, 621–625. [Google Scholar] [CrossRef] [PubMed]
- Garret-Bernardin, A.; Cantile, T.; D’Antò, V.; Galanakis, A.; Fauxpoint, G.; Ferrazzano, G.F.; De Rosa, S.; Vallogini, G.; Romeo, U.; Galeotti, A. Pain Experience and Behavior Management in Pediatric Dentistry: A Comparison between Traditional Local Anesthesia and the Wand Computerized Delivery System. Pain Res. Manag. 2017, 2017, 7941238. [Google Scholar] [CrossRef] [PubMed]
- Ferrazzano, G.F.; Quaraniello, M.; Sangianantoni, G.; Ingenito, A.; Cantile, T. Clinical effectiveness of inhalation conscious sedation with nitrous oxide and oxygen for dental treatment in uncooperative paediatric patients during COVID-19 outbreak. Eur. J. Paediatr. Dent. 2020, 21, 277–282. [Google Scholar] [CrossRef] [PubMed]
- Ministero della Salute. Indicazioni per la Presa in Carico del Paziente con Bisogni Speciali Che Necessita di Cure Odontostomatologiche, Ministry of Health. 2019. Available online: www.salute.gov.it/portale/documentazione/p6_2_2_1.jsp?id=284 (accessed on 8 February 2023).
- Mummolo, S.; Sapio, S.; Falco, A.; Vittorini, O.L.; Quinzi, V. Management of pedodontic patients in moderate sedation in clinical dentistry: Evaluation of behaviour before and after treatment. J. Biol. Regul. Homeost. Agents 2020, 34, 55–62. [Google Scholar]
- Vallogini, G.; Festa, P.; Matarazzo, G.; Gentile, T.; Garret-Bernardin, A.; Zanette, G.; Galeotti, A. Conscious Sedation in Dentistry for the Management of Pediatric Patients with Autism: A Narrative Review of the Literature. Children 2022, 9, 460. [Google Scholar] [CrossRef]
- Willumsen, T.; Vassend, O. Effects of cognitive therapy, applied relaxation and nitrous oxide sedation. A five-year follow-up study of patients treated for dental fear. Acta Odontol. Scand. 2003, 61, 93–99. [Google Scholar] [CrossRef]
- Alaki, S.M.; Safi, A.; Ouda, S.; Nadhreen, A. Comparing Dental Stress in New Child Patients and Returning Patients Using Salivary Cortisol, Immunoglobulin-A and Alpha- Amylase. J. Clin. Pediatr. Dent. 2017, 41, 462–466. [Google Scholar] [CrossRef]
- Sharma, A.; Kumar, D.; Anand, A.; Mittal, V.; Singh, A.; Aggarwal, N. Factors predicting Behavior Management Problems during Initial Dental Examination in Children Aged 2 to 8 Years. Int. J. Clin. Pediatr. Dent. 2017, 10, 5–9. [Google Scholar] [CrossRef]
0. Relaxed: smiling, willing, able to converse, displays behavior desired by the dentist. |
1. Uneasy: concerned, may protest briefly to indicate discomfort, hands remain down or partially raised. Tense facial expression, high chest. Capable of cooperating. |
2. Tense: tone of voice, question and answers reflect anxiety. During stressful procedure, verbal protest, crying, hands tensed and raised, but not interfering very much. Protest more distracting and troublesome. Child still complies with the request to cooperate. |
3. Reluctant: pronounced verbal protest, crying. Using hands to stop procedure. Treatment proceeds with difficulty. |
4. Interference: general crying, body movements sometimes needing physical restraint. Protest disrupts procedure. |
5. Out of contact: hard loud crying, swearing, screaming. Unable to listen, trying to escape. Physical restraint require. |
(a) | |
Variables | n (%) |
Age | |
3–6 years | 367 (63.6) |
7–14 years | 210 (36.4) |
Sex | |
Female | 268 (46.5) |
Male | 309 (53.6) |
Health conditions | |
Healthy | 482 (83.5) |
Physical impairment | 44 (7.6) |
Intellectual impairment | 51 (8.8) |
(b) | |
Down’s syndrome | 22 |
Autism Spectrum Disorders | 13 |
Attention Deficit Hyperactivity Disorder (ADHD) | 7 |
Cognitive disability | 6 |
Rare genetic syndromes | 3 |
Total number | 51 |
(c) | |
Cardiac disease | 18 |
Growth impairment | 12 |
Epilepsy | 6 |
Leukemia | 4 |
Other health conditions | 4 |
Total number | 44 |
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Garret-Bernardin, A.; Festa, P.; Matarazzo, G.; Vinereanu, A.; Aristei, F.; Gentile, T.; Piga, S.; Bendinelli, E.; Cagetti, M.G.; Galeotti, A. Behavioral Modifications in Children after Repeated Sedation with Nitrous Oxide for Dental Treatment: A Retrospective Study. Int. J. Environ. Res. Public Health 2023, 20, 4037. https://doi.org/10.3390/ijerph20054037
Garret-Bernardin A, Festa P, Matarazzo G, Vinereanu A, Aristei F, Gentile T, Piga S, Bendinelli E, Cagetti MG, Galeotti A. Behavioral Modifications in Children after Repeated Sedation with Nitrous Oxide for Dental Treatment: A Retrospective Study. International Journal of Environmental Research and Public Health. 2023; 20(5):4037. https://doi.org/10.3390/ijerph20054037
Chicago/Turabian StyleGarret-Bernardin, Annelyse, Paola Festa, Giorgio Matarazzo, Arina Vinereanu, Francesco Aristei, Tina Gentile, Simone Piga, Elena Bendinelli, Maria Grazia Cagetti, and Angela Galeotti. 2023. "Behavioral Modifications in Children after Repeated Sedation with Nitrous Oxide for Dental Treatment: A Retrospective Study" International Journal of Environmental Research and Public Health 20, no. 5: 4037. https://doi.org/10.3390/ijerph20054037