• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.4
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• pp.579-588
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• 1999

Monitoring of patients is essential in assuring the safety of sedation in the dental office. The purpose of this study was to explore the utilization and preferences of sedation, utilization of monitoring methods, and the preparation for emergencies during sedation. Members of the Korean Academy of Pediatric Dentistry were surveyed(n=245) from 1998. 10. 1 to 1998. 12. 20 to establish current trends in the use of sedation practices and monitoring methods in Korea. Findings of the survey include: 1. Twenty nine percent of pediatric dentists use sedative agents in their practices. Seventy one percent of pediatric dentists do not use any sedative agents in their practices 2. Thirty nine percent of pediatric dentists who use sedative agents do so without monitoring devices 3. Nitrous oxide inhalation sedation was the most frequently utilized sedation method by pediatric dentists and chloral hydrate was the most frequently utilized sedative by pediatric dentists. Pulse oximeter was the most frequently utilized monitoring method during sedation in dental office. 4. Only twenty eight percent of pediatric dentists obtain the informed consent of the child's legal guardian. 5. Only sixty percent of pediatric dentists prepare for emergencies during sedation.

• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.1
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• pp.53-61
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• 2020

Midazolam is a short-acting benzodiazepine that is widely used in pediatric dental sedation. However, its clinical effectiveness as an intravenous sedative agent in children has not been widely documented. A retrospective study was conducted to evaluate the efficacy and safety of intravenous midazolam and nitrous oxide inhalation sedation in pediatric dental treatment. The subjects were 115 patients (118 cases) who received dental treatment under intravenous midazolam and nitrous oxide inhalation sedation. Demographic factors, general health status, sedation time, midazolam and nitrous oxide dosage, and success rate of sedation were evaluated from electronic medical records. Behavioral management was the main reason of choosing sedation. Mean duration of sedation was 56.7 minutes for surgical treatment, and 74.4 minutes for restorative treatment. The initial dosage of intravenous midazolam was 0.051 ± 0.019 mg/kg. In 34 cases (28.8%), additional midazolam of 0.036 ± 0.057 mg/kg was delivered during the treatment. The concentration of nitrous oxide was maintained between 40% and 50%. The success rate of sedation was 99% (n = 117). In 1 case, laryngospasm occurred and the patient was reversed with benzodiazepine antagonist, flumazenil. Intravenous midazolam sedation with nitrous oxide was shown to be clinically effective for the dental treatment in children, if administered by trained personnel and patients are carefully selected in accordance with guidelines.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.2
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• pp.209-216
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• 2009

The purpose of this retrospective study was to examine twenty four hour postsedation events after discharge in children sedated for dental treatment. The sedation sheets of 355 children were selected. Selection criteria excluded no midazolam or nasal route of midazolam, no ASA class I, absent or incomplete questionnaire. Children received orally chloral hydrate and hydroxyzine, nitrous oxide was maintained during the sedation. Midazolam was injected to buccal submucosa with titration. Parents were interviewed via telephone within twenty four hours after sedation. Questionnaire included sleeping response, sleeping time, sleeping behavior, vomiting response at home. Two hundred twenty four (67.8%) children slept and twenty one(6.3%) children had abnormal sleeping behavior. One hundred four(31.0%) children had abnormal behavior after sleep and ten(3.0%) children had vomiting response. In the children took the higher dose of midazolam, there were the great tendency to sleep after discharge (p<0.05), the more negative response to sleeping behavior(p = 0.055), the longer sleeping time(p=0.054). In this study many children slept after sedation and a few children showed negative response. However there were not any considerable emergency events. Further study is required to determine the postsedation safety for the use of submucosal midazolam combination with chloral hydrate and hydroxyzine.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.3
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• pp.338-344
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• 2010

The purpose of this study was to evaluate the effect of children's tonsil size on the behavior during pediatric dental sedation. The sedation records of thirty five children were examined in this study. All the sedations had been performed using chloral hydrate/hydroxyzine, nitrous oxide/oxygen or/and submucosal midazolam, and the subjects were divided into 4 groups according to their tonsil size using Brodsky's tonsil classification. The results were as follows: 1. The patients with enlarged tonsils showed negative behaviors in all behavior rating aspects(sleep, movement, crying, overall behavior) during sedation than those with normal tonsils(p<0.05). 2. Enlarged tonsils were correlated with mouth breathing(p<0.05) but not with snoring and coughing(p>0.05) during sedation. 3. For the patients with enlarged tonsils, significantly higher doses of midazolam were administered during sedation than for those with normal tonsils(p<0.05).

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.1
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• pp.75-81
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• 2018

Recently, sedation is routinely used in children who lacked cooperation in pediatric dental clinics. The purpose of this study is to analyze dental treatment cases in department of pediatric dentistry at Dankook University Dental Hospital associating with sedation during 5 years. From January 2011 to December 2015, information about dental treatment cases in department of pediatric dentistry was collected and reviewed. The information gathered included patient gender, age, sedation type, sedative agents, date of operation, and type of procedure. The proportion of treatment cases with conscious sedation for total treatment cases continued to decline until 2014. On the other hand, the incidence of general anesthesia increased gradually. The frequency of midazolam administration and nitrous oxide inhalation sedation increased recently. The use of conscious sedation was significantly decreased when the age of patient was 3 years or older. The frequency of general anesthesia was similar in all age groups. There was a tendency to perform treatment with deeper sedation when the patient was male than female, and when the pulp treatment was performed together with the restorative treatment than not performed. The frequency of re-treatment within 90 days after restoration treatment decreased as the depth of sedation increased.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.3
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• pp.444-453
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• 2005

Sometimes the dentists encounter a child who can not be treated with traditional behavior management techniques (for example, reward, restraint, Tell-Show-Do, familialization). In such a case, the dentists use sedation technique. Recently, in Korea, the use of sedation by pediatric dentists is increased. But, the guideline and survey of sedation is very insufficient. Now, we need a survey of sedation practice in Korea. We carried out research on the actual condition about sedation with a questionaire to pediatric dentists in Korea. Followings are the conclusions 1. Sixty six percent of pediatric dentists use sedative agents in their practice. In this study, using sedation shows an increase as compared with the past. 2. Determinative factors of using sedation were orderly behavior management, number of visiting, guidian's opinion, amount of treatment, general condition. 3. Distribution of ages in patients sedated with agents was orderly 3 years, 4-5 years, under 2 years, 6-10 years, more than 10 years. 4. Particular sedative drugs were chloral hydrate 60-70mg/kg, hydroxyzine 10-40mg/kg(25mg/kg), and oral route was the most favorable route. 5. Observation of skin and nail color, pulse oximeter were the most frequently utillized monitoring method during sedation. 6. Only fifty six percent of pediatric dentists complete the cardiopulmonary resuscitation course.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.3
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• pp.324-333
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• 2018

Children need regularly dental check-ups after dental treatment because there are a lot of changes of oral conditions such as tooth exfoliation and eruption, occlusion, and recurrence of dental caries. The purpose of this study is to determine the factors that affect the follow-up pattern after dental treatment under conscious sedation. Patients who were treated under sedation at the department of pediatric dentistry of Ewha Womans University Mokdong Hospital from 2009 to 2013 were included in this study. The final samples comprised of 562 patients that were classified into 4 groups according to the number of visits during 3 years. The chi-square test was used to determine the factors affecting regular follow-up. There were statistically significant differences between each treatment groups and factors such as the change of doctor, overall treatment time, the number of treated teeth under sedation, restorative treatment, minor operation, and preventive treatment (p < 0.05). This study identified factors that affect regular follow-up after dental treatment under conscious sedation. It is recommended to educate the importance of regular check-ups to parents who are less likely to return.

• Journal of The Korean Dental Society of Anesthesiology
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• v.1 no.1 s.1
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• pp.16-20
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• 2001

연구배경: 일반적으로 자가통증조절기가 자가진정조절을 위해 적합한 것으로 알려져 있다. 그러나 이 장치들은 몇몇 진정제 투여 시 너무 긴 최소 폐쇄간격을 가지고 있다 WalkMed사(Medex inc, USA)의 자가통증조절기는 폐쇄간격을 0으로 설정할 수 있으며 30 ml/h로 추가용량을 투여할 수 있다. 이번 연구에서는 환자 개개인의 요구에 맞추어 환자의 진정을 조절하기 위하여 위장치를 이용한 propofol 자가진정조절기의 가능성를 조사하였다. 방법: Propofol과 전산 프로그램된 WalkMed 주입장치를 이용한 자가진정조절법이 치과치료를 받는 24명의 건강한 환자에게 시행되었다. Propofol 지속 주입량은 2 mg/kg/h로, 추가용량은 5 mg으로 조절되었으며 치소 폐쇄간격은 0으로 설정하였다. Ketoloac 30 mg이 통증 조절을 위하여 진정법 시행 전에 근주되었다. 결과: 진정법 시행 동안 주입된 propofol의 평균량은 3.4 mg/kg/h이었으며 평균 추가용량은 1.6 mg/kg/h이었다. 시간 당 추가용량에는 많은 변이가 있었다(0-32). 모든 환자는 진정법 시행 동안 완전한 각성상태였으며 이러한 진정 법에 만족하였다. 진정 법과 관련된 주요한 합병증은 관찰되지 않았다. 결론: WalkMed사의 자가통증조절기를 이용한 propofol 자가진정조절법이 치과 치료를 받는 환자들에게 유용하게 사용될 수 있다.

• Journal of the korean academy of Pediatric Dentistry
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• v.48 no.3
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• pp.313-323
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• 2021

The purpose of this study was to investigate trends in dental sedation of Korean children and adolescents. A retrospective study was conducted on patients under 20 years of age who received dental treatment under sedation using National Health Insurance Service-National Sample Cohort Database from 2002 to 2015. Based on the 1 million standard data, there were 436 cases of dental treatment under sedation in 2002, but 4002 cases in 2015, showing a trend increasing every year. The 3 - 5 year old group accounted for the largest portion (54.2%), while the 6 - 8 year old group increased recently. Nitrous oxide inhalation sedation is the most commonly used, accounting for 45.9% in 2002, but increased to 89.5% in 2015. Combination of nitrous oxide inhalation sedation, chloralhydrate and hydroxyzine was the most common, accounting for 5.7% in 2002, but decreased to 2.9% in 2015. There is a trend to use the sedation method more safely and in a way that reduces side effects.

• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.1
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• pp.38-44
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• 2015

Children commonly experience orofacial injuries and often need emergency treatment. Due to fear and anxiety, children tend to be uncooperative in emergency rooms. Ketamine hydrochloride is a well-known sedative agent at medical-based emergency rooms which has been used for procedural sedation. In this paper, we will discuss the sedation of uncooperative young patients, who needed dental treatments in the emergency room at Wonju Severance Christian Hospital, using ketamine. We collected the records of patients under 18-years-old who visited the emergency room for dental treatment from January 2010 to May 2014. The data was categorized by age, sex, required dental treatments and application of ketamine sedation. Among 659 pediatric patients who visited for emergency dental treatments, 118 patients were treated under sedation using ketamine. Majority of patients were under the age of 6 (110 patients), and the most frequent cause of sedation was suture of oral laceration (105 patients). Though ketamine should not be used by dentists alone, dentists in emergency rooms can easily meet the patients under deep sedation using ketamine. Hence, dentists in emergency rooms need to be aware of the clinical effects, considerations, and potential adverse effects of ketamine.