• Journal of The Korean Dental Society of Anesthesiology
• /
• v.14 no.1
• /
• pp.29-39
• /
• 2014

Background: Dental phobia or anxiety of patients is the serious impediment to appropriate and effective dental treatment. Sedative technique helps to mitigate patients' fear and anxiety thus make them more cooperative and familiar to dental practices. With increasing attention to sedative dentistry in dentists, educational requirements and technical qualification also become stricter but actual survey on recent sedative dentistry has not been reported yet. Especially there is insufficient study reporting the survey of sedative dentistry subjected to Korean adults. In this paper, we conducted a survey study on the actual condition and practice related to sedation with a questionnaire to dentists in South Korea. Methods: The survey was done for members of The Korean Dental Society of Anesthesiology (KDSA), who had great interest in sedation and for whom survey-by-mail was convenient. 472 members of The KDSA having dental license and solid address and contact information were subjected to the survey by sending them survey questions about their sedative techniques and knowledge. In order to increase the response rate, small gifts were presented to those who accurately responded to the survey questions and text messages and phone calls were made to encourage their participation. We collected their responses over two months and examined the returned surveys. Statistical analysis was performed using IBM SPSS Statistics 21 for each question. Results: Out of 472 dentists, 181 responded (38.4% response rate). 63.0% (114 dentists; 77 male and 37 female) of respondents had experience on sedative technique and their average age was $39.8{\pm}7.6$ year. 74 of them were private practitioners, 17 of them were professors (14.9%), 11 of them were dentists-in-service (9.6%), 11 of them were residents (specialist training) (9.6%) and 1 of them was military doctors (0.9%). There were 89 dentists (78.1%) who were specialists or receiving trainings to be specialist, most of whom were pediatric dentists (55, 48.2%) and oral surgeon (31, 27.2%). The most popular route for drug medications was orderly oral, inhalational, intravenous medication. Combination of oral and inhalational medications or single use of intravenous medication was the most common. The most preferred sedative drug was pocral in oral sedation and midazolam in intravenous sedation. 48.2% of practitioners responded that they experienced side effects and emergency situations. Airway obstruction was the most frequent. Conclusions: Results from the survey show that the protocol and system for sedative dentistry have been improved compared to the past. Nevertheless, quality of emergency protocol, monitoring devices and preparation of sedative drugs was still insufficient to achieve safe sedative procedure. This study acquires novelty since actual survey on recent sedative dentistry for adult patients has not been reported yet.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.40 no.1
• /
• pp.28-39
• /
• 2013

General anesthesia or sedation is an essential for a successful dental treatment for the disabled. The aim of this study is to assess the patients who had dental management under general anesthesia or sedation at Chungnam dental clinic for the disabled, who received dental treatment under general anesthesia, sevoflurane sedation and intravenous sedation from January, 2011 to September 2012. Of the 426 patients studied, 389 patients received dental care under general anesthesia, 20 patients received dental care under sevoflurane sedation and 17 patients received dental care under intravenous sedation. The Rate of general anesthesia was higher than that of sevoflurane sedation, intravenous sedation. Sevoflurane sedation is a useful method for short time treatment such as traumatic pediatric patients. Intravenous sedation is an option for patients who had anxiety and fear such as dentally disabled patients. Sevoflurane or intravenous sedation not only gradually reduces the use of general anesthesia but also useful methods themselves for the dentally disabled.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.24 no.2
• /
• pp.101-108
• /
• 2024

Background: Administering anesthesia in dentistry can be distressing for patients, especially those with dental fear and anxiety. Needle pain during local anesthesia is a common concern in intraoral procedures. This study aimed to compare pain perception in 4-6-year-old children following intraoral dental injections with 26- and 31-gauge needles. Methods: Fifty healthy children were divided according to age into Group I (N = 25; 4-5 years) and Group II (N = 25; 5-6 years). Each group was further subdivided according to the needle gauge as follows: Group IA (26 gauge), Group IB (31 gauge), Group IIA (26 gauge), and Group IIB (31 gauge). Using a lottery method, the gauge of the needle to be used at the first visit for local anesthesia administration was selected. Children's reactions to pain were evaluated using a Modified Behavioral Pain Scale. Immediately after administration of local anesthesia, pain perception was evaluated using the Faces pain rating scale. In the subsequent visit, another needle gauge was used to administer local anesthesia, and the previously described evaluations were performed. At the third appointment, the child was shown both syringes and asked to choose one of the syringes they preferred, and the choice was noted. Results: When local anesthesia was administered using a 31-gauge needle, pain perception was similar between the two groups. In group II, the children demonstrated significantly higher arm and leg movements (P = 0.001). However, the difference was significant in group I alone (P < 0.001). Conclusion: Irrespective of age, anesthesia with a 31-gauge needle resulted in significantly lower pain perception than anesthesia with a 26-gauge needle.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.24 no.2
• /
• pp.119-128
• /
• 2024

Background: In pediatric dentistry, fear and anxiety are common among children. Local anesthetics (LA) are widely used to control pain and reduce discomfort in children during dental treatment. Topical anesthetics play a vital role in reducing pain and the unpleasant sensation of a needle puncture in children. Peppermint oil has been extensively used for various diseases. However, its anesthetic properties remain unknown. Peppermint oil, used in mouthwashes, toothpastes, and other topical preparations has analgesic, anesthetic, and antiseptic properties. This study aimed to compare and evaluate pain perception following the topical application of peppermint oil versus lignocaine spray before an intraoral injection in children, aged 8-13 years. Method: Fifty-two children, aged between 8-13 years, who required local anesthesia for dental treatment were divided into two groups of 26 each by simple random sampling (Group 1: 0.2% peppermint oil and Group 2: lignocaine spray). In both groups, physiological measurements (e.g., heart rate) were recorded using pulse oximetry before, during, and after the procedure. Objective pain measurement (Sound Eye Motor (SEM) scale) during administration and subjective measuremeant (Wong-Baker Faces Pain Rating Scale (WBFPRS)) after LA administration were recorded. This was followed by the required treatment of the child. Physiological parameters were compared between the two groups using an independent t-test for intergroup assessment and a paired t-test and repeated-measures ANOVA for intragroup comparisons. The Mann-Whitney U test was used to analyze the pain scores. Results: Intragroup mean heart rates, before, during, and after treatment were statistically significantly different (P < 0.05). However, the intergroup mean pulse rates did not differ significantly between the two groups. The mean WBFPS score in the lignocaine spray group was 4.133 ± 2.06 was statistically different from that of the peppermint oil group (0.933 ± 1.03; P < 0.001^*). The mean SEM score was significantly lower in the peppermint oil group than that in the lignocaine spray group (P = 0.006). No negative effects were observed in this study. Conclusion: 0.2% peppermint oil was effective in reducing pain perception.

• Journal of Oral Medicine and Pain
• /
• v.39 no.4
• /
• pp.152-155
• /
• 2014

Temporomandibular joint (TMJ) dislocation is defined that the disc-condyle complex is positioned anterior to the articular eminence in the open mouth position, and is unable to return to a normal closed mouth position without a manipulative maneuver. TMJ dislocation can recur habitually and result several problems to patients such as discomfort, pain, fear, and anxiety. The only definitive treatment for TMJ dislocation is surgical alteration of the joint itself. In most cases, however, a surgical procedure is far too aggressive for the symptoms experienced by the patient. In addition, the effect of surgical treatment may be insufficient, and the recurrence have been reported. It is also possible to develop several complications after surgical treatment. Therefore much effort should be directed at supportive therapy in an attempt to eliminate the disorder or at least reduce the symptom to tolerable levels. Through this cases the authors present favorable treatment outcome using occlusal splint with the patient of TMJ dislocation. Occlusal splint therapy can be considered as easy, safe, and useful non-invasive modality to treatment of TMJ dislocation.

• Journal of Periodontal and Implant Science
• /
• v.53 no.4
• /
• pp.269-282
• /
• 2023

Purpose: Dental fear hinders patients from receiving appropriate dental treatment. In particular, the noise generated by high-speed air turbines and ultrasonic scalers can adversely affect patients. Many efforts have been made to reduce the discomfort caused by noise, but no methods are definitively recommended. The purpose of this study was to determine the efficacy of active noise-canceling (ANC) headphones in reducing the pain and discomfort associated with dental scaling. Methods: Fifty-five patients requiring scaling and root planing, aged ≥19 years and showing no auditory problems, were included. Scaling was performed for the bilateral maxillary molars and premolars while patients wore headphones, with ANC turned either on or off. The degree of noise and pain reduction in the on and off conditions were surveyed using a visual analog scale (VAS). The Wilcoxon signed-rank test was performed to compare noise-and pain-related discomfort with ANC turned on and off. Results: The sample included 28 men and 27 women with a mean age of 45.45±13.12 years. The average noise-related discomfort score was 3.84±2.12 and 2.95±1.99 when noise-canceling was turned off and on, respectively, with a statistically significant difference (P<0.05). Similarly, the average pain-related discomfort score was 3.78h±2.00 and 3.09±1.96 when noise-canceling was turned off and on, respectively, which was a statistically significant difference (P<0.05). Conclusions: The use of ANC headphones seems to reduce the discomfort caused by noise and pain in patients undergoing scaling.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.7 no.2
• /
• pp.114-119
• /
• 2007

Background: Dental disabilities mean the poor cooperation for dental treatment because of patient's inherent disability, severe fear and anxiety, and communication problem. Sedation and general anesthesia are usually used for behavioral control in dentally disabled patients. In particular, sedation (conscious and deep) can help them to tolerate the proper dental treatment effectively and safely. Methods: From March 2002 to September 2007, total 35 sedation were carried out in 33 patients (male : female = 20 : 13) with dental disabilities at Seoul National University Dental Hospital and Hanyang University Medical Center. Patients' dental charts and sedation records were retrospectively reviewed. Results: Tooth extraction (19 cases) was the most common dental treatment performed under intravenous sedation (30 cases). Occasionally, inhalation sedation using Sevoflurane 1-2% was adapted (5 cases). Deep sedation (28 cases) was carried out using midazolam 2-3 mg bolus injection and propofol infusion via TCI (4.2 ${\pm}$ 0.9 mg/kg/h), and conscious sedation (7 cases) was carried out using midazolam bolus onlywithout severe complications. The duration of dental treatment was 25.5 ${\pm}$ 12.3 min and that of sedation was 43.2 ${\pm}$ 9.7 min. Conclusion: Sedation for dentally disabledpatients should be selected for effective behavioral control in conjunction with general anesthesia, considering the duration and pain-evoking potentials of dental treatment, the type and severity of patients' disabilities, and the experience of dental anesthesiologists altogether.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.41 no.1
• /
• pp.27-33
• /
• 2014

There are several ways to analyse stress resulting from anxiety and fear within dental treatment for children. Surveying questionnaires and monitoring biologic reaction are the most common ways for evaluating stress. Pulse oximeter is a popular device for detecting heart rate but not appropriate for moving children. In this study, we compared a recently introduced wrist- watch type heart rate monitor(Alpha, MIO, USA) with a pulse oximeter(MP110, MECKIS, Republic of Korea) for 10 attendants with two conditions including resting state and excited state after exercise. Data were analyzed using Wilcoxon Signed Rank test and there is no statistical difference between two devices(p < 0.05).

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.24 no.1
• /
• pp.37-45
• /
• 2024

Background: The delivery of profound local anesthetics helps children receive successful treatment by reducing fear, anxiety, and discomfort during dental procedures. Local anesthetic injections are the most anticipated stimuli in dental surgery. Children's perceptions of pain can be altered by applying cryotherapy to precool the oral mucosa or by diverting their minds through taste distractions before administering local anesthetic injections. This study aimed to evaluate the efficacy of cryoanesthesia and xylitol sweet-tasting solution at the injection site in 7-10-year-old children. Methods: A total of 42 participants, aged 7-10 years, who underwent dental treatment requiring local anesthesia, were enrolled in the study. The children were randomly divided into three groups. In group I, sterile water was held in the mouth for 2 minutes before anesthetic administration, similar to group II, and in group III, a xylitol sweet-tasting solution was used for 2 minutes before needle insertion. The analysis of pain perception was carried out based on the Visual Analog Scale (VAS) and the Sound, Eyes, and Motor (SEM) scale. For VAS analysis, a one-way analysis of variance (ANOVA) was performed for intergroup comparison, and a post hoc Tukey test was performed for subgroup analysis. For the categorical SEM scale, the Kruskal-Wallis test followed by the post hoc test was performed for intergroup comparison. Where a P value of <0.05 was considered statistically significant at 95% confidence intervals. Results: Cryoanesthesia significantly reduced pain scores on VAS (4.21 ± 1.42) when compared to those on VAS with xylitol sweet-tasting solution (5.50 ± 1.40) and that with sterile water (6.14 ± 2.47). Intergroup comparison of the VAS scores among the three groups was performed using one-way ANOVA, which demonstrated statistically significant differences (P value <0.026) on the VAS scale. Intergroup comparison of the SEM scale was performed using the Kruskal-Wallis test, followed by post hoc comparison, which exhibited statistically significant differences (P < 0.007) among the three groups for the SEM scale. Conclusion: Cryoanesthesia demonstrated higher efficacy in reducing injection pain than that exhibited by the xylitol sweet-tasting solution.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.24 no.2
• /
• pp.109-117
• /
• 2024

Background: Dental fear and anxiety are significant challenges in managing behavior in children. Oral administration of sucrose or sweet-tasting solutions has shown effectiveness in reducing procedural pain in infants and neonates. This study aimed to investigate whether pre-application of sucrose solution had an effect on minimizing pain perception during injection and to assess the potential impact of the child's age and sweet preference. Methods: A randomized control clinical trial was conducted on 60 children aged 3-9 years requiring buccal infiltration injections. Following parental consent, demographic data of the children were recorded. Sweet preferences was assessed using a modified forced-choice test. Children were equally and randomly allocated into study (sucrose) and control groups using a lottery method. Sucrose solution or distilled water, respectively, was applied to the lateral surface of the tongue for 2 min. Topical anesthetic was applied at the site of injection, followed by local anesthesia administration. The children rinsed their mouths thrice with water immediately after anesthetic injection. A video was recorded during injection which was then scored by three blinded examiners on the Sound Eye Motor (SEM) scale. The children also self-evaluated using Wong-Baker Faces Pain Rating Scale (WBFPS). Results: The mean SEM scores and WBFPS scores were analyzed using the Kruskall-Wallis test. The mean SEM score in the study group was 1.37 ± 0.61, compared to 3.17 ± 0.87 in the control group, showing a statistically significant difference (P < 0.001). Mean pain scores assessed by WBFPS in the study group were 0.60 ± 1.4, while in the control group, they were 6.27 ± 2.33, also showing a statistically significant difference (P < 0.001). Children with a sweet preference demonstrated a subjective reduction in pain perception. Conclusion: Application of sucrose before dental injections in children helps to minimize pain upon injection across all age groups.