Sedação moderada como alternativa de tratamento em odontopediatria

Abstract

Behavior management of children in pediatric dentistry consultation is often unpredictable, which hinders the performance of the dentist and the respective dental treatment. There are several behavioral control techniques that have been developed in order to respond to these cases, particularly non-pharmacological techniques, such as communication skills and techniques of modification of conduct. However, sometimes these are insufficient leading the dental surgeon to resort to pharmacological methods such as sedatives, painkillers and other drugs acting on the control of pain, fear and anxiety. Moderate sedation has been shown to be an important aid in the dental treatment of children with a certain degree of anxiety and fear, as well as patients with special physical or mental disabilities. This is an effective and safe technique, alternative to general anesthesia, in which the patient is mildly sedated, some cooperation maintaining and managing the physical stimulation and to respond to verbal commands, allowing the professional performing a dental treatment plan. Conscious sedation techniques involve a variety of pharmacological agents such as nitrous oxide and other drugs, such as benzodiazepines. The treatment plan for each clinical case will depend on a careful review of past and current medical history of the patient, the respective individual need and the cost-effectiveness of the procedure. The objective of this paper is to present a literature review aimed to describe the different methods of sedation used in dental treatment in pediatric patients and patients with special needs, giving greater emphasis to moderate intravenous sedation. Pharmacological agents selected for the different techniques, indications and contraindications, possible side actions and dosages thereof. Finally, to illustrate the importance of the technique, two cases of special patients, performed at the University Dental Clinic, are presented. Without the use of this added value, these patients would not have an effective response to their oral problems, since they do not let themselves be treated in a normal query environment. The use of advanced anesthetic techniques is, of course, some of the near future by a person exercising exclusively Pediatric Dentistry. The referral of children with early age with oral health states frankly compromised and need to make multiple pulp treatments with placement of steel/zirconia crowns, as well as children already subject to failed attempts at treatment and therefore are of no posture collaboration and often phobia of dental care are constant challenges for the professional. To give an answer to these children and these parents necessarily the dentist has to offer a treatment plan under sedation or eventually under general anesthesia. This will be the right way of development of clinical practice of Pediatric Dentistry.

Date of Award	2 Nov 2015
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Andreia Sofia de Paiva Figueiredo (Supervisor) & Filipa Alexandra dos Santos Bexiga (Co-Supervisor)