Anxiety, pain control and assessment for sedation Flashcards
What are MEDICAL conditions that are aggravated by stress of dental treatment that would indicate for conscious sedation?
Ischaemic heart disease
Hypertension
Asthma
Epilepsy
Psychosomatic illness
Ulcerative colitis
Chron’s
What are MEDICAL conditions that affect co-operation that would indicate conscious sedation?
Mild moderate movement or learning difficulties
Spasticity disorders
Parkinson’s disease
What are some PSYCHOSOCIAL indications for conscious sedation?
Phobias - needles, drills, dental procedures
Gagging
Persistent fainting
Definition of phobia?
An irrational and uncontrollable fear, which is related to a specific object or situation. It is persistent, despite avoidance of the provoking stimulus. It has a direct effect on the patient’s lifestyle.
Dental indications for conscious sedation?
Difficult or unpleasant procedures
- Surgical extraction wisdom teeth
- Ortho extractions
- Implants
What are some causes of dental anxiety?
Past negative experience
Learned from parenteral or “playground”
Fear of criticism
Lack of communication
Helplessness
Fear of surgery/ hospital environment
What are some general medical contra-indications for conscious sedation?
Severe or uncontrolled systemic disease
Severe mental or physical disability
Severe psychiatric problems
Narcolepsy
Hypothyroidism
What are some medical conditions that contra-indicate IV sedation?
Intracranial pathology
COPD
Myasthenia gravis
Hepatic insufficiency
Pregnancy and lactation
What are some medical conditions that contra-indicate inhalation sedation?
Blocked nasal airway
COPD
Pregnancy
Dental contraindications for conscious sedation?
Procedure too difficult for LA alone - if patient willing
Procedure too long
Spreading infection
Airway threatening
Limits LA
Procedure too traumatic
What are some advantages of conscious sedation?
Decrease dentist stress
Decrease staff stress
Decrease patient stress
Fewer Medical Incidents
More productive appointments
What are some disadvantages of conscious sedation?
Training required
Equipment required
Recovery time and after care
What is the ASA I classification?
Normal, healthy patient.
What is the ASA II classification?
Mild systemic disease
What is the ASA III classification?
Severe systemic disease, limits activity but not incapacitating
