Introduction to Pain + Anxiety

Question 1

Define conscious sedation

Answer 1

Use of a drug produces a state of depression out of the CNS
Verbal contact maintained throughout

Question 2

Medical indications for IV sedation

Answer 2

Conditions aggravated by stress of dental tx
- Ischaemic heart disease
- Hypertension
- Asthma
- Epilepsy

Conditions which affect cooperation
- Mild-moderate movement or learning difficulties
- Spasticity disorders
- Parkinsons disease

Question 3

Psychosocial indications for Sedation

Answer 3

Phobias of needles/dental procedures
Gagging
Persistant fainting

Question 4

Medical contraindications of Sedation

Answer 4

Severe systemic disease
Severe psychiatric problems
Narcolepsy
Hypothyroidism

Question 5

Contraindications for IV sedation

Answer 5

Pregnancy + lactation
Intracranial pathology
Hepatic insufficiency (unable TO metabolise drug)

Question 6

Contraindications for IS

Answer 6

Blocked nasal airway
COPD
Pregnancy (carcinogenic, multiple exposure can harm baby)

Question 7

Social contraindications for sedation

Answer 7

Unwilling
Uncooperative
Unaccompanised
Under 12

Question 8

Dental contraindications for Sedation

Answer 8

Procedure too difficult for LA alone
Procedure too long
Spreading infection
Airway threatening
Traumatic procedure

Question 9

Advantages of sedation

Answer 9

Decreased
- Dentist stress
- Staff stress
- Patient stress

Question 10

Disadvantages of sedation

Answer 10

Training required
Equipment required
Recovery time and aftercare

Question 11

Define a dental phobia

Answer 11

Irrational and uncontrollable fear
Related to a specific object or situation
Persistent despite avoidance of unprovoking stimulus

Question 12

ASA Classifications

Answer 12

1 - Healthy
2 - Mild systemic disease (well controlled diabetes, high BP, social drinker)
3 - Severe systemic disease (smoker)
4 - Severe systemic disease constant threat to life
5 - Moribund pt not expected to survive w/o operation
6 - Brain dead