Introduction to Pain & Anxiety Control Flashcards
What are some medical indications for use of sedation in dentistry?
Conditions aggravated by stress of dental treatment:
- ischaemic heart disease
- hypertension
- asthma
- epilepsy
- psychosomatic illness
- ulcerative collitis or crohn’s disease
What are some cooperation medical indications for use of sedation in dentistry?
- spasticity disorders
- parkinson’s disorders
What are some psychosocial indications for use of sedation in dentistry?
- phobias
- gagging
- persistent fainting (anxiety related)
- idiosyncracy to LA (feeling faint)
what is a 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.
What are some causes of dental anxiety?
- trauma (usually in childhood)
- transferred or learned (parents/playground)
- fear of criticism
- fear of dress
- lack of communication
- helplessness
- invasion of body orifice
- environment & surgery appearance
- staff continuity
what are some dental indications for sedation?
- difficult or unpleasant procedures (surgical extraction of wisdom teeth, orthodontic extractions, implants)
what are some medical contra-indications to use of sedation?
- severe of uncontrolled systemic disease
- severe mental or physical disability (lack of understanding)
- severe psychiatric problems
- narcolepsy
- hypothyroidism
What is an ASA 1?
A normal healthy patient
What is an ASA 2?
A patient with mild systemic disease
What is an ASA 3?
a patient with severe systemic disease (poorly controlled diabetes)
What is an ASA 4?
A patient with severe systemic disease that is a constant threat to life
What is an ASA 5?
A moribund patient who is not suspected to survive without the operation
What is an ASA 6?
a declared brain-dead patient whose organs are being kept alive for donation purposes
What level of ASA patients can dentists treat?
ASA 1 & 2 (anything further must be treated by anaesthetist)
What are some medical contraindications to intravenous sedation?
- intracranial pathology
- COPD
- myasthenia gravis
- hepatic insufficiency (unable to metabolise drug properly)
- pregnancy & lactation
What are some medical contraindications to inhalational sedation?
- blocked nasal airway
- COPD
- pregnancy (sedates the fetus)
What are some social contraindications to sedation?
- unwilling
- uncooperative
- unaccompanied
- children (for IV… must be inhalation)
- very old
What are some dental contraindications to intravenous sedation?
- procedure too difficult for LA
- procedure too long
- spreading infection (airway threatening & limits LA)
- procedure too traumatic
What are the advantages of use of sedation in dentistry?
- decrease dentist stress
- decrease staff stress
- decrease patient stress
- fewer medical incidents
- more productive appointments
What are the disadvantages of use of sedation in dentistry?
- training required (both dentist & nurse)
- equipment required
- recovery time & after care
