Sedation and Special Care

Question 1

what is SCD?

Answer 1

special care dentistry are those with DISABILITY or ACTIVITY RESTRICTION that directly or indirectly affects their oral health

Question 2

what are problems in providing dental tx for a SCD pt?

Answer 2

communication
anxiety
moving target
perception of reality
prev exp

Question 3

what are a number of SCD movement disorders?

Answer 3

muscular dystrophy
cerebral palsy
multiple sclerosis
parkinson’s disease
huntingdon’s chorea

Question 4

how do you manage pt’s with involuntary movements?

Answer 4

assessment:
- mental + physical status
- anxiety
- pain experience

Question 5

what are some learning difficulties in SCD patients?

Answer 5

• stroke (CVA - cerebral vascular accident)
• alzheimer’s
• dyslexia

Question 6

whats the act thats relevant for a patient who is unable to give consent?

Answer 6

Adults Incapacity Act (2000) Scotland

Question 7

what are the types of conscious sedation techniques?

Answer 7

inhalation
IV
oral
transmucosal (rectal, intranasal, sublingual)

Question 8

what information is relevant for the choice of sedation technique decided?

Answer 8

• patient cooperation
• degree of anxiety
• dentistry required
• skills of the dental team
• pt’s previous experience
• facilities available
• anaesthetist required?

Question 9

Advantages of Inhalation sedation?

Answer 9

useful for anxiety relief
rapid recovery
flexible duration

Question 10

disadvantages for inhalation sedation?

Answer 10

keeping nasal hood in place
less muscle relaxation
coordination of nasal breathing when mouth open

Question 11

+ of IV sedation?

Answer 11

good sedation achieved
less cooperation needed
muscle relaxation

Question 12

• of IV sedation?

Answer 12

baseline readings
IV cannulation required
assessing sedation level is challenging
behaviour during recovery
efficacy swallowing

Question 13

During IV sedation, what are the main safety factors to keep into consideration?

Answer 13

pts ability to swallow
pts airway
liver
medication interactions

Question 14

+ Oral/Transmucosal sedation?

Answer 14

avoid cannulation
induction to IV sedation more pleasant
better cooperation
future behaviour is better

Question 15

• oral/transmucosal sedation?

Answer 15

baseline readings
bitter taste/stinging
lag time to work
un-titratable
difficulty in monitoring pts level of sedation
Behaviour in recovery