Special Care & Conscious Sedation

Question 1

What problems are associated with providing dental treatment to special care patients?

Answer 1

• communication
• anxiety
• excessive movement
• perception of reality
• previous experience

Question 2

What congenital/genetic disorders can cause movement problems in the chair?

Answer 2

• muscular dystrophy
• cerebral palsy
• multiple sclerosis
• parkinson’s disease
• huntingdons

Question 3

How are patients with involuntary movement disorders managed?

Answer 3

• assessment
• consent
• sedation

Question 4

How can learning difficulties be acquired?

Answer 4

• trauma
• infection
• CVA
• Alzheimer’s

Question 5

In your assessment of patients with learning difficulties, what must you decide?

Answer 5

• will behavioural management be possible
• is pharmacological management needed?
• sedation or GA or both?

Question 6

How is the choice of sedation technique decided?

Answer 6

Based on:
- patient cooperation
- degree of anxiety
- dentistry required
- skills of the dental team
- patient’s previous experience
- facilities available
- is an anaesthetist required

Question 7

what are the advantages of using inhalation sedation in special care patients?

Answer 7

• useful for anxiety relief
• rapid recovery
• flexible duration

Question 8

what are the disadvantages of using inhalation sedation in special care patients?

Answer 8

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

Question 9

what are the advantages of using intravenous sedation in special care patients?

Answer 9

• good sedation achieved
• less cooperation needed
• muscle relaxation

Question 10

what are the disadvantages of using sedation in special care patients?

Answer 10

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

Question 11

what are the advantages of using oral/transmucosal sedation in special care patients?

Answer 11

• avoid cannulation
• can make induction more pleasant
• better cooperation
• better future behaviour

Question 12

what are the disadvantages of using oral/transmucosal sedation in special care patients?

Answer 12

• baseline readings
• bitter taste / stinging
• lag time
• untitrateable
• difficulty in monitoring level of sedation
• behaviour in recovery