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Child’s temperament could be predictor of sedation success in dental treatment

By Dental Tribune International
February 16, 2017

SEATTLE, USA: Nitrous oxide inhalation sedation is commonly employed to improve cooperation in children during dental procedures in particular. However, in some patients, it fails to provide adequate levels of sedation. In a recent study, researchers found that a child’s temperament plays an important role in the success of the method and that it is most effective in children who are able to concentrate well, for example.

The study included 48 child–caregiver dyads with children aged 36–95 months (58 percent male) receiving restorative dental treatment requiring administration of local anesthesia with nitrous oxide inhalation sedation at a university-based pediatric dental clinic. To assess child temperament, the caregivers completed a questionnaire.

The researchers reported an overall sedation success rate of 85.4 percent. There was no indication that age, sex or treatment type and complexity were associated with the outcome. However, the results showed that success in nitrous oxide sedation was significantly linked to the overall domain of effortful control, which is associated with maintaining concentration for a long time. Children who were easy to soothe when they become upset and had a low frustration level were also considered easier to treat.

“Over the course of a dental procedure, children who are able to successfully receive care must inhibit negative reactions. This corresponds to the innate ability to focus on a task and persist even though it is difficult. Because effortful control appears to be particularly important in predicting treatment success, future studies should investigate how an assessment of this domain could be practically implemented in clinical scenarios to help guide treatment decisions,” the researchers stated.

“By determining which children fail to receive dental care with nitrous oxide sedation, practitioners may reduce negative patient experiences and improve case selection for pharmacologic behavior guidance techniques such as oral sedation and general anesthesia,” they concluded.

The study, titled “Temperament as a predictor of nitrous oxide inhalation sedation success,” was published in the Spring 2017 issue of the Anesthesia Progress journal. It was conducted at the University of Washington’s Department of Pediatric Dentistry.

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