Porskamp, L.C.M. (2018) Gebruik van sedativa binnen de bijzondere tandheelkunde bij patiënten met een verstandelijke- of lichamelijke beperking of extreme angst voor de tandarts. thesis, Dentistry.
Full text available on request.Abstract
Introduction Mentally or physically disabled people have a relatively higher change of obtaining dental problems. In order to enable dental treatments for these people, sedatives may be used. Sedation reduces the consciousness of a patient by administering medication, and hence the procedure may become less unbearable. This improves the working conditions of a dentist. However, during sedation, communication with the patient needs to remain possible. Hence, the optimal sedation procedure, which reduces the consciousness but enhances the possibility of communication, is difficult to determine. More research on a range of sedatives is required. The aim of this literature review is to obatain an overview of the sedatives used, and determine the side-effects. Moreover, a questionnaire written by the Horace Wells commission of the Vereniging tot Bevordering der Tandheelkundige Gezondheidszorg voor Gehandicapten (VBTGG), will reveal which sedatives have caused the most incidents/calamities in The Netherlands. Furthermore, it will describe how aftercare is organized at the centers of special dentistry (CBT) in The Netherlands. Materials and methods This literature study has researched the databases of Pubmed and Embase to find papers describing techniques of sedation in the dentistry. Moreover, several papers were found by means of the ‘snowball technique’, and with the assistance of professionals within the field of study. The study includes papers which are published between 1997 and 2017. The population of the study consists of mentally disordered patients and anxious adults. The data obtained by the questionnaire is analysed using the Chi-square and the Pearsons-r test. Results The literature revealed that every sedative has its side-effects and contraindications that do not benefit the dental treatment of a patient. For example, nitrous oxide has the benefit that a patient can go home immediately after the treatment, while all other sedatives require aftercare. On the other hand, a disadvantage of nitrous oxide is that it must be anatomically and mentally possible to breath nasally. Furthermore, the Chi-square test shows that there is no statistically significant difference between the number of incidents with the oral use of midazolam and the number of incidents with intravenous use of Propofol. The Pearsons-r test shows that there is a slight negative correlation between the years of experience and the number of incidents. No statistically significant relationship can be found between knowledge of national guidelines and the number of incidents. However, there appears to be a correlation between the existence of protocols and the number of incidents. Discussion At this moment, no optimal way of sedation is known. Each sedative has its advantages and disadvantages. It is only possible to roughly describe which sedative is most appropriate in each situation. However, further research is necessary.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Janknegt, dr. E.M. |
| Faculty: | Medical Sciences |
| Date Deposited: | 23 Nov 2021 12:07 |
| Last Modified: | 23 Nov 2021 12:07 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2821 |
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