A report on dental anxiety levels in children undergoing nitrous oxide inhalation sedation and propofol target controlled infusion intravenous sedation.
OBJECTIVE
To report on two separate child sedation cohorts; one undergoing propofol intravenous sedation (IVS) and the other, nitrous oxide inhalation sedation (IS) in respect to changes in dental anxiety and subject characteristics.


METHODS
The age, gender, level of social deprivation and amount of treatment performed and observed patient behaviour during treatment, using the Frankl and a VAS scale, were recorded for each subject. Anxiety questionnaires were completed before and after treatment. These were: - Modified Child Dental Anxiety Scale (MCDAS); Children's Fear Survey Schedule- Dental Subscale (CFSS-DS) and two Visual Analogue Scales (VAS).


RESULTS
Participants (36) attended for treatment under IS and 40 attended for treatment under propofol IVS. The IVS cohort was older (p<0.01), by between 1.9 and 4.1 years and had more treatment [p = 0.015, 95% confidence interval for the difference between the cohort medians was (0, 3) units]. The two cohorts were closely matched in respect to pre-operative anxiety as measured by the MCDAS and CFSS-DS scales. There were significant anxiety reductions within each cohort as measured by three of the scales: - MCDAS, CFSS-DS and VAS (1) (p< or = 0.001) but no significant change in the VAS (2) scores. When the two cohorts were compared, there was no significant difference in the reduction of the self-reported anxiety for any of the four scales (p>0.05). The observed behaviour was good for both cohorts.


CONCLUSIONS
Propofol target-controlled intravenous sedation and nitrous oxide inhalation sedation were similarly efficacious at anxiety reduction in referred dentally anxious children. Subjects undergoing propofol IVS were older than those undergoing IS. Propofol TCI may offer the opportunity for more treatment at each visit. Further propofol TCI conscious sedation studies are required.
Alexopoulos
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E
Dept Paediatric Dentistry, Glasgow Dental School, Glasgow, Scotland, UK.
Hope
A
A
Clark
S L
SL
McHugh
S
S
Hosey
M T
MT
D000293:Adolescent; D000367:Age Factors; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D015331:Cohort Studies; D016292:Procedural Sedation / Q000379:methods*; D016854:Dental Anxiety / Q000145:classification* / Q000517:prevention & control; D003729:Dental Care / Q000523:psychology; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D009609:Nitrous Oxide / Q000008:administration & dosage*; D015742:Propofol / Q000008:administration & dosage*; D012737:Sex Factors; D012923:Social Class; D016896:Treatment Outcome; D035862:Vulnerable Populations
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D009609:Nitrous Oxide; D015742:Propofol