title: The challenge of sedation with adolescents: case studies and clinical recommendations.
abstract: Adolescent dental patients pose a unique challenge to providers, particularly when intravenous sedation is introduced to the treatment plan. Surveys show many adolescents are afraid of the dentist. Five to six per cent overall are fearful of dental injections and may avoid care or have irregular attendance. At the same time, adolescents may assert their independence by refusing to cooperate with providers' and parents' requests even while accepting that the goal of better health is reasonable. Successful treatment of--and rapport with--the adolescent dental patient, however, can ensure that adolescents' oral needs are met. Successful providers recognise that adolescents alternate between childlike and mature coping strategies during the course of dental treatment. Identifying an adolescent's current coping style can help the dental team select appropriate strategies to help treatment proceed more smoothly for the adolescent and clinical team. Working with adolescents' individual coping styles, rather than expecting consistently adult behaviour, will ideally help decrease frustration and improve treatment outcome.
authors.affiliation: Dental Public Health Sciences, Box 357475, University of Washington, Seattle, WA 98195, USA. tcoolidg@u.washington.edu
authors.forename: Trilby
authors.initials: T
authors.lastname: Coolidge
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Heaton
authors.forename: Peter
authors.initials: P
authors.lastname: Milgrom
mesh_terms: D000223:Adaptation, Psychological; D000284:Administration, Oral; D000293:Adolescent; D000294:Adolescent Behavior; D000766:Anesthesia, Dental / Q000379:methods*; D019162:Anesthetics, Combined / Q000008:administration & dosage; D016292:Procedural Sedation / Q000379:methods*; D016854:Dental Anxiety / Q000517:prevention & control*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007267:Injections; D008012:Lidocaine / Q000008:administration & dosage; D000077442:Lidocaine, Prilocaine Drug Combination; D008874:Midazolam / Q000008:administration & dosage; D011318:Prilocaine / Q000008:administration & dosage
chemical_list: D019162:Anesthetics, Combined; D006993:Hypnotics and Sedatives; D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D008012:Lidocaine; D008874:Midazolam