title: Noise level measurement, a new method to evaluate effectiveness of sedation in pediatric dentistry.
abstract: OBJECTIVE
  Pediatric dentists perform moderate sedation frequently to facilitate dental treatment in uncooperative children. Assessing the depth and quality of sedation is an important factor in the clinical utilization of moderate sedation. We aimed to determine if the level of noise, created by the children who are undergoing moderate sedation during dental procedures, could be used as a nonsubjective measurement of the depth of sedation and compare it to the Ohio State Behavior Rating Score (OSBRS).
  
  
  METHODS
  Following Institutional Review Board approval and after receiving informed consent, we studied 51 children with a mean age of 4.2 years and average weight of 18.5 kg, who were undergoing restorative or extractive dental procedures, requiring moderate sedation. Sedation efficacy was assessed using OSBRS at several stages of the procedure. The noise level was measured by using a NoisePRO logging device to record the noise level at a rate of every second throughout the procedure.
  
  
  RESULTS
  The depth of sedation assessed by OSBRS during the operative procedure was significantly correlated with noise level. The act of administering the local anesthesia and the operative procedure itself were two phases of the encounter that were significantly associated with higher OSBRS as well as noise levels.
  
  
  CONCLUSIONS
  Measurement of noise level can be used as an effective guide to quantify the depth of sedation at different stages of the dental procedure. It is a nonsubjective and continuous measurement, which could be useful in clinical practice for the administration of moderate sedation during dental procedures. By using noise level analysis we are able to determine successful, poor, and failed sedation outcome.
authors.affiliation: Department of Anesthesiology, Women and Children's Hospital of Buffalo, SUNY School of Medicine, Buffalo, NY, USA. Electronic address: asabouri@partners.org.
authors.forename: A Sassan
authors.initials: AS
authors.lastname: Sabouri
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Farshid
authors.initials: F
authors.lastname: Firoozabadi
authors.affiliation: Department of Pediatric and Community Dentistry, SUNY School of Dentistry, Buffalo, NY, USA.
authors.forename: Drew
authors.initials: D
authors.lastname: Carlin
authors.affiliation: Department of Pediatric and Community Dentistry, SUNY School of Dentistry, Buffalo, NY, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Creighton
authors.affiliation: Department of Anesthesiology, Women and Children's Hospital of Buffalo, SUNY School of Medicine, Buffalo, NY, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Raczka
authors.affiliation: Division of Pediatric Critical Care, Women and Children's Hospital of Buffalo, SUNY School of Medicine, Buffalo, NY, USA.
authors.forename: Prashant
authors.initials: P
authors.lastname: Joshi
authors.affiliation: Department of Anesthesiology, Women and Children's Hospital of Buffalo, SUNY School of Medicine, Buffalo, NY, USA; Department of Pediatric and Community Dentistry, SUNY School of Dentistry, Buffalo, NY, USA; Division of Pediatric Critical Care, Women and Children's Hospital of Buffalo, SUNY School of Medicine, Buffalo, NY, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Heard
mesh_terms: D002675:Child, Preschool; D016292:Procedural Sedation / Q000379:methods*; D006801:Humans; D009622:Noise; D010377:Pediatric Dentistry; D017410:Practice Guidelines as Topic
keywords: moderate sedation; noise level; pediatric dentistry; practice guidelines