A Survey of Sedation Practices in the Korean Dentistry

치과 치료 시 진정법 시행에 대한 실태 조사 연구

  • Bae, Chi-Hoon (Department of Dental Anesthesiology, School of Dentistry, Seoul National University) ;
  • Kim, Hyuk (Department of Dental Anesthesiology, School of Dentistry, Seoul National University) ;
  • Cho, Kyoung-Ah (Department of Dental Anesthesiology, School of Dentistry, Seoul National University) ;
  • Kim, Mi-Seon (Department of Dental Anesthesiology, School of Dentistry, Seoul National University) ;
  • Seo, Kwang-Suk (Department of Dental Anesthesiology, School of Dentistry, Seoul National University) ;
  • Kim, Hyun-Jeong (Department of Dental Anesthesiology, School of Dentistry, Seoul National University)
  • 배치훈 (서울대학교치의학대학원 치과마취과학교실) ;
  • 김혁 (서울대학교치의학대학원 치과마취과학교실) ;
  • 조경아 (서울대학교치의학대학원 치과마취과학교실) ;
  • 김미선 (서울대학교치의학대학원 치과마취과학교실) ;
  • 서광석 (서울대학교치의학대학원 치과마취과학교실) ;
  • 김현정 (서울대학교치의학대학원 치과마취과학교실)
  • Received : 2014.03.26
  • Accepted : 2014.04.02
  • Published : 2014.03.31

Abstract

Background: Dental phobia or anxiety of patients is the serious impediment to appropriate and effective dental treatment. Sedative technique helps to mitigate patients' fear and anxiety thus make them more cooperative and familiar to dental practices. With increasing attention to sedative dentistry in dentists, educational requirements and technical qualification also become stricter but actual survey on recent sedative dentistry has not been reported yet. Especially there is insufficient study reporting the survey of sedative dentistry subjected to Korean adults. In this paper, we conducted a survey study on the actual condition and practice related to sedation with a questionnaire to dentists in South Korea. Methods: The survey was done for members of The Korean Dental Society of Anesthesiology (KDSA), who had great interest in sedation and for whom survey-by-mail was convenient. 472 members of The KDSA having dental license and solid address and contact information were subjected to the survey by sending them survey questions about their sedative techniques and knowledge. In order to increase the response rate, small gifts were presented to those who accurately responded to the survey questions and text messages and phone calls were made to encourage their participation. We collected their responses over two months and examined the returned surveys. Statistical analysis was performed using IBM SPSS Statistics 21 for each question. Results: Out of 472 dentists, 181 responded (38.4% response rate). 63.0% (114 dentists; 77 male and 37 female) of respondents had experience on sedative technique and their average age was $39.8{\pm}7.6$ year. 74 of them were private practitioners, 17 of them were professors (14.9%), 11 of them were dentists-in-service (9.6%), 11 of them were residents (specialist training) (9.6%) and 1 of them was military doctors (0.9%). There were 89 dentists (78.1%) who were specialists or receiving trainings to be specialist, most of whom were pediatric dentists (55, 48.2%) and oral surgeon (31, 27.2%). The most popular route for drug medications was orderly oral, inhalational, intravenous medication. Combination of oral and inhalational medications or single use of intravenous medication was the most common. The most preferred sedative drug was pocral in oral sedation and midazolam in intravenous sedation. 48.2% of practitioners responded that they experienced side effects and emergency situations. Airway obstruction was the most frequent. Conclusions: Results from the survey show that the protocol and system for sedative dentistry have been improved compared to the past. Nevertheless, quality of emergency protocol, monitoring devices and preparation of sedative drugs was still insufficient to achieve safe sedative procedure. This study acquires novelty since actual survey on recent sedative dentistry for adult patients has not been reported yet.

Keywords

References

  1. Henning Abrahamsson K, Berggren U, Hakeberg M, Carlsson SG: Phobic avoidance and regular dental care in fearful dental patients: a comparative study. Acta Odontologica 2001; 59(5): 273-9. https://doi.org/10.1080/000163501750541129
  2. Lautch H: Dental phobia. The British Journal of Psychiatry 1971; 119(549): 151-8. https://doi.org/10.1192/bjp.119.549.151
  3. The Korean Dental Society of Anesthesiology: Dental Anesthesiology. 2nd ed. Seoul, Koonja. 2010, pp 477-85.
  4. Malamed SF: Sedation: a guide to patient management, Elsevier Health Sciences. 2009.
  5. D'eramo EM: Mortality and morbidity with outpatient anesthesia: the Massachusetts experience. Journal of oral and maxillofacial surgery 1999; 57(5): 531-6. https://doi.org/10.1016/S0278-2391(99)90069-1
  6. The Korean Academy of Dental Sciences: The Guideline Manual of Dental Sedation. Seoul, Koonja. 2010.
  7. Müller M, Hänsel M, Stehr S, Weber S, Koch T: A state-wide survey of medical emergency management in dental practices: incidence of emergencies and training experience. Emergency Medicine Journal 2008; 25(5): 296-300. https://doi.org/10.1136/emj.2007.052936
  8. Cavalieri TA: Management of pain in older adults. JAOA: Journal of the American Osteopathic Association 2005; 105(3 suppl): 12S-7S.
  9. An SY, Choi BJ, Kwak JY, Kang JW, Lee JH: A survey of sedation practices in the Korean pediatric dental office. Journal of the Korean Academy of Pediatric Dentistry 2005; 32: 444-52.
  10. Houpt M: Project USAP 2000-use of sedative agents by pediatric dentists: a 15-year follow-up survey. Pediatric dentistry 2002; 24(4): 289-94.
  11. Vermeulen M, Vinckier F, Vandenbroucke J: Dental general anesthesia: clinical characteristics of 933 patients. ASDC Journal of dentistry for children 1991; 58(1): 27.
  12. Sage D, Close A, Boas R: Reversal of midazolam sedation with anexate. British journal of anaesthesia 1987; 59(4): 459-64. https://doi.org/10.1093/bja/59.4.459
  13. Severinghaus JW: History and recent developments in pulse oximetry. Scandinavian Journal of Clinical and Laboratory Investigation 1993; 53(s214): 105-11. https://doi.org/10.1080/00365519309086911
  14. Iwasaki J, Vann Jr W, Dilley D, Anderson J: An investigation of capnography and pulse oximetry as monitors of pediatric patients sedated for dental treatment. Pediatr Dent 1989; 11(2): 111-7.