Sedation Success Tied to Children’s Traits

When a child has to undergo a dental procedure (other than the typical exam and cleaning), nitrous oxide inhalation sedation is often used to improve cooperation. However, this method isn’t always successful. Recently, a team of researchers set out to determine which children are better candidates for this form of sedation, and to try to find out why it doesn’t always work.

The study was conducted at the University of Washington’s Department of Pediatric Dentistry and involved 48 child-caregiver dyads. The children were aged 36-95 months and were 58% male. According to a recent article from the Dental Tribune, they were all receiving restorative dental treatment that required administration of local anesthesia with nitrous oxide inhalation sedation. In order to assess child temperament, the caregivers completed a questionnaire.

The results indicated an overall sedation success rate of 85.4%, with no signs that age, sex or treatment type and complexity had any association with the outcome. The results did, however, show a significant correlation between success in nitrous oxide sedation and the “overall domain of effortful control, which is associated with maintaining concentration for a long time.” In other words, children who could focus for longer periods of time had a more successful experience with nitrous oxide sedation method. Additionally, children who were easy to soothe when they became upset and had a low frustration level were also considered easier to treat.

“Over the course of a dental procedure, children who are able to successfully receive care must inhibit negative reactions. This corresponds to the innate ability to focus on a task and persist even though it is difficult. Because effortful control appears to be particularly important in predicting treatment success, future studies should investigate how an assessment of this domain could be practically implemented in clinical scenarios to help guide treatment decisions,” the researchers stated.

They further concluded that “by determining which children fail to receive dental care and nitrous oxide sedation, practitioners may reduce negative patient experiences and improve case selection for pharmacologic behavior guidance techniques such as oral sedation and general anesthesia.”