• Journal of Dental Anesthesia and Pain Medicine
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• 제24권2호
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• pp.101-108
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• 2024

Background: Administering anesthesia in dentistry can be distressing for patients, especially those with dental fear and anxiety. Needle pain during local anesthesia is a common concern in intraoral procedures. This study aimed to compare pain perception in 4-6-year-old children following intraoral dental injections with 26- and 31-gauge needles. Methods: Fifty healthy children were divided according to age into Group I (N = 25; 4-5 years) and Group II (N = 25; 5-6 years). Each group was further subdivided according to the needle gauge as follows: Group IA (26 gauge), Group IB (31 gauge), Group IIA (26 gauge), and Group IIB (31 gauge). Using a lottery method, the gauge of the needle to be used at the first visit for local anesthesia administration was selected. Children's reactions to pain were evaluated using a Modified Behavioral Pain Scale. Immediately after administration of local anesthesia, pain perception was evaluated using the Faces pain rating scale. In the subsequent visit, another needle gauge was used to administer local anesthesia, and the previously described evaluations were performed. At the third appointment, the child was shown both syringes and asked to choose one of the syringes they preferred, and the choice was noted. Results: When local anesthesia was administered using a 31-gauge needle, pain perception was similar between the two groups. In group II, the children demonstrated significantly higher arm and leg movements (P = 0.001). However, the difference was significant in group I alone (P < 0.001). Conclusion: Irrespective of age, anesthesia with a 31-gauge needle resulted in significantly lower pain perception than anesthesia with a 26-gauge needle.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권6호
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• pp.303-315
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• 2023

Painless treatment determines the quality of pediatric dental care. Although local anesthesia has been used to manage pain in dentistry, children often cite traditional aspirating syringes as a symbol of fear and pain. Adequate pain control during dental procedures may help alleviate fear and anxiety and instill positive oral health attitudes in children. Newer approaches such as intranasal spray, centbucridine, jet injectors, buzzy devices, and acupressure have been developed to help dentists provide near-painless injections while reducing dental anxiety. This review aims to summarize newer approaches to alleviate pain and anxiety in children.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권3호
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• pp.219-221
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• 2024

• 대한장애인치과학회지
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• 제3권1호
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• pp.6-10
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• 2007

Many disabled patients need extensive dental treatment because they have much difficulty in maintaining their oral hygiene. However, because they are not cooperative and not manageable, they require physical restraints, drug induced sedation or general anesthesia. General anesthesia is useful in control of the patients who cannot be treated in other ways. Additionally, general anesthesia provides more safe environment for medically compromised patients. The aim of the present study was to investigate a kind of disorder, sources of referral, preoperative oral condition, experience of dental visit, and performing general anesthesia or not of 930 disabled patients in Kyung-Hee University dental hospital for 30 years.

• Journal of Yeungnam Medical Science
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• 제7권1호
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• pp.127-131
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• 1990

10세 미만의 유 소아 환아중 서혜부 수술 50예에서 1% Lidocaine에 epinephrine(1:200,000)을 혼합한 용액 10mg/kg을 주입해서 미추마취를 시행하여 다음과 같은 결과를 얻었다. 1. 유 소아에서 미추마취를 쉽게 시행할 수 있었다. 2. Lidocaine 10mg/kg 투여로 서혜부 수술을 하였으며 술후 진통효과가 우수하였다. 3. 미추 마취의 합병증이 드물게 나타날 수 있었으므로 기술상의 숙련 및 세심한 환자 감시가 필요하다. 이상의 결과를 얻은 바 소아 미추 마취는 적응이 되는 부위의 수술에 좋은 마취방법이라 사료된다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권3호
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• pp.187-193
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• 2024

Background: Patients with autism spectrum disorder (ASD) present challenges in dental treatment cooperation owing to deficits in communication skills and social interaction. Behavioral guidance, sedation, and general anesthesia may be employed to ensure the quality of dental care for individuals with ASD. This study aimed to examine the trends in dental treatment for patients with ASD who visited the Department of Pediatric Dentistry at Dankook University Jukjeon Dental Hospital, an oral health center for the disabled in the Gyeonggi region, over the past 10 years. Methods: This study utilized the order communication system to gather data on sex, age, cooperation level, number of quadrants treated, and administration of sedation or general anesthesia for patients with ASD who visited the Department of Pediatric Dentistry at Dankook University Jukjeon Dental Hospital between January 2013 and December 2022. Results: The total number of patients with ASD increased annually, possibly due to an increase in ASD prevalence and the hospital's designation as a center for disabled oral health. General anesthesia was predominant before 2017, with a shift towards N₂O-O₂ sedation. The most common age group for sedation or general anesthesia was 6-9 years, with a higher prevalence in males than in females. Notably, N₂O-O₂ and midazolam sedation resulted in better cooperation and fewer treated teeth than general anesthesia. Conclusion: This study highlights the evolving trends in dental treatment for individuals with ASD, indicating a shift towards outpatient methods, particularly N₂O-O₂ sedation. The sex distribution aligns with national statistics, emphasizing a higher prevalence of ASD in males than in females. These findings underscore the need for further research to establish evidence-based guidelines for optimal dental care strategies tailored to the unique needs of individuals with ASD.

• 대한소아치과학회지
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• 제45권1호
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• pp.109-114
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• 2018

Chronic infantile neurological cutaneous articular (CINCA) 증후군은 만성 염증성 질환으로, 주기적으로 발열을 일으킨다. 이 증후군의 환아들은 전신적인 염증으로 인해 치과적 문제에 노출되기 쉽다. 협조가 어려운 환자에 있어서 전신마취는 행동 조절 방법으로 널리 사용되어 왔으며, CINCA 증후군의 경우 전신적인 염증성 질환이기 때문에 전신마취를 시행할 때 있어 주의를 기울어야 한다. 본 증례 보고에서는 CINCA 증후군을 가진 비협조적 환아를 전신마취 하 치과 치료 시행한 증례보고와 함께 이러한 환아들에서 치과치료 전 고려사항을 고찰하고자 한다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권4호
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• pp.283-288
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• 2016

Background: Sevoflurane sedation in pediatric and disabled patients has the advantage of faster induction and recovery compared to general anesthesia, as well as minimum influence on the respiratory and cardiovascular functions, and airway protective reflexes. This study aimed to evaluate the clinical efficacy of sevoflurane sedation used in dental treatment at one provincial dental clinic center for the disabled. Methods: We investigated patients' gender, age, reasons for undergoing sedation, medication history prior to treatment, duration of anesthesia, treatment length, type of treatment, and yearly patterns, for 387 cases of dental treatment performed using sevoflurane sedation from January 2013 to October 2016. Results: We analyzed 387 cases (215 male patients, 172 female patients). Male patients aged 20 year or older accounted for 39.0% of all patients, marking the highest proportion. Patient's lack of cooperation was the most common reason for performing dental sedation. Prosthetic treatment was the most frequently practiced, accounting for 174 treatment cases. The mean lengths of the entire treatment and of the dental procedure were 55.2 min and 39.8 min, respectively. Conclusions: Sevoflurane sedation has the advantage of fast anesthesia induction and recovery compared to general anesthesia; therefore, it can be used efficiently to induce anesthesia in pediatric and disabled patients during short dental procedures, enabling stable treatment of these patients.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권4호
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• pp.239-254
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• 2022

The high success rate of dental treatment is dependent on the cooperation of pediatric patients during procedures. Dental treatment often causes pain, particularly in children. The factors in providing treatment to pediatric patients include the characteristics and location of the tooth, profoundness of the anesthesia including the type of local anesthetic, and cooperation of the patient. Previous studies have examined several techniques to successfully achieve profound pulpal anesthesia in maxillary permanent teeth. The dentist should select the injection technique to be used based on patient needs. In children, either buccal with palatal injections or buccal with intra-septal injections may be used to anesthetize the permanent maxillary first molar. Buccal with palatal injections are commonly used prior to routine maxillary dental procedures. Currently, there are only a few studies on the employment of buccal with intra-septal injections to anesthetize permanent maxillary first molars in pediatric patients. This review will focus on efficacy of buccal with palatal versus buccal with intra-septal pulpal anesthesia of the permanent maxillary first molars in pediatric patients and aim to determine which technique should be used during routine dental procedures.

• 대한소아치과학회지
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• 제33권2호
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• pp.317-322
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• 2006

소아환자를 진료하다 보면 불안과 공포가 극도로 심하여 일반적인 행동조절법으로는 양질의 치과치료가 불가능한 상황에 자주 접하게 된다. 음성조절과 신체 속박 또는 입 가리기 등의 강압적이고 물리적 인 방법을 사용하여도 역시 치료결과가 만족스럽지 않고 이러한 경우 환자와 보호자에게 가해지는 정신적인 상해는 결코 무시할 수 없다. 따라서 행동 조절의 어려움과 치과 질환의 심각성 등으로 인해 전신마취하의 치과치료가 필요한 경우가 많으며 이 경우 전신마취는 행동조절법의 하나로 간주될 수 있다. 치과전신마취는 비용이 많이 드는 것과 적지만 있을 수 있는 부작용의 위험성을 가지고 있다. 그러나 환자의 내원횟수를 줄일 수 있고 치과치료에 대한 부정적인 행동반응을 유발하지 않아 의사와 환자의 스트레스를 줄일 수 있으며 양질의 진료가 가능하다는 점에서 장점을 갖는다. 이번 실태조사는 2000년 12월부터 2005년 4월까지 전북대학교 치과병원 소아치과에서 전신마취하에 광범위한 치과치료를 받은 200여명의 환자를 대상으로 하여 나이, 성별 등의 인적 사항, 전신마취가 필요했던 이유, 전신마취시간, 치료의 종류, 전신마취횟수 등에 관하여 조사하였다.