Department of Paediatric Dentistry, UCL Eastman Dental Institute, 256 Gray's Inn Road, London, WC1X 8LD.
Br Dent J. 2010 Jun;208(11):E21; discussion 522-3. doi: 10.1038/sj.bdj.2010.542.
To audit the clinical practice of a dental sedation service in the primary care sector and determine which services dentists use to manage unco-operative children.
Retrospective analysis and prospective audit.
Sedation clinic in primary care, 2007, England.
Children attending for dental treatment under sedation. General dental practitioners (GDPs) in the Brighton and West Sussex regions.
Questionnaire.
Clinical service audit, patient satisfaction, referrer satisfaction.
Four hundred children (age range 5-12 years) had been referred for caries (78%), with the remainder for orthodontic extractions. The most common treatment carried out on primary and permanent teeth was extractions followed by restorations. A combination of intravenous (IV) midazolam/ketamine/fentanyl was used in 40% of cases, and IV midazolam/ketamine was used in 34% of cases. Seventy-four percent of parents responded to the satisfaction questionnaire; of these 97% rated sedation as excellent/good and 80% would choose sedation or recommend sedation for others. Only 45% of questionnaires to referrers were returned. Fifty-six percent of dentists preferred general anaesthesia (GA) and 66% preferred IV sedation.
Dental treatment for children was provided under IV sedation with most parents satisfied with the procedure. Little difference was seen between referring dentists' perceptions of IV sedation or GA.
审查初级保健部门牙科镇静服务的临床实践情况,并确定牙医用于管理不合作儿童的服务。
回顾性分析和前瞻性审计。
2007 年英格兰初级保健镇静诊所。
在镇静下接受牙科治疗的儿童。布莱顿和西苏塞克斯地区的普通牙科医生。
问卷调查。
临床服务审计、患者满意度、推荐者满意度。
400 名儿童(年龄 5-12 岁)因龋齿(78%)接受转诊,其余儿童因正畸拔牙接受转诊。在主要和永久牙齿上进行的最常见治疗是拔牙,其次是修复。40%的病例采用静脉注射咪达唑仑/氯胺酮/芬太尼联合用药,34%的病例采用静脉注射咪达唑仑/氯胺酮。74%的家长对满意度问卷做出了回应;其中 97%的人将镇静评为优秀/良好,80%的人会选择镇静或推荐镇静给他人。只有 45%的推荐者问卷被退回。56%的牙医更喜欢全身麻醉(GA),66%的牙医更喜欢静脉镇静。
为儿童提供了牙科治疗,在静脉镇静下进行,大多数家长对该过程感到满意。推荐医生对静脉镇静或 GA 的看法几乎没有差异。