Dentistry Unit, Bambino Gesù Children's Hospital, IRCCS, Viale Ferdinando Baldelli 41, 00146 Rome, Italy.
Department of Pedodontics, Faculty of Dental Medicine, 'Carol Davila' University of Medicine and Pharmacy, 032799 Bucharest, Romania.
Int J Environ Res Public Health. 2023 Feb 24;20(5):4037. doi: 10.3390/ijerph20054037.
Sedation with nitrous oxide (NO) has been widely used as a viable alternative to general anesthesia to perform dental treatments in uncooperative or anxious children. The purpose of this retrospective study is to assess if repeated sedations with NO can improve collaboration of uncooperative children. The medical records of 650 children, aged between 3 and 14 years, who underwent at least two sedations, were consulted. Differences in the Venham score during the first sedation and subsequent sedations were collected. After removal incomplete records, 577 children's records (309 males and 268 females) were analyzed. The Venham score decreased both during each sedation and with repeated sedations ( < 0.01 for both comparisons). In particular, a significant reduction of the Venham score was observed at the first contact with the dentist, with a mean score ranging from 1.56 ± 1.46 to 1.16 ± 1.37, comparing the first and the second sedation, and from 1.65 ± 1.43 to 1.06 ± 1.30, comparing the first with the third sedation ( < 0.01). The reduction in the Venham score was recorded in both healthy and physically impaired patients, and it was significantly greater in older children than in younger children ( < 0.01). In conclusion, uncooperative children with or without physical impairments can be successfully treated with NO sedation in order to increase their confidence in dental procedures.
一氧化二氮（NO）镇静已被广泛用作替代全身麻醉的可行方法，以对不合作或焦虑的儿童进行牙科治疗。本回顾性研究旨在评估重复使用 NO 镇静是否可以提高不合作儿童的合作程度。查阅了 650 名年龄在 3 至 14 岁之间、至少接受过两次镇静的儿童的病历。收集了首次镇静和随后镇静期间 Venham 评分的差异。去除不完整记录后，分析了 577 名儿童的记录（309 名男性和 268 名女性）。每次镇静和重复镇静过程中 Venham 评分均降低（两次比较均 < 0.01）。特别是，在首次与牙医接触时，Venham 评分明显降低，平均评分从 1.56 ± 1.46 降至 1.16 ± 1.37，首次与第二次镇静相比，从 1.65 ± 1.43 降至 1.06 ± 1.30，首次与第三次镇静相比（< 0.01）。在健康和身体有障碍的患者中均记录到 Venham 评分降低，且在年龄较大的儿童中降低更为显著（< 0.01）。总之，有或没有身体障碍的不合作儿童可以成功接受 NO 镇静治疗，以增强他们对牙科治疗的信心。
