Dental treatment in young handicapped patients. An assessment of relative analgesia as an alternative to general anaesthesia.

A trial was undertaken to assess the suitability of oxygen/nitrous oxide sedation (relative analgesia) for dental treatment in unmanageable handicapped young patients. Fifty patients with chronological ages 5-22 years and mental ages 1 1/2-14 years participated in the double blind trial to see if premedication with diazepam 0.2 mg/kg would be a useful adjunct. After the trial, previous dental histories and behaviour at regular recall visits over the next 12-18 months were studied. Seventeen of 19 patients previously treated with general anaesthesia and 27 of 31 formerly untreated patients accepted treatment in the trial; of the 50 patients, 33 are continuing treatment with oxygen/nitrous oxide sedation, seven need general anaesthesia and 10 have moved from the district. It appears that the use of diazepam premedication improves patient demeanour and operating conditions although this improved effect is not carried over to recall visits. The results obtained indicate that routine dental procedures can be safely carried out by an experienced operator-sedationist in young handicapped patients using oxygen/nitrous oxide sedation. The frequency with which potentially hazardous techniques need to be used can be reduced, as can hospital admissions.