Use of practice sedation interventions in dentistry: a clinical retrospective study

Sedation is widely used in uncooperative patients, patients with special needs, severe anxiety, and dental phobia to facilitate dental treatment. This study aimed to present data regarding our experience with the sedation approaches for different types of dental treatments. The medical records of 1267 patients receiving dental treatment under sedation were reviewed retrospectively. Demographic data, American Society of Anesthesiologists (ASA) classification, duration of anesthesia, sedation agents used, oral disorders, type of dental treatment, comorbid diseases, and complications were recorded. Among the patients evaluated, 618 were classified as ASA I, 618 as ASA II, and 31 as ASA III. Furthermore, 396 (31.3%) patients with mental disability were identified. The most common comorbid diseases were psychiatric and neurologic diseases ( n = 84;6.6%) and cardiovascular diseases ( n = 94;7.4%), respectively. Three hundred ninety-six patients (31.3%) had dental phobias, and 53 patients (4.2%) had gag reflexes. Dental caries was the most common oral disorder ( n = 1088; 85.8%). The majority of the patients received surgical procedures ( n = 1142;90.1%). Tooth extraction was the most commonly performed surgical procedure. Midazolam ( n = 1093;86.2%) and nitrous oxide ( n = 451;35.6%) were the most commonly used intravenous and inhalation agents, respectively. Eight hundred fifty-eight patients (76.6%) were treated under single sedation. The complication rate was 1.4%. Complications included syncope, spasm, arrhythmia, nausea-vomiting, bradycardia, convulsion, and arrest. Our results in the oral and maxillofacial surgery clinic revealed low complication and failure rates, confirming previous findings. With a multidisciplinary approach between the dental and anesthesia team, dental treatments can be performed in a safer and more comfortable way in patients with systemic diseases, special needs, or dental phobia.