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Pediatric pain can be inadequately assessed and often goes untreated. 1 – 3 Many studies address adult dental pain but few focus on children. Clinicians often assume that children do not perceive pain to the same magnitude as adults. 1 Clinical trials have demonstrated that parents underestimate their child's pain when compared with the child's self-reported pain. 4 , 5 Additional barriers to appropriate pediatric pain management include false assumptions that: (1) analgesics are not needed, (2) children do not remember painful

medication. 2 Intranasal sedation is increasingly being used by anesthetists in the United States as a premedication prior to general anesthesia. 4 INS has not been recommended in the South African Society of Anaesthesiologists pediatric sedation guidelines because of the burning sensation and bitter taste experienced by children during INM administration. 5 However, INM enables rapid onset of sedation and provides the shortest recovery period than any other route of sedation. INM may therefore prove to be a viable route of sedation for pediatric emergency dental

The treatment of preschool children with early childhood caries is recognized as a significant public health issue. 1 – 3 For a select few pediatric dental patients, nonpharmacologic and minimal or pharmacologic interventions with moderate sedation are not appropriate or adequate for the pediatric dentist to achieve comprehensive care. In this group of pediatric dental patients, deep sedation or general anesthesia is the treatment of choice because of the patient's extensive treatment needs, acute situational anxiety, uncooperative age-appropriate behavior

approximately 1 million young children required anesthetic management to facilitate their dental treatment. 5 The guidelines of the American Academy of Pediatric Dentistry outline the specific populations in which deep sedation/general anesthesia (GA) is indicated. These include children and patients with special needs requiring extensive treatment and those with acute situational anxiety, uncooperative age-appropriate behavior, immature cognitive functioning, disabilities, or medical conditions that require deep sedation/general anesthesia. 6 In 2012, the Pediatric Oral

INTRODUCTION Pediatric patients often require general anesthesia (GA) during dental treatment because of uncooperative behavior that can stem from a lack of psychological or emotional maturity and/or mental, physical, or medical disability. 1 The use of GA for dental treatment is considered an acceptable and desirable option for parents and practitioners. 2 , 3 In North America, dental patients may receive treatment under GA in different surgical venues, including a hospital operating room (H-OR), an ambulatory surgery center (ASC

the most commonly used pediatric enteral moderate sedation technique with midazolam can be as short as 20–30 minutes, be only partially effective but allow treatment completion, or be ineffective. If the treatment plan cannot be completed in 1 sedation visit, alternatives may include physical immobilization, using a different moderate sedation technique, or GA. Supplemental dosing with additional or different oral medication(s) is ill advised for moderate sedation because gastric absorption is very unpredictable and unintended deep sedation is more likely. With GA

Dental caries is the most prevalent chronic disease in the pediatric population, and approximately 40% of children are affected by dental caries by the time they reach kindergarten. 1 Thus, the need to treat dental caries and improve a child’s overall health at a young age is imperative. High levels of fear and anxiety in young children toward dental treatment may require pharmacologic interventions to permit safe and effective care. 2 Oral administration of anxiolytics, opioids, and/or sedative-hypnotics, often in combination with inhalational sedation

Office-based sedation and anesthesia is a critical component of the modern pediatric dental practice. This is especially true for the management of special populations that include patients with cognitive impairments, developmental delay, precooperative age, and other conditions that limit the effectiveness of behavior management techniques. Some pediatric dentists provide minimal or moderate sedation while simultaneously performing dentistry. Although this practice has been a cornerstone of pediatric dental practice for generations, there are limitations

have not been shown to be statistically significant. 10 , 12 , 13 To the best of our knowledge, no well-designed clinical trials have been conducted to assess the cardiovascular effects of topical epinephrine on gingival tissue in a pediatric population. The purpose of this pilot study was to determine the cardiovascular safety and hemostatic efficacy of topical racemic epinephrine compared to placebo. The primary objective was to determine if topical racemic epinephrine had any effect on heart rate (HR) or blood pressure in children receiving dental care

in dentistry and their ability to potentially cause methemoglobinemia, dental practitioners need more information on the disorder and its toxic manifestations. It is particularly important that dental clinicians treating pediatric dental patients use dosing guidelines that preclude clinical toxicity. The purpose of this study was to measure and compare the peak (maximum) methemoglobin levels achieved and the lengths of time to peak methemoglobin levels following the use of injectable prilocaine and lidocaine during comprehensive dental rehabilitation in