Correlation Between Body Movements and Salivary Secretion During Sedation
During dental sedation, control of the cough reflex is crucial for a safe and smooth procedure. Accumulated saliva is one of the predisposing factors for coughing. Body movements during dental sedation appear to enhance salivation. Therefore, the aim of this study was to investigate the difference in salivary secretion between the with-movements state and the without-movements state during sedation. Salivary weight for 1 min was measured 3 times in 27 patients with intellectual disability during dental treatment under deep sedation with midazolam and propofol. The observed variables were body movements, bispectral index (BIS), and predicted propofol effect-site concentration. A total of 81 measurements were classified into the with-movements state (n = 39; ie, measurements during which body movements were observed) or the without-movements state (n = 42; ie, measurements during which no body movements were observed). The median salivary weight was significantly smaller in the without-movements state compared with the with-movements state (0.03 vs 0.11 g, P < .0001). The BIS was significantly lower in the without-movements state. There was no significant difference in the predicted propofol effect-site concentration between the 2 states. Significant correlation was observed between salivary weight and BIS in the with-movements state (r = 0.44, P = .004). The findings indicate that salivary secretion decreased according to deep sedation. Furthermore, immobility also reduced salivary secretion. We concluded that one reason that immobility is beneficial is because of the resulting decreased salivary secretion during dental treatment under deep sedation.

Experimental protocol.

Box plots of salivary weight in without-movements and with-movements states. Boxes indicate the median and 25% (bottom box; Q1) and 75% (top box; Q3), upper whiskers indicate Q3 + 1.5 interquartile range (IQR); lower whiskers indicate Q1 − 1.5 IQR. * indicates significant differences (P < .0001).

Scatter plots of bispectral index (BIS) versus salivary weight in (A) without-movements (closed circles) and (B) with-movements (open circles) states.

(A) Picture of Coolex. (B) Picture of Coolex placed on the right upper dentition.
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