IADR Abstract Archives
Sedation with orally administrated midazolam in dental patients suffering from severe dementia
Objectives:
In dentistry sedation with midazolam is a commonly used premedication within paediatric dentistry, oral surgery and in patients suffering from dental fear. Little is known on this topic in other patient groups. Therefore the aim of this study was to evaluate peroral sedation with midazolam in relation to dose, effect and other medications in patients with dementia.
Methods:
The patients included in the study were suffering from severe dementia (n=62, women 65%) They had been referred to a hospital dentistry unit in Sweden due to un-cooperative behaviour and sedated with midazolam per os between 2006-2011. Data concerning dose, degree of acceptance to dental treatment (four point scale: “full acceptance”=1 to “no acceptance”=4) and number of drugs were collected from dental records.
Results:
On average the patients were 80 years old (age: 62-93) and used 3.5 (SD=1.9) psychotropic drugs. The midazolam dose/kg of body weight was 0.11 (SD=0.03) and thus proved to follow the guidelines for sedation (<65 years: 0.2, >65 years: 0.1-0.15). Twenty-seven patients (44%) had no cooperative problems after sedation (grade 1) and 26 (42%) could be treated with minor adaptation to patients' reactions (grade 2). Dental treatment was impossible only in three patients (grade 4). No statistically significant differences were found for degree of acceptance to treatment and age, sex, dose, number of psychotropics or other interacting drugs. Ten patients used antiepileptics, a drug considered to cause decreased or no effect combined with midazolam. One of these patients was treated with difficulty and two were not treatable at all. In total, unfavourable side effects were rare, one patient became hyperactive and one drowsier than expected.
Conclusions: This study shows that orally administrated midazolam is a well-functioning method in dentistry in treatment of un-cooperative patients with dementia, despite many interacting drugs. However, medication with antiepileptic drugs might give slightly reduced success.
In dentistry sedation with midazolam is a commonly used premedication within paediatric dentistry, oral surgery and in patients suffering from dental fear. Little is known on this topic in other patient groups. Therefore the aim of this study was to evaluate peroral sedation with midazolam in relation to dose, effect and other medications in patients with dementia.
Methods:
The patients included in the study were suffering from severe dementia (n=62, women 65%) They had been referred to a hospital dentistry unit in Sweden due to un-cooperative behaviour and sedated with midazolam per os between 2006-2011. Data concerning dose, degree of acceptance to dental treatment (four point scale: “full acceptance”=1 to “no acceptance”=4) and number of drugs were collected from dental records.
Results:
On average the patients were 80 years old (age: 62-93) and used 3.5 (SD=1.9) psychotropic drugs. The midazolam dose/kg of body weight was 0.11 (SD=0.03) and thus proved to follow the guidelines for sedation (<65 years: 0.2, >65 years: 0.1-0.15). Twenty-seven patients (44%) had no cooperative problems after sedation (grade 1) and 26 (42%) could be treated with minor adaptation to patients' reactions (grade 2). Dental treatment was impossible only in three patients (grade 4). No statistically significant differences were found for degree of acceptance to treatment and age, sex, dose, number of psychotropics or other interacting drugs. Ten patients used antiepileptics, a drug considered to cause decreased or no effect combined with midazolam. One of these patients was treated with difficulty and two were not treatable at all. In total, unfavourable side effects were rare, one patient became hyperactive and one drowsier than expected.
Conclusions: This study shows that orally administrated midazolam is a well-functioning method in dentistry in treatment of un-cooperative patients with dementia, despite many interacting drugs. However, medication with antiepileptic drugs might give slightly reduced success.