Pediatric dental treatment under deep sedation in a hospital outpatient-clinic

Background: In providing oral health care for infants, children, adoles¬cents, and children with special needs, a continuum of both nonpharmacological and pharmacological behavior guidance techniques may be used. Intravenous sedation is a safe and easy option for providing pediatric dental treatment for uncooperative young healthy children and children with special needs. Objectives: Recount our experience in providing pediatric dental treatment under deep IV sedation with spontaneous ventilation in a hospital outpatient-clinic setting, which may become a preferable in these cases. Methods: 94 young healthy children and children with special needs aged 1 to 16 years (mean=3 years) underwent dental treatment under deep IV sedation due to lack of cooperation capabilities. About half (50.62%) of the children were either physically and/or mentally disabled or suffered from oral and maxillofacial malformations such as cleft lip and palate (20.92%) and micrognathia resulting in sleep apnea (11.15%). Results: A total of 1050 procedures were successfully completed according to preplanned dental treatment. None of the procedures were interrupted for any reason associated with the deep IV sedation technique. No clinically-significant adverse events (aspiration, laryngospasm, respiratory failure, cardiac arrest) were recorded during any of the reviewed procedures, which included: tooth extractions (194), pulp treatment (92), stainless steel crowns (211), dental tooth restoration (378) and pit and fissure sealants (175). Conclusion: Deep IV sedation under spontaneous ventilation, performed by a trained anesthesiologist, in a hospital outpatient setting may serve as a safe and easy alternative method for pediatric dental treatment on uncooperative young healthy, syndrome-affected or medically compromised children.