A randomized clinical trial of agents to reduce sensitivity after crown cementation.

Three desensitizing agents were evaluated for the control of sensitivity after cementation of 77 crowns. Information was collected on pain in response to hot, cold, or bite preoperatively; and postoperatively with temporary crowns at one week and at one month after cementation of crowns. No medicament was clearly better than the placebo.

Electronic anesthesia versus topical anesthesia for the control of injection pain.

The ability of a dental transcutaneous electronic nerve stimulator to control pain from injection of local anesthesia was compared to the pain-controlling ability of topical anesthesia. Two maxillary infiltration injections were completed on 21 patients, one injection after electronic anesthesia, the other after topical anesthesia. Patients reported the level of pain caused when the needle pierced their tissue and the solution was injected and their overall evaluation of the injection. No difference was reported for piercing of the tissue; however, the level of pain was very low. Significantly less pain was reported for the injection of local anesthesia solution and the overall evaluation of the injection was more favorable when electronic anesthesia was used. The patients preferred the electronic technique three to one over the topical anesthesia.

The efficacy and memory effects of oral triazolam premedication in highly anxious dental patients.

Triazolam (0.375 or 0.50 mg) or placebo was administered orally to 31 highly anxious dental patients in a double-blind clinical trial 1 hr before treatment. The drug was safe and highly effective, in comparison to placebo, in reducing both anxious cognitions and disruptive movement during oral injections of local anesthetic and drilling. Episodic memory and implicit memory were both adversely affected by the active drug but not the placebo.

Experience with triazolam in preschool children.

Triazolam (0.125 to 0.25 mg) was administered preoperatively to 17 unmanageable children aged 22 to 65 months. The children were monitored visually and by pulse oximeter. No child experienced any airway obstruction and none had oxygen saturation below 90%. Older children had lower SaO2 values than younger children. There was no relationship between the mg/kg dose and SaO2 values.

Clinical study of diffusion hypoxia after nitrous oxide analgesia.

In order to estimate the incidence of diffusion hypoxia, arterial oxygen saturation was measured in 104 healthy adult dental patients who were administered nitrous oxide-oxygen analgesia and who did not receive postcessation oxygen. Pretreatment saturation levels as determined by pulse oximetry ranged from 93% to 100%. When the nitrous oxide-oxygen administration ceased, the saturation levels were from 95% to 100%. The mean saturation dropped about 2% over the next 4 min and then stabilized. No patient had a posttreatment oxygen saturation of less than 92%.

The combined effect of nitrous oxide and oxygen and electrical stimulation during restorative dental treatment.

A total of 124 adult patients were treated with nitrous oxide (N2O) and oxygen (O2), an electrical analgesic, or a combination of N2O/O2 and an electrical analgesic during restorative dental procedures. The use of electrical analgesic or N2O/O2 without local anesthetics resulted in a high failure rate and poor patient acceptance. However, combining N2O/O2 sedation with electrically induced analgesia resulted in a statistically significant improvement over either technique used alone, and provided an overall 81% success rate when used during restorative dentistry.

Clinical experience with TENS and TENS combined with nitrous oxide-oxygen. Report of 371 patients.

Transcutaneous electrical nerve stimulation (TENS) alone or TENS combined with nitrous oxide-oxygen (N2O) was administered for restorative dentistry without local anesthesia to 371 adult patients. A total of 55% of TENS alone and 84% of TENS/N2O visits were rated successful. A total of 53% of TENS alone and 82% of TENS/N2O patients reported slight or no pain. In multivariable analyses, pain reports were related to the anesthesia technique and patient fear and unrelated to sex, race, age, tooth, or depth of preparation.

A premix of 50% nitrous oxide - 50% oxygen for sedation during dental procedures.

The use of a premixed source of 50% N(2)O and 50% O(2) diluted with room air was evaluated in a series of 32 patients undergoing a routine dental procedure. Dependent variables observed were the flow rates of gas necessary to achieve adequate sedation, patient acceptance of the administration method and clinical signs of hypoxia. The median flow rate observed when patients were sedated was 3 liters per minute (range 1 to 5 liters per minute). Twenty-four patients tolerated the dental procedure without need to alter the initial dose, 6 required an increased dose and 2 required less of the gas mixture. No clinical signs of diffusion hypoxia were noted in this small sample. The results of this open clinical evaluation suggest that use of a premixture of 50% N(2)O and 50% O(2) results in adequate sedation, is well tolerated by patients and dose not result in any clinically obvious signs of hypoxia.