Dentoalveolar oral surgery in children and adolescents: organization and surgical treatment in a large, Danish municipal dental service.

OBJECTIVE: To describe a population-based organization of dentoalveolar surgical service for 0 to 18-year old subjects in a Danish municipal dental service, and analyze the type of dentoalveolar surgical interventions needed. MATERIAL AND METHODS: The study was conducted in the Municipality of Aarhus, Denmark during five consecutive school-years. An internal referral system was established within the municipality where patients could be referred to colleagues with a higher level of competencies and more experiences with paediatric dentoalveolar surgery. The analysis includes a total of 1812 children and a total of 2854 surgical interventions. RESULTS: Almost 80% of the patients, representing more than 80% of the dentoalveolar surgical interventions needed, were referred internally. Denudations were the most frequent treatment type (40.3%) carried out, followed by removal of third molars (18.0%). Furthermore, 22 odontomas and 100 supernumerary teeth were removed. CONCLUSIONS: The need of dentoalveolar surgery in children and adolescents is relatively low, but includes a wide range of interventions. An organizational system, where dentists can refer to colleagues who have developed special competencies in this field, results in most of these surgical patients being referred and treated internally.

A placebo-controlled, double-blind, crossover trial on analgesic effect of nitrous oxide-oxygen inhalation.

BACKGROUND: The sedative effect of nitrous oxide-oxygen (N2 O/O2 ) inhalation is relatively well established. Less in known about its analgesic effect. AIM: To determine the analgesic effect of N2 O/O2 inhalation on pulp sensitivity and jaw muscle pressure pain threshold in children. DESIGN: A placebo-controlled, double-blind, crossover trial with random allocation to two sequences: atmospheric air at the first session and N2 O/O2 at the second; or N2 O/O2 at the first session and atmospheric air at the second. Measurements included reaction time, pulp pain sensitivity, jaw muscle pressure pain thresholds and a VAS score of overall discomfort from the pain tests. RESULTS: Fifty-six children (12-15 years) completed the study. N2 O/O2 inhalation increased reaction time (P < 0.001). Pulp pain sensitivity was reduced during N2 O/O2 inhalation (P < 0.001), but no effect was found after adjustment for the increased reaction time. Pressure pain threshold on the jaw muscle was also reduced during N2 O/O2 inhalation (P < 0.001), also after adjustment for reaction time (P < 0.005). An effect was still found 10 min after the mask had been removed (P = 0.03). No effect on VAS scores of discomfort from the tests could be found. CONCLUSIONS: No analgesic effect of N2 O/O2 inhalation on pulp pain sensitivity was found, whereas an increased pressure pain threshold of jaw muscles was found.