Explanatory models of co-morbid traits related to dental anxiety (DA) as described in the literature were tested and relative strengths analyzed in two groups of Danish adults, one with psychiatric diagnoses (n = 108)...Explanatory models of co-morbid traits related to dental anxiety (DA) as described in the literature were tested and relative strengths analyzed in two groups of Danish adults, one with psychiatric diagnoses (n = 108) and the other healthy incoming patients at a large dental school teaching clinic (n = 151). Dental Anxiety Scale (DAS) and self-report measures representing three co-morbidity explanatory models, 1) presence of other fears;2) anxiety sensitivity and 3) feelings of vulnerability specific to dental treatment, were collected in subscales of a 53-item questionnaire. Other items identified gender, age, education, income, avoidance behavior and dental symptoms. Frequency, chi-square, odds ratio and logistic regression analyses were performed. Results: All individuals with high DA (DAS > 13) regardless of group, demonstrated significant differences in avoidance of treatment (>2 yr.) versus lower or no anxiety. Patients with psychiatric diagnoses were three times more likely to have high DA and nearly two times more likely to have avoided dental treatment >2 yr.;25.9% reported extreme DA, compared to 9.3% of controls. Models of high general fear levels, predisposing anxiety sensitivity and vulnerability all demonstrated significant and strong association with intensity of dental anxiety in bivariate analyses. Feelings of vulnerability were the strongest predictor of DAS high anxiety, according to logistic regression analyses. Conclusion: Co-morbidity explanatory models as represented in present trait measures appear not to be competitive, but rather explain different aspects of a vulnerability model in high dental anxiety. Higher incidence of DA and treatment avoidance in psychiatric patients requires special attention.展开更多
Objective To evaluate the effect of midazolam alone on sedation in young children for dental restorative care. Methods Forty children, aged 5 to 10 years with a mean age of 7.3 years, participated in this study. Twent...Objective To evaluate the effect of midazolam alone on sedation in young children for dental restorative care. Methods Forty children, aged 5 to 10 years with a mean age of 7.3 years, participated in this study. Twenty-one patients were assigned to intervention group received 0. 5 mg/kg of oral midazolam 20 minutes prior to the beginning of dental treatment, and 19 patients in control group received placebo liquid 20 minutes before treatment. All patients received painless local anesthetic injection and were restrained with children＇s board and bands. Blood pressure （ BP）, heart rate （HR）, oxygen saturation, treatment compliance scores of the Ramsay scale, the Briekopf and Butmer scale, Frankl scale, and the Houpt scale were recorded. Each procedure was taped and all the data were evaluated every 5 minutes by an anesthetist or experienced dentist who was unaware of the drug given to the child. Results HR in intervention group （82. 5 ± 5.1 bpm） was much lower than that in control group （95.2 ± 8.9 bpm; F=31.20, P 〈0. 001 ）. Intervention group had a significantly lower systolic BP level （94.8±5.6 mmHg） than control group （98.5±5.5 mm Hg; F=4. 34, P =0. 04）, but the diastolic BP （63.0 ± 3.5 mm Hg） was not significantly lower than control group （ 65.5 ± 4. 8 mm Hg; F = 3.31, P = 0. 07 ）. Children in intervention group showed more compliance. The patients＇ scores of the Ramsay scale, Briekopf and Buttner scale, Frankl scale, and Houpt scale in intervention group （ 1.37 ± 0. 96, 1.37 ± 0. 83, 1.32 ± 0. 67, and 2. 32 ± 1.49, respectively） were significantly lower than those in control group （3.71 ± 1.23, 2.71 ± 0. 96, 2.71 ± 0. 90, and 4.71 ± 1.19 ; F = 44. 66, 22. 36, 30.39,and 31.88,respectively,all P〈0.001） Conclusions Oral midazolam alone is safe and produces effective sedation for the dental treatment of young children. Oral midazolam application should be generally preferred because it is more easily accepted by pediatric patients.展开更多
文摘Explanatory models of co-morbid traits related to dental anxiety (DA) as described in the literature were tested and relative strengths analyzed in two groups of Danish adults, one with psychiatric diagnoses (n = 108) and the other healthy incoming patients at a large dental school teaching clinic (n = 151). Dental Anxiety Scale (DAS) and self-report measures representing three co-morbidity explanatory models, 1) presence of other fears;2) anxiety sensitivity and 3) feelings of vulnerability specific to dental treatment, were collected in subscales of a 53-item questionnaire. Other items identified gender, age, education, income, avoidance behavior and dental symptoms. Frequency, chi-square, odds ratio and logistic regression analyses were performed. Results: All individuals with high DA (DAS > 13) regardless of group, demonstrated significant differences in avoidance of treatment (>2 yr.) versus lower or no anxiety. Patients with psychiatric diagnoses were three times more likely to have high DA and nearly two times more likely to have avoided dental treatment >2 yr.;25.9% reported extreme DA, compared to 9.3% of controls. Models of high general fear levels, predisposing anxiety sensitivity and vulnerability all demonstrated significant and strong association with intensity of dental anxiety in bivariate analyses. Feelings of vulnerability were the strongest predictor of DAS high anxiety, according to logistic regression analyses. Conclusion: Co-morbidity explanatory models as represented in present trait measures appear not to be competitive, but rather explain different aspects of a vulnerability model in high dental anxiety. Higher incidence of DA and treatment avoidance in psychiatric patients requires special attention.
文摘Objective To evaluate the effect of midazolam alone on sedation in young children for dental restorative care. Methods Forty children, aged 5 to 10 years with a mean age of 7.3 years, participated in this study. Twenty-one patients were assigned to intervention group received 0. 5 mg/kg of oral midazolam 20 minutes prior to the beginning of dental treatment, and 19 patients in control group received placebo liquid 20 minutes before treatment. All patients received painless local anesthetic injection and were restrained with children＇s board and bands. Blood pressure （ BP）, heart rate （HR）, oxygen saturation, treatment compliance scores of the Ramsay scale, the Briekopf and Butmer scale, Frankl scale, and the Houpt scale were recorded. Each procedure was taped and all the data were evaluated every 5 minutes by an anesthetist or experienced dentist who was unaware of the drug given to the child. Results HR in intervention group （82. 5 ± 5.1 bpm） was much lower than that in control group （95.2 ± 8.9 bpm; F=31.20, P 〈0. 001 ）. Intervention group had a significantly lower systolic BP level （94.8±5.6 mmHg） than control group （98.5±5.5 mm Hg; F=4. 34, P =0. 04）, but the diastolic BP （63.0 ± 3.5 mm Hg） was not significantly lower than control group （ 65.5 ± 4. 8 mm Hg; F = 3.31, P = 0. 07 ）. Children in intervention group showed more compliance. The patients＇ scores of the Ramsay scale, Briekopf and Buttner scale, Frankl scale, and Houpt scale in intervention group （ 1.37 ± 0. 96, 1.37 ± 0. 83, 1.32 ± 0. 67, and 2. 32 ± 1.49, respectively） were significantly lower than those in control group （3.71 ± 1.23, 2.71 ± 0. 96, 2.71 ± 0. 90, and 4.71 ± 1.19 ; F = 44. 66, 22. 36, 30.39,and 31.88,respectively,all P〈0.001） Conclusions Oral midazolam alone is safe and produces effective sedation for the dental treatment of young children. Oral midazolam application should be generally preferred because it is more easily accepted by pediatric patients.
