Sedação consciente: suas possibilidades em odontopediatria

Abstract

Fear and anxiety are closely related to dental treatment and, unfortunately, in the child population this factor assumes an increased magnitude, often translating negatively in the child's behavior, compromising or even making the procedures unfeasible. The dental treatment of pediatric patients with behavioral problems can be a real challenge for the dental surgeon, and the traditional non-pharmacological behavioral control techniques are not always sufficient to achieve the cooperation of the child, and in many cases, it is necessary to combine them with pharmacological techniques. Thus, the present study aims to describe the conscious sedation alternatives safely employed in the management of fear and anxiety in pediatric dentistry. This is a descriptive literature review, based on scientific productions selected from the main health databases, such as the National Library of Medicine National Institutes oh Health (Pubmed), Scientific Electronic Library Online (Scielo), VHL (Virtual Health Library), Lilacs (Latin American Health Sciences Literature), and Google Scholar. The descriptors used were: "conscious sedation", "odontopediatrics", "oral sedation", "inhalational sedation", "intranasal sedation", and their combinations as PubMed. Conscious sedation is used in pediatric dentistry as a pharmacological behavioral control technique, which aims to induce in children a minimal state of depressed consciousness, making them able to cooperate and enabling the necessary treatments to be carried out safely. The routes of administration of commonly used sedative agents can be divided into two groups, as enteric route: (oral, sublingual, rectal); and parenteral route (intranasal, inhalation, intramuscular and intravenous). The drugs and techniques used to provide conscious sedation must have a safety margin large enough to make loss of consciousness unlikely. Thus, the level of sedation must be such that the patient remains conscious, maintains protective reflexes, and is able to understand and respond to verbal commands. Conscious sedation is a viable method, and when well indicated, it is considered safe. Its role in dentistry has been consolidated over time, due to its numerous benefits.