Pediatric Dentistry · patient case question
A child receives 25 percent nitrous oxide with oxygen and remains fully responsive to verbal command. What level of sedation is this?
Patient case: A young patient in the mixed dentition
demo: 5-year-old female
chief: Routine examination. Her mother is worried that her front teeth are coming through early.
history: Healthy. The family moved recently from a community with fluoridated water to one with none. Her mother reports the older sibling had a similar early pattern.
meds: None.
findings: Both mandibular permanent central incisors are fully erupted. A 3 mm midline diastema is present in the maxilla between the primary central incisors. A periapical film of a maxillary lateral incisor shows an invagination of enamel and dentin extending into the pulp chamber.
Show answer and explanation
Correct answer: B. Minimal sedation, or anxiolysis
- A. Deep sedation means the patient is not easily roused and may need airway support.
- B. Correct. Minimal sedation is a drug-induced state in which the patient responds normally to verbal command. Cognition and coordination may be impaired but ventilation and cardiovascular function are unaffected. Nitrous oxide at these concentrations reliably produces this level, which is why it is the most widely used sedative in paediatric dentistry.
- C. Moderate sedation, previously called conscious sedation, means purposeful response to repeated or painful stimulation with a maintained airway.
- D. A pharmacological agent has been administered and is producing an anxiolytic effect, so this is sedation, just at its lightest level.
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