Children’s experiences with conscious sedation in dental care: a Norwegian cross-sectional study
DOI:
https://doi.org/10.2340/aos.v84.44807Keywords:
Conscious sedation, pediatric dentistry, dental anxietyAbstract
Objective: This study explores how 9- and 17-year-olds in Norway experience conscious sedation during dental treatment, examining its impact on treatment ease, perceived ability to refuse, and memory retention.
Material and methods: A cross-sectional electronic questionnaire was distributed to 13,013 children and adolescents (6,686 9-year-olds and 6,327 17-year-olds) in the Public Dental Service of Hordaland County, Norway, in 2019. Response rates were 65.6% for 9-year-olds and 52.2% for 17-year-olds. The survey included validated instruments for dental fear and nonvalidated items assessing subjective sedation experiences. Data were analyzed using descriptive statistics, chi-squared tests, and Mann–Whitney U-tests.
Results: Of the respondents, 13.6% (n = 596) of the 9-year-olds and 9.5% (n = 313) of the 17-year-olds reported having undergone dental treatment with conscious sedation. Among them, 67.4% felt sedation made treatment easier, while 8.5% found it difficult to refuse treatment under sedation. A total of 51.2% remembered the treatment, and memory retention was associated with higher levels of dental fear (p < 0.001).
Conclusion: While conscious sedation is perceived to facilitate dental treatment for many children, a large proportion retain memories of the treatment, particularly those with high dental fear. This highlights the importance of understanding children’s subjective experiences to improve sedation practices.
Downloads
References
Klingberg G, Broberg AG. Dental fear/anxiety and dental behaviour management problems in children and adolescents: a review of prevalence and concomitant psychological factors. Int J Paediatr Dent. 2007;17(6):391–406. https://doi.org/10.1111/j.1365-263X.2007.00872.x DOI: https://doi.org/10.1111/j.1365-263X.2007.00872.x
Berggren U, Meynert G. Dental fear and avoidance: causes, symptoms, and consequences. J Am Dent Assoc. 1984;109(2):247–51. https://doi.org/10.14219/jada.archive.1984.0328 DOI: https://doi.org/10.14219/jada.archive.1984.0328
Marques C, Dinis M, Machado V, Botelho J, Lopes LB. Evaluating the quality of systematic reviews on pediatric sedation in dentistry: an umbrella review. J Clin Med. 2024;13(12):3544. https://doi.org/10.3390/jcm13123544 DOI: https://doi.org/10.3390/jcm13123544
Ashley P, Anand P, Andersson K. Best clinical practice guidance for conscious sedation of children undergoing dental treat-ment: an EAPD policy document. Eur Arch Paediatr Dent. 2021;22(6):989–1002. https://doi.org/10.1007/s40368-021-00660-z DOI: https://doi.org/10.1007/s40368-021-00660-z
Attri JP, Sharan R, Makkar V, Gupta KK, Khetarpal R, Kataria AP. Conscious sedation: emerging trends in pediatric dentistry. Anesth Essays Res. 2017;11(2):277. https://doi.org/10.4103/0259-1162.171458 DOI: https://doi.org/10.4103/0259-1162.171458
Inchingolo F, Inchingolo AM, Ferrante L, de Ruvo E, Di Noia A, Palermo A, et al. Pharmacological sedation in paediatric dentis-try. Eur J Paediatr Dent. 2024:1. Sep 3;25(3):230-237 https://doi.org/10.23804/ejpd.2024.2204
Rienhoff S, Splieth CH, Veerkamp JSJ, Rienhoff J, Krikken JB, Campus G, et al. Hypnosis and sedation for anxious children undergoing dental treatment: a retrospective practice-based longitudinal study. Children. 2022;9(5):666. https://doi.org/10.3390/children9050611 DOI: https://doi.org/10.3390/children9050611
Viana KA, Daher A, Maia LC, Costa PS, Martins CC, Paiva SM, et al. What is the level of evidence for the amnestic effects of sedatives in pediatric patients? A systematic review and meta-analyses. PLoS One. 2017;12(7):e0180248. https://doi.org/10.1371/journal.pone.0180248 DOI: https://doi.org/10.1371/journal.pone.0180248
Aarvik RS, Svendsen EJ. Agdal ML. Held still or pressured to receive dental treatment: self-reported histories of children and adolescents treated by non-specialist dentists in Hordaland, Norway. Eur Arch Paediatr Dent. 2022;23(4):609–18. https://doi.org/10.1007/s40368-022-00724-8 DOI: https://doi.org/10.1007/s40368-022-00724-8
Lov om pasient- og brukerrettigheter (pasient- og brukerrettighetsloven) [Internet]. Lovdata; 1999 [cited 2025 Jan 28]. Availa-ble from: https://lovdata.no/dokument/NL/lov/1999-07-02-63/
Statistics Norway. Areal og befolkning i tettsteder, etter region, statistikkvariabel og år [Area and population in densely popu-lated areas, by region, statistical variable and year] [Internet]. 2019 [cited 2025 Jan 28]. Available from: https://www.ssb.no/statbank/table/04860/tableViewLayout1/
Statistics Norway. Income and wealth statistics for households [Internet]. 2019 [cited 2025 Jan 28]. Available from: https://www.ssb.no/en/statbank/table/06944/tableViewLayout1/
Lov om tannhelsetjenesten (tannhelsetjenesteloven) [Internet]. Lovdata; 1983 [cited 2025 Jan 28]. Available from: https://lovdata.no/dokument/NL/lov/1983-06-03-54/
Statistics Norway. Spesialistutdanning. 4. kvartal, etter spesialitet, alder, statistikkvariabel, år og kjønn [Specialist education. 4th quarter, by specialty, age, statistical variable, year, and gender] [Internet]. 2019 [cited 2025 Jan 28]. Available from: https://www.ssb.no/statbank/table/07935/tableViewLayout1
Helsedirektoratet. Lokal anestesi, smertestillende legemidler, sedasjon eller generell anestesi (narkose) ved tannbehandling av barn og unge [Local anaesthesia, analgesics, sedation or general anaesthesia in dental treatment of children and adole-scents] [Internet]. [cited 2025 Jun 24]. Available from: https://www.helsedirektoratet.no/retningslinjer/tannhelsetjenester-til-barn-og-unge-020-ar/lokal-anestesi-smertestillende-legemidler-sedasjon-eller-generell-anestesi-ved-tannbehandling-av-barn-og-unge
Gustafsson A, Arnrup K, Broberg AG, Bodin L, Berggren U. Child dental fear as measured with the Dental Subscale of the Children’s Fear Survey Schedule: the impact of referral status and type of informant (child versus parent). Community Dent Oral Epidemiol. 2010;38(3):256–66. https://doi.org/10.1111/j.1600-0528.2009.00521.x DOI: https://doi.org/10.1111/j.1600-0528.2009.00521.x
Berge KG, Vika M, Agdal ML, Lie SA, Skeie MS. Reliability, validity and cutoff score of the Intra-Oral Injection Fear scale. Int J Paediatr Dent. 2017;27(2):98–107. https://doi.org/10.1111/ipd.12237 DOI: https://doi.org/10.1111/ipd.12237
Jensen B, Schröder U. Acceptance of dental care following early extractions under rectal sedation with diazepam in preschool children. Acta Odontol Scand. 1998;56(4):229–32. https://doi.org/10.1080/00016359850142844 DOI: https://doi.org/10.1080/00016359850142844
Aarvik RS, Agdal ML, Svendsen EJ. Restraint in paediatric dentistry: a qualitative study to explore perspectives among public, non-specialist dentists in Norway. Acta Odontol Scand. 2021;79(6):443–50. https://doi.org/10.1080/00016357.2021.1881159 DOI: https://doi.org/10.1080/00016357.2021.1881159
Öst LG, Clark DM. Cognitive behaviour therapy. In: Cognitive behaviour therapy for dental Phobia and anxiety. Chichester: John Wiley & Sons; 2013. p. 89–107. DOI: https://doi.org/10.1002/9781118499825.ch7
Lourenço-Matharu L, Papineni McIntosh A, Lo JW. Predicting children’s behaviour during dental treatment under oral seda-tion. Eur Arch Paediatr Dent. 2016;17(3):157–63. DOI: https://doi.org/10.1007/s40368-015-0205-9
Kohli N, Hugar S, Soneta S, Saxena N, Kadam K, Gokhale N. Psychological behavior management techniques to alleviate den-tal fear and anxiety in 4–14-year-old children in pediatric dentistry: a systematic review and meta-analysis. Dent Res J. 2022;19(6):47. DOI: https://doi.org/10.4103/1735-3327.346405
Kong X, Song N, Chen L, Li Y. Non-pharmacological interventions for reducing dental anxiety in pediatric dentistry: a network meta- analysis. BMC Oral Health. 2024;24(1):1151. https://doi.org/10.1186/s12903-024-04919-x DOI: https://doi.org/10.1186/s12903-024-04919-x
Krosnick JA, Presser S. Question and questionnaire design. In: Marsden PV, Wright JD, editors. Handbook of survey research. 2nd ed. Bingley, UK: Emerald Group Publishing; 2010. p. 285–288.
Aarvik RS. Restraint in pediatric dentistry in the Norwegian Public Dental Service. dissertation. Oslo: University of Oslo; 2022.
Tisnado DM, Adams JL, Liu H, Damberg CL, Hu FA, Chen WP, et al. Does the concordance between medical records and pa-tient self-report vary with patient characteristics? Health Serv Outcomes Res Methodol. 2006;6(3):157–75. https://doi.org/10.1097/01.mlr.0000196952.15921.bf DOI: https://doi.org/10.1007/s10742-006-0012-1
Hauge MS, Stora B, Willumsen T. Dental anxiety treatment by a dentist in primary care: a 1-year follow-up study. Eur J Oral Sci. 2022;130(4):e12872. DOI: https://doi.org/10.1111/eos.12872
Published
Issue
Section
License
Copyright (c) 2025 Regina Skavhellen Aarvik, Edel Jannecke Svendsen, Maren Lillehaug Agdal
This work is licensed under a Creative Commons Attribution 4.0 International License.
Acta Odontologica Scandinavica publishes original research papers as well as critical reviews relevant to the diagnosis, epidemiology, health service, prevention, aetiology, pathogenesis, pathology, physiology, microbiology, development and treatment of diseases affecting tissues of the oral cavity and associated structures including papers on cause and effect or explanatory/associative relationships for experimental or observational studies.
