The evaluation of child behavior during dental examination and treatment using predmedication and placebo.

The purpose of this study were to determine the association of scores on the North Carolina Behavior Rating Scale (NCBRS) to those of the Frankl scale during restorative visits; and to quantify and compare rated behavior of children during an oral examination and restorative visits involving either a placebo or a combination of chloral hydrate (CH) and hydroxyzine. Fifteen patients 21-37 months old participated in this institutionally approved study. The study was a double-blind, crossover design. Following an examination using a mirror, explorer, and prophylaxis cup, the child received either a placebo or a combination of chloral hydrate (CH) and hydroxyzine. Fifteen patients 21-37 months old participated in this institutionally approved study. The study was a double-blind, crossover design. Following an this institutionally approved study. The study was a double-blind, crossover design. Following an examination using a mirror, explorer, and prophylaxis cup, the child received either a placebo or a combination of chloral hydrate and hydroxyzine. The sequence was reversed at the next appointment. All exam and treatment visits were videotaped and analyzed using the NCBRS. In addition, all treatment visits were rated with the Frankl scale. The data were analyzed using a repeated ANOVA and correlation coefficients. The results showed a high interrater reliability (> 86% agreement) and a significant correlation between the NCBRS and Frankl scale (P < 0.001). No significant difference was found for the amount of disruptive behavior among oral examination, placebo, and medication visits (P < or = 0.097), although a consistent decrease in mean disruptive behavior for that order of visits was observed most frequently.(ABSTRACT TRUNCATED AT 250 WORDS)

Electromyography: its potential as an adjunct to other monitored parameters during conscious sedation in children receiving dental treatment.

The purpose of this study was to evaluate the effect of a combination of a low dose of chloral hydrate and hydroxyzine on the frontalis muscle electromyogram in addition to other physiologic parameters in pediatric dental patients. A double blind, two-appointment cross-over design was used. Either a placebo or a combination of chloral hydrate and hydroxyzine was given to children during the first visit with the sequence of placebo/drug conditions being randomly determined. During the second visit, the children received that agent not given during the first visit. Baseline physiologic data was obtained at the beginning of each visit and the physiologic measures were again recorded during topical and local anesthesia administration, high-speed tooth preparation, and at the end of the dental appointment. The results indicated that the frontalis muscle activity and cardiovascular parameters were significantly affected by the drug and dental procedures. Oxygen saturation was least affected. The frontalis muscle appears to be a sensitive physiologic parameter to monitor during conscious sedation as an index of the amount of patient relaxation.