PubMed Health⌕ Search

Biomedical subjects

N D Robb

Publications and source records attributed to N D Robb.

At least 19 recordsLinked to original sources
PubMed2004

A partially blinded randomised controlled trial of patient-maintained propofol sedation and operator controlled midazolam sedation in third molar extractions.

Patient-maintained sedation using propofol has recently been shown to be effective for dental surgery. We compared this new technique to the established technique of operator administered midazolam. The two groups were compared before, during and after sedation. The two primary outcomes were time until discharge and oxygen saturation. Vital signs, anxiety and psychomotor skills were also compared. State anxiety was reduced to a greater extent in the propofol group (mean difference 10 (SD 4) mm; p = 0.010. Propofol patients recovered quicker (mean difference 7 (SD 1.4) min; p = 0.001). Propofol patients had a smaller reduction in arterial oxygen saturation (mean difference 0.8 (SD 0.3)%; p = 0.030), and a reduced increase in heart rate (mean difference 9 (SD 2) beats.min(-1); p < 0.001). Both techniques were well tolerated and safe. Propofol sedation offered superior anxiolysis, quicker recovery, less amnesia and less depression of simple psychomotor function.

Adolescent↗
PubMed2003

Intravenous conscious sedation in patients under 16 years of age. Fact or fiction?

Recently published guidelines on the use of conscious sedation in dentistry have published varying recommendations on the lower age limit for the use of intravenous conscious sedation. There are a large number of dentists currently providing dental treatment for paediatric patients under intravenous conscious sedation. The 18 cases reported here (age range 11-15 years), were successfully managed with intravenous conscious sedation. The experience in this paper is not sufficient evidence to recommend the wholesale use of intravenous conscious sedation in patients who are under 16 years. The fact that a range of operators can use these techniques on paediatric patients would suggest that further study should be carried out in this population. The guidance should be modified to say there is insufficient evidence to support the use of intravenous conscious sedation in children, rather than arbitrarily selecting a cut off point at age 16 years.

Adolescent↗
PubMed1997

Postgraduate education in sedation--a new development.

Although demand for sedation courses has continued to increase, the traditionally theoretical format has tended to leave participants without the necessary clinical skills to practice sedation techniques with confidence. This article describes a new model of sedation course, introduced at Newcastle Dental Hospital and School, which has managed to overcome this problem.

Anesthesia, Dental↗
PubMed1997

The prevalence, etiology and management of tooth wear in the United Kingdom.

STATEMENT OF PROBLEM: Recent epidemiologic evidence suggests that tooth wear is now a significant problem in both children and adults. There is growing evidence that a major cause of severe wear in patients is regurgitation erosion due to a variety of factors including gastroesophageal reflux disease. PURPOSE: The purpose of this article is to discuss the prevalence of tooth wear in the United Kingdom. Emphasis in management should be on accurate diagnosis, and in some patients, long-term monitoring before embarking on any irreversible, interventive treatment. Even when treatment is necessary, a period of monitoring is helpful to assess the rate of progress of the wear, the effectiveness of preventive measures, and therefore the extent of the treatment necessary.

Adolescent↗
PubMed1997

Sedation in practice. 4: The use of sedation for the medically compromised patient.

This, the fourth paper in a series of uses of sedation in general dental practice, reviews the use of sedative techniques for patients who have medical conditions which will affect their ability to co-operate with dental treatment or which may be aggravated by the stress of treatment. Advice is given on a range of other conditions which may present as incidental findings when the patient's medical history is being taken.

Anesthesia, Dental↗
PubMed1996

Epileptic fits under intravenous midazolam sedation.

A case is presented of a patient who suffered from recurrent epileptic fits while being treated under intravenous sedation with midazolam. Those using sedation are advised to beware of the patient who gives a history of fits being provoked in the dental environment.

Adult↗
PubMed1996

The prevalence of toothwear in 1007 dental patients.

The dental profession is becoming increasingly concerned about unacceptable levels of toothwear and there is an impression that the condition is becoming more prevalent. There is, as yet, little epidemiological evidence to illuminate the question and so this study is therefore intended to provide baseline data on the prevalence of toothwear in a sample of the dental attending population of South East England. A degree of toothwear is normal and progresses throughout life. Toothwear which is acceptable in an older age group would not be so with younger patients. It is therefore necessary to designate threshold values of acceptable levels of toothwear for different age groups to reach realistic conclusions about the prevalence of unacceptable levels of toothwear. Of the 1007 patients examined only nine had completely unworn dentitions. More than 93,500 tooth surfaces were examined and of these 5.1% had wear which exceeded the threshold values. Despite increasing the threshold values for the older age groups from those proposed in an earlier study by Smith & Knight (1984), these patients still had higher levels of unacceptable toothwear. There was a slight tendency for men to have more wear than women, but there was no clinically significant relationship between the number of missing posterior teeth and wear of the anterior teeth.

Adult↗
PubMed1996

Sedation in dentistry. Part 1: assessment of patients.

This is the first in a series of articles on the uses of sedation in general dental practice. This paper reviews current recommendations for the practice of sedation, and the importance of patient assessment as a part of treatment. The dental and psychosocial indications, as well as medical contraindications, for sedation are discussed. Future articles will expand on other areas where sedation may be a useful tool in the general dental practitioner's armamentarium. It is hoped that these articles will encourage all practitioners to consider a wider use of sedative techniques in dentistry.

Adult↗
PubMed1996

Sedation in dentistry. Part 2: Management of the gagging patient.

Sedation should be considered as a useful part of the general dental practitioner's armamentarium and as an important alternative to general anaesthesia in selected cases. In this, one of a series of articles on the uses of sedation in various circumstances, the management of the gagging patient is discussed. The many factors involved in the aetiology of the hyperactive gag response are reviewed and measures for dealing with it suggested.

Adaptation, Psychological↗
PubMed1995

The parallel stripes mystery.

A series of artefacts seen on intra-oral radiographs are described. These have been shown to be caused by contamination from fixing solution on the clips used to hold the films during processing. Thorough cleaning of these clips between uses prevented recurrence of these artefacts.

Artifacts↗
PubMed1995

The distribution of erosion in the dentitions of patients with eating disorders.

Anorexia and bulimia nervosa (the eating disorders) are potentially life threatening and are becoming more prevalent. This paper reviews the effects of these disorders on dental erosion and reports a study to assess the effects of the eating disorders on the erosion of teeth relating the severity of erosion to factors such as the frequency of self-induced vomiting (SIV). One hundred and twenty-two eating disorder patients and an equal number of age, sex, and social class matched controls were studied. The study population was divided into subgroups according to the eating disorder. All the subgroups had significantly more abnormal toothwear than the controls (P < 0.005), with the differences being most marked in the SIV groups. Further analysis did not find any consistent relationships to the frequency or duration of SIV.

Anorexia↗
PubMed1993

Tolerance to intravenous midazolam as a result of oral benzodiazepine therapy: a potential problem for the provision of conscious sedation in dentistry.

Tolerance to the sedative effects of the benzodiazepine group of drugs is well documented. A brief review of the literature is presented. Three cases in which tolerance to intravenous midazolam became apparent and caused a significant problem during the attempted induction of conscious sedation are described. The patients were all concurrently receiving treatment with other benzodiazepines. It is recommended that patients with a history of regular, current benzodiazepine use be treated with caution with regard to this type of sedation.

Adult↗
PubMed1991

Regurgitation erosion as a possible cause of tooth wear in ancient British populations.

Clinically, in modern populations, tooth wear can be differentiated into three main types--attrition, abrasion and erosion, acting either separately or together. Anthropologists generally have not recognized erosion as a factor affecting the teeth of past populations. This study compares the patterns of wear known to be associated with erosion in present-day dental patients with those found in some British, pre-Conquest, skeletons. It is concluded that erosion may have been a major factor causing the extensive tooth wear in some 20 of 151 individuals.

Adolescent↗