A Case of Dental Treatment with Nitrous Oxide for a Patient with Front Temporal Dementia

DOI
  • Ouchi Kentaro
    Department of Dentistry, Sasaguri Hospital, Medical Corporation Inoue-kai Department of Dental Anesthesiology, Field of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University Graduate School

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Other Title
  • 前頭側頭型認知症患者の歯科治療に亜酸化窒素を用いて行動調整した1症例

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Abstract

<p>　A 67-year-old man with front temporal dementia（FTD）beginning 3 years prior underwent dental treatment for dental prosthesis repair. He presented with a repetitive jaw tapping movement and repeatedly put candy in his mouth, claiming that the jaw tapping could only be stopped if he had candy in his mouth；hence, he also did not want to take the candy out of his mouth. We decided to perform the required dental treatment for dental prosthesis repair under inhalation sedation with nitrous oxide.</p><p>　During the first dental treatment, inhalation sedation was induced by nitrous oxide administered via a nasal cannula. Four minutes later, the anesthesiologist asked the patient to take the candy out of his mouth, to which he complied. The scheduled dental treatment was performed under inhalation sedation without the patient demonstrating continuous jaw tapping. During the subsequent second and third dental treatments, as soon as the anesthesiologist applied the nasal cannula on the patientʼs nose, he took the candy out of his mouth.</p><p>　This patient demonstrated compulsive behavior in the form of jaw tapping, which he believed could only be stopped if he had candy in his mouth. Sedation with nitrous oxide inhalation helped to reduce the obsession. FTD patients often exhibit reflex actions in response to external stimuli. In the present case, it is possible that the patient developed a new habit of stopping jaw tapping and not requiring candy when wearing a nasal cannula for the induction of inhalation sedation.</p><p>　In conclusion, inhalation sedation with nitrous oxide during dental treatment was useful in reducing our FTD patientʼs obsessive behavior during the treatment.</p>

Journal

  • Ronen Shika Igaku

    Ronen Shika Igaku 32 (2), 96-101, 2017

    Japanese Society of Gerodontology

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