The document discusses hyperventilation, which is an increase in breathing rate and depth that lowers carbon dioxide levels in the blood. It can be caused by anxiety, stress, or certain medical conditions. In dentistry, it often occurs due to patient anxiety. Symptoms include chest tightness, dizziness, and tingling. Treatment involves stopping dental work, calming the patient, having them breathe into a paper bag, and avoiding oxygen. Preventing hyperventilation requires addressing the underlying anxiety or fear.

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Chapter 9
Hyperventilation

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Objectives
• Upon completion of this chapter, you will
be able to:
– Define hyperventilation
– Describe the signs and symptoms of
hyperventilation
– Explain the causes of hyperventilation
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Objectives (cont’d.)
– Explain the treatment of hyperventilation
– Describe the best way to prevent
hyperventilation
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Introduction
• Hyperventilation: an increase in the rate or
depth of breathing that results in a change
in the blood chemistry
– Usually occurs as a result of anxiety
– A common emergency in the dental office
since dental visits can cause anxiety for some
people
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Causes
• Most common cause is anxiety
• Can also be caused by:
– Certain physical conditions
– Emotional upset
– Stress
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Causes (cont’d.)
• Hyperventilation occurs most often in
patients who hide their feelings and do not
admit their fears of dentistry
– Anxiety builds until they are no longer able to
control it
• Not usually seen in children
– Children tend to cry or scream when fearful
preventing hyperventilation
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Physiology
• Carbon dioxide in the blood automatically
triggers the breathing reflex and stimulates
respiration
• A person hyperventilating increases the
depth and rate of respirations and exhale
a large amount of carbon dioxide
– Suffer from a lack of carbon dioxide
– Must work consciously to inhale and exhale
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Physiology (cont’d.)
• Cycle of hyperventilation
– Patient:
• Becomes anxious
• Begins to hyperventilate
• Realizes he/she is having trouble breathing
• Becomes more anxious
• Hyperventilates more severely
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Physiology (cont’d.)
– Cycle continues until dental team recognizes
the problem, intervenes, and attempts to calm
the patient
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Signs and Symptoms
• Patient:
– Appears anxious
– Begins to breathe faster and deeper
– Usually does not realize the change in
breathing
– May complain of chest tightness or suffocation
– May experience dizziness and tingling in the
extremities
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Signs and Symptoms (cont’d.)
Emergency Basics Box 9-1: Signs and Symptoms of Hyperventilation
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Treatment
• Stop all dental treatment
– Remove all materials and instruments from
the patient’s mouth
• Position the patient upright
– Patient will be more comfortable if seated
upright
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Treatment (cont’d.)
• Attempt to calm the patient
– Explain the condition to the patient
– Tell the patient to inhale and hold their breath
for several seconds prior to exhaling
• If the patient is too upset to hold their
breath, use other techniques
– Have the patient breathe into a paper bag
– Allow the patient to hold the paper bag
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Treatment (cont’d.)
• Do not administer oxygen
– Patient has too much oxygen and not enough
carbon dioxide
• The dentist may have to administer an
anti-anxiety medication
– If the patient is experiencing a severe
hyperventilation episode
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copied, duplicated, or posted to a publicly accessible website, in whole or in part.
Summary
• Hyperventilation usually occurs in the
dental office because of anxiety
• Important for the dental team to determine
what the patient fears about dentistry
– Can help prevent future episodes of
hyperventilation
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