When faced with an anxious patient with complex needs who requires dental care, it can be difficult to decide on the most appropriate method to manage their pain and anxiety. There are a range of conscious sedation techniques that may be used, and on some occasions, general anaesthesia may be required.
This paper describes the methods available and the factors influencing the decision-making process. The general dental practitioner (GDP) may not be able to offer care in their setting, but knowing more about the decision-making process and the information required to make that decision can help them guide patients and their families.
Joint Advisory Committee for Special Care Dentistry (JACSCD). A case for need: proposal for a Specialty in Special Care Dentistry. London: JACSCD; 2003.
2.
ManleyMCGSkellyAMHamiltonAG. Dental treatment for people with challenging behaviour: general anaesthesia or sedation?Br Dent J. 2000Apr8;188(7):358-60.
3.
CraigDBoyleC. Practical Conscious Sedation. Oral Surgery and Oral Medicine. Volume 2. QuintEssentials Series. London, Quintessence Publishing; 2017.
4.
YeeRWongDChayPL, et al. Nitrous oxide inhalation sedation in dentistry: An overview of its applications and safety profile. Singapore Dent J. 2019May31;1-9.
5.
RobbNDrysdaleD.The use of Intranasal Midazolam in a special care dentistry department within a hospital-based setting: Technique and Cases. SAAD Digest. 2018;34:8-12.
6.
Scottish Dental Clinical Effectiveness Program (SDCEP). Conscious Sedation in Dentistry - Dental Clinical Guidance. 3rd Edition. London: SDCEP; 2017.
DougallAFiskeJ.Access to Special Care Dentistry, Part 1: Access. Br Dent J. 2008;204(11):605-16.
9.
The dental faculties of the royal colleges of surgeons and the Royal College of Anaesthetists. Standards for Conscious Sedation in the Provision of Dental Care. London: The Intercollegiate Advisory Committee for Sedation in Dentistry; 2015.
10.
HoseyT.Managing anxious children: the use of conscious sedation in paediatric dentistry. Int J Paed Dent. 2002;12(5):359-372.
11.
ManleyMCGRansfordNJLewisDAForbesM. Retrospective audit of the efficacy and safety of the combined intranasal/intravenous midazolam sedation technique for the dental treatment of adults with learning disability. Br Dent J. 2008;205:E3.
12.
ReillyDBoyleCCraigD.Obesity and dentistry: a growing problem. Br Dent J. 2009;207(4): 171-175.
13.
CurlCBoyleC.Sedation for Patients with Movement Disorders. Dent Update. 2012;39:45-48.
