The use of anaesthetic agents to provide anxiolysis and sedation in dentistry and oral surgery

Abstract

Throughout the world there is considerable variation in the techniques used to manage anxious dental patients requiring treatment. Traditionally anxious or phobic dental patients may have been sent for general anaesthesia to allow dental treatment be undertaken. While this is still the case for the more invasive oral surgical procedures, such as wisdom teeth extraction, sedation in general dentistry is becoming more popular. Various sedation techniques using many different anaesthetic agents have gained considerable popularity over the past 30 years. While the practice of sedating patients for dental procedures is invaluable in the management of suitably assessed patients, patient safety must always be the primary concern. Medical, dental and psychosocial considerations must be taken into account when evaluating the patient need and the patient suitability for sedation or general anaesthesia. The regulations that govern the practice of dental sedation vary throughout the world, in particular regarding the techniques used and the training necessary for dental practitioners to sedate patients. It is necessary for medical and dental practitioners to be up to date on current practice to ensure standards of practice, competence and safety throughout our profession. This article, the first in a two-part series, will provide information to practitioners on the practice of sedation in dentistry, the circumstances where it may be appropriate instead of general anaesthesia and the risks involved with sedation. It will also discuss the specific training and qualifications required for dental practitioners to provide sedation. The second article in this series will outline the different techniques used to administer inhalation, oral and intravenous sedation in dentistry and will focus on specific methods that are practiced.

Awareness on Commonly used Sedatives Hypnotic in Dental Practices among Dental Students

“…A small, but a significant portion of the public, have fears so great that it impedes their ability to properly maintain oral health care [3]. Patients with a high level of fear who probably do not seek dental care on a regular basis.…”

Current methods of sedation in dental patients - a systematic review of the literature

“…In these cases, procedures must be performed with the patient under conscious sedation (3). However, in some cases requiring very complex dental procedures, or if the patient is in poor condition, conscious sedation may be inadvisable or the class of drugs used may be contraindicated.…”

“…Some patients simply cannot be treated with loco regional anesthesia alone for various reasons, generally due to behavioral problems resulting from some form of disability or because the patient is a child. In these cases, procedures must be performed with the patient under conscious sedation ( 3 ). However, in some cases requiring very complex dental procedures, or if the patient is in poor condition, conscious sedation may be inadvisable or the class of drugs used may be contraindicated.…”

Are Special Care Dentistry Services Prepared for a Global Disruption in Healthcare? A Call for a Wider Promotion of Dental Conscious Sedation Training

“…The rise in online communication during this time demonstrated that the theoretical aspects of many training programs may be delivered through distance learning and hybrid/blended learning formats. What is more, implementation of novel, combined, and/or advanced DCS techniques [ 23 , 24 ] by primary/secondary dental care providers is likely to diminish the impact of limited GA sessions and the overall burden of restricted access to the hospital setting as a result of any epidemic scenario in future, if it occurs. The new DCS postgraduate training curriculum model ought to comprise specific and unique elements managed by interdisciplinary consultants and faculty experts.…”