Conscious sedation framework set up for NHS

The NHS is being given guidelines for the use of conscious sedation for patients with an innate fear of the dentist.

The conscious sedation of anxious patients during treatment is outlined in The Guidelines for the Appointment of DwSIs in Conscious Sedation, put together by the Faculty of General Dental Practice (UK) (FGDP UK) and the Department of Health (DoH).

The guidelines aim to develop a framework for Primary Care Trusts (PCTs) in which conscious sedation services can be developed, and to give a list of competencies for NHS dentists interested in training in that area.

Many people avoid treatment because of their phobia of the dentist’s chair, and conscious sedation – administered intravenously, orally or via inhalation – is considered an effective method of managing both pain and anxiety.

Conscious sedation allows the patient to maintain control over their breathing and swallowing during treatment and is best suited to:
· Patients who fear needles
· Patients requiring multiple dental procedures
· Patients have a strong gag reflex
· Patients suffering from other physical disabilities.

The ‘standard’ conscious sedation techniques are suitable for use by all appropriately trained and experienced primary care dentists.

However, a DwSI in conscious sedation may be able to offer more advanced or ‘alternative’ conscious sedation techniques and provide conscious sedation for patients with more complex medical histories and/or treatment needs.

David Craig, Head of Sedation and Special Care Dentistry at Kings College London Dental Institute and chair of the working group which developed the DwSI guidelines, said: ‘There is a shortage of suitably trained and experienced dentists who are able to offer alternative sedation techniques for the small number of patients who cannot be safely and effectively managed using standard techniques.’

• The guidelines, to be read in conjunction with key reports – The Standing Dental Advisory Committee’s Conscious Sedation in The Provision of Dental Care (2003) and the Standing Committee on Sedation for Dentistry’s Standards for Conscious Sedation in Dentistry: Alternative Techniques (2007) – were developed in conjunction with representatives from the Society for the Advancement of Anaesthesia in Dentistry, the Association of Dental Anaesthetists and the British Dental Association.

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