SPECIAL CARE sedation standards and guidance

Question 1

what sedation guidelines do dentists use?

Answer 1

Intercollegiate advisory committee for sedation in dentistry standards
SDCEP conscious sedation in dentistry

Question 2

what are the responsibilities of the referring practitioner?

Answer 2

1. make sure your pts know that sedation is not GA and they will be awake
2. make sure they know that they will not be sedated at initial appt

Question 3

explain the sedation process?

Answer 3

appropriate referral
virtual/ telephone consultation
in person assessment
baseline monitoring
identify suitable technique
agree tx plan
start consent process
list for tx under sedation

Question 4

how can you be clear with instructions for sedation?

Answer 4

verbal instructions
written instructions
encourage qs
document all the above

Question 5

what is safe sedation in practice?

Answer 5

trained personnel
appropriate facilities and equipment for sedation, monitoring, recovery and emergencies
careful patient selection
use of recognised techniques

Question 6

what is included in informed consent for sedation?

Answer 6

full explanation of sedation technique and dental tx
discussion of alternatives and risk
deal with misconceptions e.g., amnesia vs unconsciousness, lack of control
obtain written consent to sedation, LA, and dentistry

Question 7

what GDC standard relates to informed consent for sedation?

Answer 7

3.1.6 - you must obtain written consent where tx involves conscious sedation or GA

Question 8

what is general anaesthesia?

Answer 8

controlled unconsciousness
loss of protected reflexes

Question 9

what are the indications for GA?

Answer 9

lengthy or complex surgery

very anxious/ dental phobic or pts with a profound learning disability who cant tolerate tx under other modalities

multiple XLA in multiple quadrants

severe trauma/ acute dental infection

IHS/IV is contraindicated or inappropriate

Question 10

what are the disadvantages/ limitations of GA?

Answer 10

preop assessment medical and dental needed
careful tx planning
tx often has to be more radical to be done in one visit
‘open’ consent
does not help pt build confidence/ get over their fear
cost
preop fasting and after care

risk of GA - morbidity and mortality

Question 10

what are the advantages of GA?

Answer 10

pt cooperation not required
pt unaware of procedure
alot of tx can be carried out
may be able to coordinate interventions with other specialities

Question 11

what is ‘open’ consent?

Answer 11

for the tx plan to change during the GA i.e., take out more teeth than expected