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Dental anxiety is common and frequently poses a barrier to necessary dental treatment. The increasing availability of conscious sedation in dental practice has made treatment much more accessible for anxious patients. At present, benzodiazepines are the most commonly used drugs in sedation practice and provide a pleasant experience for most, but not all, patients. An understanding of the mechanism of action of benzodiazepines should inform our practice and deepen our understanding of why and how sedation may fail.
CPD/Clinical Relevance: As an increasing number of dentists provide sedation for their patients an update on benzodiazepines is timely.
Article
Dental anxiety is a common phenomenon and one with which practising clinicians are all too familiar. Research into the prevalence of dental anxiety in various populations has produced estimates ranging from less than 3% to more than 20%.1 The UK Adult Dental Health Survey 2009 reported extreme dental anxiety in 12% of the adult population and found that this was associated with patients accessing dental treatment only when in pain.2 Anxious patients (and their dentists) experience more stress before and during dental appointments and there are patients who do not receive appropriate dental treatment because they avoid dentists altogether. Sedation in the dental surgery has revolutionized the provision of dental treatment for many such patients, making it acceptable and therefore accessible (Figure 1). More than any other group of drugs, benzodiazepines have allowed the development of safe, predictable sedation by operator-sedationists, such as dentists. An appreciation of the mechanism of action of benzodiazepines, their uses and limitations, can only enhance our success as sedationists and deepen our understanding of why and how benzodiazepine sedation may fail.
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