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Assistant Professor and Consultant of Conscious Sedation and Special Care Dentistry, Department of Basic and Clinical Oral Science, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
Assistant Professor of Oral Medicine, Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, Faculty of Dentistry, Taif University, Saudi Arabia
Assistant Professor and Consultant of Endodontics, Department of Restorative Dentistry, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
Intravenous (IV) sedation with midazolam works as an anxiolytic and muscle relaxant agent and has proved successful in providing safe root canal treatment (RCT) for patients with dental anxiety or special care needs. However, before starting RCT under IV sedation with midazolam, clinicians should consider obtaining a thorough medical history and written, informed consent including any significant or unavoidable risks. A responsible adult escort should also accompany the patient to their appointment. The dental team should also ensure labelling the IV sedation drugs and irrigant solutions, and using a well-sealed rubber dam.
CPD/Clinical Relevance: This article provides clinical recommendations to help provide safe RCT under IV sedation with midazolam.
Article
Dental anxiety is considered a significant barrier to many patients seeking dental treatment,1,2 including those who are fit and well, medically compromised, or special care patients.3 Root canal treatment (RCT) has been reported by patients to cause them the most anxiety,4 which may also increase pain intensity.4 Conscious sedation techniques can be used to help reduce the patient's anxiety while delivering safe dental treatment.5
The Intercollegiate Advisory Committee for Sedation in Dentistry (IACSD) defines conscious sedation as a ‘technique in which the use of a drug or drugs produces a state of depression of the central nervous system enabling treatment to be carried out, but during which verbal contact with the patient is maintained throughout the period of sedation.’6 All conscious sedation techniques should be administrated by qualified medical or dental care providers with an accredited certification to perform conscious sedation.6
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