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A conscious decision.London: Department of Health; 2000
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Paediatric dental treatment under inhalation sedation by a therapist in secondary care: An audit Elara Palmer Sarah-Jayne Campbell Lee Foo Dental Update 2024 47:11, 707-709.
We investigated the success of paediatric dental treatment under inhalation sedation (IHS) with nitrous oxide completed by a dental therapist, as an alternative to general anaesthesia (GA) in secondary care. We found that 94% of had treatment successfully completed under IHS by a therapist. These patients were assessed as being suitable for IHS and were referred to the therapist via a new patient clinic. The success of therapists treating paediatric patients with IHS could help reduce pressure on GA waiting lists. As well as being a safer treatment option, this method allows effective conservative treatment to be completed and thereby reducing the number of extractions required, which is a major benefit to patients' future health and wellbeing.
CPD/Clinical Relevance: This study shows the success of treatment under inhalation sedation by a dental therapist. Appropriate referral to therapists has the potential to reduce the need for procedures under general anaesthesia. This has the affect of reducing the strain on our general anaesthetic waiting lists, as well as having a positive impact on the health and wellbeing of our patients with IHS being considered the safer option.
Article
In 2013, the most recent survey by the Health and Social Care Information Centre concluded that almost half of all 8 year olds (46%) and one-third of 5 year olds (31%) in England, Wales and Northern Ireland had experienced obvious dental decay in their deciduous teeth.1 While dental treatment is often successfully completed in the primary care setting, many children require more specialist treatment and are referred to hospital for dental treatment under conscious sedation (CS) or general anaesthesia (GA). The NHS is under a great deal of pressure to provide GA for paediatric dental treatment, with £35 million spent on hospital-based extractions for those under the age of 18 in 2014–2015.2 As well as being an obvious financial strain on the NHS, the high demand for dental general anaesthetic services results in subsequently long waiting times. This is illustrated in a study by Goodwin and colleagues who found the average waiting times over six hospitals to be 8 months.3 These factors highlight the importance of finding methods to reduce the number of hospital admissions for paediatric dental extractions under GA. A review by the Department of Health in 2000 advised that inhalation sedation with nitrous oxide is a safer and more cost-effective alternative to general anaesthetic for dental treatment.4 Further studies also found inhalation sedation (IHS) to be a more cost-effective treatment option in comparison to GA.5,6,7
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