Sedation for dental treatment of children in the primary care sector (UK)

Br Dent J. 2010 Jun;208(11):E21; discussion 522-3. doi: 10.1038/sj.bdj.2010.542.

Abstract

Objective: To audit the clinical practice of a dental sedation service in the primary care sector and determine which services dentists use to manage unco-operative children.

Design: Retrospective analysis and prospective audit.

Setting: Sedation clinic in primary care, 2007, England.

Subjects: Children attending for dental treatment under sedation. General dental practitioners (GDPs) in the Brighton and West Sussex regions.

Interventions: Questionnaire.

Main outcome measures: Clinical service audit, patient satisfaction, referrer satisfaction.

Results: Four hundred children (age range 5-12 years) had been referred for caries (78%), with the remainder for orthodontic extractions. The most common treatment carried out on primary and permanent teeth was extractions followed by restorations. A combination of intravenous (IV) midazolam/ketamine/fentanyl was used in 40% of cases, and IV midazolam/ketamine was used in 34% of cases. Seventy-four percent of parents responded to the satisfaction questionnaire; of these 97% rated sedation as excellent/good and 80% would choose sedation or recommend sedation for others. Only 45% of questionnaires to referrers were returned. Fifty-six percent of dentists preferred general anaesthesia (GA) and 66% preferred IV sedation.

Conclusions: Dental treatment for children was provided under IV sedation with most parents satisfied with the procedure. Little difference was seen between referring dentists' perceptions of IV sedation or GA.

MeSH terms

  • Anesthesia, Dental / methods*
  • Anesthesia, General
  • Anesthetics, Combined
  • Anesthetics, Dissociative / administration & dosage*
  • Anesthetics, Intravenous / administration & dosage*
  • Child
  • Child Behavior / drug effects
  • Child, Preschool
  • Conscious Sedation / methods*
  • Dental Audit
  • Dental Care for Children*
  • England
  • Fentanyl / administration & dosage
  • General Practice, Dental
  • Humans
  • Injections, Intravenous
  • Ketamine / administration & dosage
  • Midazolam / administration & dosage
  • Parents / psychology
  • Patient Satisfaction
  • Primary Health Care
  • Retrospective Studies
  • Surveys and Questionnaires

Substances

  • Anesthetics, Combined
  • Anesthetics, Dissociative
  • Anesthetics, Intravenous
  • Ketamine
  • Midazolam
  • Fentanyl