Can intravenous conscious sedation with midazolam be effective at facilitating surgical dentistry in adolescent orthodontic patients? A service evaluation

Oral surgery: Considerations for the younger patient

The need for oral surgery will, for many younger patients, precipitate their first significant interaction with healthcare professionals; this will inevitably impact on the planning and delivery of their treatment.This paper will describe the range of oral surgical procedures which are most commonly performed on younger patients. It will explore the indications for treatment, the techniques used to promote successful treatment outcomes, and the role of general dental practitioners in the management of younger patients undergoing oral surgery. Consideration will be given to the unique challenges encountered when undertaking surgical procedures in younger patients with a dentition which is still developing.

Retrospective audit of midazolam dose and intravenous sedation record keeping in a primary care oral surgery service

Regular and robust audit of conscious sedation practice is key to the delivery of safe and effective patient care in all clinical settings. Analysis of outcomes will help to highlight any necessary modifications to procedures and techniques. The Intercollegiate Advisory Committee for Sedation in Dentistry (IACSD) states that conscious sedation procedures must be the subject of robust and regular audit in which every member within the team takes part.¹ This completed audit cycle highlighted the efficacy of intravenous (IV) midazolam in anxious patients undergoing oral surgical procedures and the suitability for its use in the primary care setting. No patient safety concerns or complications were recorded in this audit and midazolam was administered within the recommended dose range. By the conclusion of two audit cycles, all clinicians providing intravenous sedation within the service were aware of the missing elements in sedation record-keeping and were able to complete accurate contemporaneous records before, during and after conscious sedation, ensuring the continuous delivery of high-quality, safe, and patient-centred care.

Service evaluation of an intravenous sedation service within a hospital paediatric dentistry unit: ten-year results

Background An intravenous sedation (IVS) service was established in 2008 for young people aged 12 years or over, within the paediatric dentistry department at the Eastman Dental Hospital in London. The aim of this study was to carry out a service evaluation and assess the case mix and success rate of this service over the last ten years.Materials and methods A retrospective service evaluation was carried out, including all patients attending the IVS clinic between April 2009 and March 2019.Results A total of 457 patients attended over 525 appointments. The mean age was 14. The success rate was over 98%. The average dose of midazolam was 4 mg and dosage ranged from 1.5-10 mg.Conclusion This IVS service has been established successfully and offers patients an alternative to general anaesthetic. This consequently reduced the general anaesthetic waiting list by 10%.