Current UK dental sedation practice and the 'National Institute for Health and Care Excellence' (NICE) guideline 112: sedation in children and young people

Coulthard, Paul; Craig, David; Holden, C; Robb, N; Sury, M. R. J.; Chopra, Sarvjit K.; Holroyd, I

doi:10.1038/sj.bdj.2015.338

Cited by 10 publications

(7 citation statements)

References 8 publications

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“…Furthermore, the nature of sedation provided now warrants close scrutiny, particularly for children under 12 years of age. The recent paper by Coulthard et al, 41 clearly demonstrates that whilst the majority of children in this age bracket are reported to have inhalation sedation, in line with recent guidance, 1 there is a significant proportion having single or multiple i.v. drug therapies.…”

Section: Discussionmentioning

confidence: 73%

Conscious sedation: is this provision equitable? Analysis of sedation services provided within primary dental care in England, 2012–2014

2016

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Aim:Patients receiving primary dental care may occasionally require conscious sedation as an adjunct to care. It is one of a range of options to support anxious patients or those undergoing difficult procedures. The aim of this study was to examine patterns of conscious sedation within primary dental care in relation to patient demography, deprivation status, geography (local authority, region) and type of care (Band) within England to examine equity in distribution of service provision.Materials and Methods:Descriptive analysis of cross-sectional primary dental care data, obtained from national claims held by the National Health Service (NHS) Business Services Authority, on patients who had received one or more courses of care involving sedation.Results:Just under 137,000 episodes of care involving sedation are provided for over 120,000 patients per year, the majority of which are for adults. Four out of ten (41%) patients were children, with 6–12-year-olds forming the largest group; 6% were aged under six years. Eleven per cent of patients had more than one course of care involving sedation, with adults aged 25–34 years having the highest rate: 1.17 (s.d.: 0.887) in 2012/2013 and 1.16 (s.d.: 0.724) in 2013/2014. There was a clear social gradient, whereby the most deprived quintile had the highest volume of patients that had received sedation at least once in primary dental care in both years (31.5%). Whilst there was a clear social gradient amongst children and young adults who received sedation, the gradient flattened among middle-aged and was flat amongst older adults. The majority of courses of care involving sedation were associated with Band 2 claims for care (88.6% in 2012/2013; 88.8 in 2013/2014). Whilst one or more patients in all higher tier local authorities received care involving sedation, there were marked geographic inequalities.Discussion:Patients receive sedation in support of NHS primary dental care across the life course and social spectrum. Whilst the pattern of uptake of care parallels the social gradient in younger age groups overall, there are clear geographical inequalities in provision. As sedation is only one of a series of adjuncts to care which may be provided across different sectors of the health system, a wider systems analysis should be undertaken as the findings raise important issues about equitable access to appropriate care. Furthermore, there should be a greater emphasis on prevention to reduce the need for care. The implications for child oral health, access and quality are discussed.

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Section: Discussionmentioning

confidence: 73%

Conscious sedation: is this provision equitable? Analysis of sedation services provided within primary dental care in England, 2012–2014

2016

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“…The systems of inhalation, intravenous, intramuscular and oral sedation have been taught for a long time in dental schools, through proceeding training channels. It has been accepted that the pharmacological sedation does not decrease or wipe out the fear; it incidentally dodges it (Nelson and Xu, 2015, Coulthard et al, 2015). Its quality is based fundamentally on making dental procedures congenial for the patients by reducing anxiety and processing a provisional state of tranquility (Gazal and Mackie, 2007).…”

Section: Introductionmentioning

confidence: 99%

A randomized control trial comparing the visual and verbal communication methods for reducing fear and anxiety during tooth extraction

Gazal

Tola

Fareed

et al. 2016

The Saudi Dental Journal

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“…Moreover, within these categories of sedatives, chloral hydrate, midazolam, dexmedetomidine are prescribed for sedation in children in the guideline 22 . Chloral hydrate is recommended by the NICE 2010 guideline for children under 15 kg who are unable to tolerate a painless procedure had a wide margin of safety 23 .…”

Section: Discussionmentioning

confidence: 99%

Comparison of Chloral Hydrate Nasal Spray With an Oral Solution for Sedation Before Electroencephalography in Children

Karimi

Aidy

et al. 2022

Preprint

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Background The choice of route of drug administration is given depends not only on the compliance but also on the drug’s pharmacokinetics pathway. In this study, the efficacy, and safety of nasal and oral administration of chloral hydrate in the pediatric ready for electroencephalography were evaluated. Methods 143 infants who had to undergo EEG for the diagnosis of neurological disorders received chloral hydrate between January 2017 and December 2018. Chloral hydrate was administered nasally or orally to infants using doses of 50-100 mg/kg. Clinical parameters are being analyzed to measure the efficacy/safety of nasal spray Vs. oral administration was (a) Heart rate Pre-sedation, (b) Heart rate Post Sedation, (c ) Hypoxemia, (d) Apnea), and (e) Oxygen Supplementation. Mean procedure time, mean recovery time, and total nursing times were calculated. Results Oral chloral hydrate group showed a lower heart rate and also a significantly higher percentage of hypoxemia. Apnea was not statistically different between the groups. The mean procedure time for the nasal and oral solution was ranged from 10 to 15 and 15-25 min, respectively. The mean recovery time for the nasal and oral solution was 5-8 and 10-15 min, respectively. Conclusion Chloral hydrate nasal spray is likely to be more safe and effective than oral in pediatric sedation.

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Current UK dental sedation practice and the 'National Institute for Health and Care Excellence' (NICE) guideline 112: sedation in children and young people

Abstract: We found good agreement between the current practice of sedation and the recommendations of the NICE guidance 112.

Cited by 10 publications

References 8 publications

Conscious sedation: is this provision equitable? Analysis of sedation services provided within primary dental care in England, 2012–2014

Conscious sedation: is this provision equitable? Analysis of sedation services provided within primary dental care in England, 2012–2014

A randomized control trial comparing the visual and verbal communication methods for reducing fear and anxiety during tooth extraction

Comparison of Chloral Hydrate Nasal Spray With an Oral Solution for Sedation Before Electroencephalography in Children

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