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Anaesthesia And Sedation in dental treatment

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The first general anaesthetics administered were for dental extractions. The concept can be traced back to Connecticut Dentist Horace Wells. Having observed that laughing gas-induced anaesthesia, Wells started experimenting with laughing gas on himself.

Local anaesthesia should be administered by a specialist under observation and care. Recommendations are made that the administration of dental anaesthesia should only be carried out by:

i. Anaesthetists on the specialist register of the General Medical Council;

ii. Trainees working under supervision in programmes accredited by the Royal College of Anaesthetists; or

iii. Non-consultant career grade doctors working under the responsibility of a named consultant anaesthetist.

The procedure should be carried out only in:

i. Situations in which it would be impossible to achieve adequate local anaesthesia and so complete treatment without pain;

ii. Patients who, because of problems related to age/maturity or physical/learning disability, are unlikely to allow safe completion of treatment; and

iii. Patients in whom long-term dental phobia will be induced or prolonged.

Before the procedure the following questions can apply:

• Who will provide evaluate my child before the procedure, including their past medical histories such as allergies, current prescription and over-the-counter medications and previous illnesses and hospitalizations?

• How long should my child go without food or drink before the procedure (except for necessary medications taken with a sip of water)?

• Will I be giving any sedation medication to my child at home before their coming to the office and, if so, what should I be on the look-out for?

• What training and experience does the person providing sedation or anaesthesia for the procedure have?

• Does assist staff have emergency training? Do they renew their training regularly?

• Does the dentist have all the permits or licenses required by the state dental board to provide the planned level of anaesthesia or sedation?

During the procedure:

• In addition to local anaesthesia (numbing), what level of sedation or general anaesthesia will my child be given? Is it minimal sedation (relaxed and awake), moderate sedation (sleepy but awake), deep sedation (barely awake) or general anaesthesia (unconscious)?

• How will my child be monitored before, during and after the procedure until the child is released to go home? Will there be at least two people with the proper training and credentials present during my child's procedure? Are the appropriate emergency medications and equipment immediately available if needed, and does the office have a written emergency response plan for managing medical emergencies?

After the procedure:

• Will the sedation/anaesthesia provider give me instructions and emergency contact information if there are any concerns or complications after returning home?

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