Are Special Care Dentistry Services Prepared for a Global Disruption in Healthcare? A Call for a Wider Promotion of Dental Conscious Sedation Training
Abstract
:1. Introduction
2. Professional Guidance and Recommendations for the Use of Dental Sedation during COVID-19 Pandemic
3. Transition from a General Anaesthesia-Based Model to the Use of Various Dental Sedation Methods for Anxiety Management
4. Enhancement of Dental Conscious Sedation Students’ Curricula
5. Broader Access to Postgraduate Dental Training for Newly Graduated Dentists and Experienced Practitioners. Promotion of Local On-Site Training in DCS
6. Dedicated Support for Research with Direct Relevance to Dental Conscious Sedation
7. Summary
8. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Conscious Sedation Method | Advantages | Disadvantages |
---|---|---|
Oral sedation (OS) | Simple method, does not require specific training/equipment, side effects are rare if any, can be combined with other DCS methods | Age restricted, unpredictable pharmacokinetics and patients’ response, limited efficiency of anxiolysis, risk of oversedation or undersedation, unpredictable sedative effect, sometimes prolonged recovery, may require a chaperone person |
Inhalation sedation (IHS) | No age restrictions, although it requires good cooperation, wide safety margin, can be enhanced by additional techniques, such as music and tranquilizing verbal descriptions, quick recovery, does not require chaperone person | Limited efficiency, requires special, expensive equipment; anxiolysis less effective in adults; special facilities requirements (scavenging); operator sensitive; technique sensitive |
Intravenous sedation with single-drug titration (midazolam IVS) | Effective in situations where OS or IHS failed or for patients with severe dental phobia who cannot be sedated with IHS, well-controlled patient’s response due to drug titration, allows a profound anxiolysis, post-operative amnesia effect, may substitute dental general anaesthesia in selected cases, reversal agent in case of intraoperative complications or abnormal reaction associated with the use of benzodiazepine agent | Age limited, usually not used in children below 12 y.o.a., risk of systemic complications, age-restricted, requires advanced training and cannulation skills, requires training in advanced life support, chaperone person required, comprehensive pre- and postoperative instructions for patient |
Intranasal, transmucosal sedation with a short-acting benzodiazepine (midazolam) | Non-invasive, often used as an adjunct to IV sedation prior to cannulation, allowing a better patient’s co-operation during cannulation; does not require specific facilities or equipment; reversal agent in case of complications | Unpredictable sedative effect, unpleasant sensations during administration, usually not used alone, requires advanced training and cannulation skills (in case of adverse effects) |
Tool/Method | Educational Application and Features |
---|---|
Lecture: traditional, online, blended/mixed type | Mainly theoretical aspects, knowledge transfer with limited interaction |
Student’s presentation: classroom, online | Direct involvement in a certain subject, deep understanding of required knowledge, communication skills development |
Assignment: tentative, summative | Assessment of acquired knowledge and understanding |
Case study reflection: classroom, online | Personal opinion about clinical case, with involvement of other students, learning from reflecting on past experience |
Simulation: high-fidelity simulation with patient simulator and low-fidelity simulation with actors as simulated patients | Practical aspects of DCS without patient’s involvement |
Workshop | Sharing experience, open discussion, exchange of thoughts and ideas, practical exercises |
Virtual Reality Training | Expensive equipment, requires special software and knowledge/training, does not provide real interaction or tactile sensations, purely “technical feedback” |
Clinical sessions | Practical training with patient’s presence, real interaction in clinical environment, communication skills practice |
Peer Review and Research | Evidence-based aspects of DCS practice |
Conference attendance | Variety of different topics, experts’ opinions, and experience, limited feedback |
Self-learning (online) | Lack of interaction, no feedback, wide/uninterrupted access |
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Dziedzic, A.; Tanasiewicz, M.; Abed, H.; Dickinson, C.; Picciani, B. Are Special Care Dentistry Services Prepared for a Global Disruption in Healthcare? A Call for a Wider Promotion of Dental Conscious Sedation Training. Healthcare 2020, 8, 419. https://doi.org/10.3390/healthcare8040419
Dziedzic A, Tanasiewicz M, Abed H, Dickinson C, Picciani B. Are Special Care Dentistry Services Prepared for a Global Disruption in Healthcare? A Call for a Wider Promotion of Dental Conscious Sedation Training. Healthcare. 2020; 8(4):419. https://doi.org/10.3390/healthcare8040419
Chicago/Turabian StyleDziedzic, Arkadiusz, Marta Tanasiewicz, Hassan Abed, Chris Dickinson, and Bruna Picciani. 2020. "Are Special Care Dentistry Services Prepared for a Global Disruption in Healthcare? A Call for a Wider Promotion of Dental Conscious Sedation Training" Healthcare 8, no. 4: 419. https://doi.org/10.3390/healthcare8040419