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

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.