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Teaching, Lecturing & Mentoring in Inhalation Sedation

RA Coaching & Mentoring
One day courses with Richard Charon BDS

In 2003, with the assistance of Chris Charon, he developed and they have been delivering a one-day, hands-on, focused teaching day, covering the theory and practical aspects of successfully and safely providing inhalation sedation (I.S.), often still referred to by it’s former name of Relative Analgesia (RA). In 2011, Richard Charon also undertook a basic teaching award (City and Guilds: PTLLS Level 4) to underpin these teaching activities. These courses have proven highly successful as witnessed by the many positive testimonials received and the fact that dental teams have travelled from Inverness to the Channel Islands and from the Baltic states to the West coast of Ireland to attend them. What is RA?
Dental inhalation sedation, using titrated mixes of oxygen and nitrous oxide, has been used with an exemplary safety record in the UK, Ireland and many other countries, notably the USA, Canada Australia and New Zealand for about 50 years, having been pioneered in its present mode of use in the USA in the 1930s. One of several options for the management of the anxious dental patient, it has been accepted by the General Dental Council, on the advise of the UK and Ireland’s leading experts in Dental Sedation and Anaesthesia as being safe, valuable and effective1. This statement may be further modified in the light of more recent recommendations by stating: When administered by a competent operator-sedationist, assisted by an appropriately trained dental nurse in suitably equipped and managed treatment environment.
1 DSTG: Oct 2000; Standards in Conscious Sedation in Dentistry:

“I find being able to treat someone that hasn’t been able to visit the dentist due to fear much more inspirational than reading the 1000th article about veneers and bleaching we find in every journal!”
Dr Uzman al Haq

“Mum, will you buy me one of these!”
Anon, 5 year old child.

“Thanks ever so much for making this afternoon such a painless experience! I really would never have believed it possible.”

“You have fixed a broken part of my personality.”

A unique feature of these courses, unequalled in the UK, is the small group size and the interactive nature of the learning environment. 8-15 maximum.

One day courses: Who are they for and how is the course structured? A unique feature of these courses, unequalled in the UK, is the small group size and the interactive nature of the learning environment. 8-15 maximum. This is a mixed ability group which will always vary but has since 2003 included: Dentists: GDPs in Private and NHS practice, Hospital and Community services. Recent UK graduates and those qualified outside the UK , often with no undergraduate teaching in this subject, as well as practitioners with 25 years of previous experience. In addition Endodontic and Paedodontic specialists have attended. All have said how useful the teaching had been. Other specialists notably periodontists and implantologists would also benefit.

Dental nurses: It is expected that dental nurses will attend with dental practitioners. It is the practitioner’s responsibility to ensure that they are assisted by an appropriately trained dental nurse and this is usually taken to mean training provided external to the practice unless experienced practitioners can provide this internally. This course is suitable for RDNs. Trainees close to their examination with at least 12 months clinical experience would benefit. Trainees in the early months of their training might in some cases find the course difficult though no doubt interesting. Dental Hygienists and Therapists: Many have attended and found the course very helpful. Mentoring to competency can often be provided at the practice in which I.S. is being provided. If attendance is to further a career progression then mentorship would need to be sought at a later date.

Course Structure – 2/3rds of a day of interactive lectures. – 1/3rd day practical The practical consists of: 1. Chairside demonstration of equipment and of some delegates being sedated as demonstrations to the group. Practitioners will have the opportunity to sedate another delegate under supervision. 2. Either or both of: Live patient demonstrations and pre-recorded video of patients undergoing treated under I.S. for discussion amongst the group.

Dr. Richard Charon BDS
(V.U.Manc. 1975)

What’s in it for me?
– Attract more patients. Grow your practices. – Reduce failures and cancellation of appointments through anxiety. – Gain uptake of advanced treatment plans from anxious patients. – Reduce time wasted on failed attempts at treatment with anxious patients or gaggers. – Increase productivity with anxious patients. No more one filling at a time! – Reduce stress for you and your team. Far few” heart-sink” patients on your day-list. – Add a new service, get local people talking positively about your practice.

Richard Charon has been a General Dental Practitioner since qualifying in Manchester in 1975. Since 1999 this has been in private practice in Newbury, Berkshire. He has been successfully utilizing “RA” since 1977 and by 2013 will have undertaken well over 8000 administrations on close to 5-6000 patients. The technique has been an integral part of his daily general practice. Richard has been a member of SAAD since the mid 1980s and of the Dental Sedation Teachers Group since 2007. Richard has authored a number of articles for the dental press (Private Dentistry, Dentistry magazine, Dental Nursing, DH&T) and on-line for example for By invitation in 2011, a chapter in the compilation book edited by Dr. Stephen Hudson: Messages from Dental Masters I together with many thought leaders in UK and Irish Dentistry. In October 2013 Richard delivered a lecture on the subject as part of a Deanery update on conscious sedation at Liverpool Dental School.

Q What is the cost of setting up? A In 2013 the set up costs are about £5000 but this will vary according to whether a mobile or fixed installation is chosen. Discuss your requirements with a specialist supplier of Inhalation Sedation equipment. Q Do I have to bring my nurse on a course? A It is advisable. Either your nurse will have little or no experience at assisting with sedated patients and with I.S. specifically or may have done so but would need an update. If the Dental nurse who will be assisting you has the NEBDN certificate in Dental Sedation Nursing or has completed the SAAD weekend course in conscious sedation in the previous 2 years or so then that would normally suffice. However recommendations do change every few years so regular updates are important. In 2011 vCPD requirements, for GDC registrants, were published at 12 hours every 5 years. Q Do patients need an escort? A In general patients recover rapidly from I.S. They can usually leave the treatment room after 3-4 minutes and would be ready to leave the practice after 15-30 minutes when assessed fit to do so. They should not drive or cycle for at least 30 minutes but can return to work or school or to care for others. Q What level of Life support training is needed? A Inhalation Sedation / “R.A. is a level 1 or Tier 1 sedation technique which because of its safety record only required Basic Life Support training. Richard Charon is happy to exchange e-mail or telephone support for those who have attended the course or undertaken mentoring.

Patient testimonial

Even grown ups get scared sometimes and when you get time to think about it you find it’s just the fear of the unknown, you always fear the worst.
When you discussed the technique of extracting my wisdom tooth that alone would make a grown man shiver! Then you offered happy gas thoroughly explaining the benefits and how my fear would fade! How right you were, you could of extracted every tooth and I wouldn’t of cared! The downside? You turned it off when you had finished, from space cadet back to everyday life, gutted! But, at the same time eternally grateful for your guidance and true professionalism. Well done, good job done and fear now gone. Malcolm Ricks Read more testimonials from patients and RA Coaching alumni on our website

RA Mentoring
Mentoring, Competency and Scope of Practice – who can provide I.S. The current recommendations, amongst many, are that a) Practitioners (Dentists, Dental Therapists and Dental Hygienists) for whom I.S. falls within the GDC’s prescribed Scope of Practice, new to any form of conscious sedation, should be mentored. In the case of I.S. they should undertake their first 10 cases under supervision. The practitioner’s performance to be assessed formatively and summatively. The summative assessment normally takes the form of a multiple choice questionnaire with a 70% pass mark. At the discretion of the mentor, this may be supplemented with an oral examination. The successful practitioner will then be certified by the mentor as being competent to undertake Inhalation Sedation without further supervision. Please note that SAAD are unable to provide competency certification or clinical mentoring. Our Services – How we help you to achieve success Courses, Lectures Presentations and Mentoring Courses The one-day courses are held in general 3-4 times each year but could be held more often depending on demand. Since 2003, they have been held in Newbury and Thatcham in Berkshire, in Wexford and Dublin in Ireland and in Northumberland, Saddleworth, Stratford-on-Avon and in London at the end of 2013. Courses can be organized at practitioner’s own practices for 12-15 people depending on location. Please request an individual quotation as this will vary according to numbers and location. Lectures Richard Charon is available to lecture on this specific aspect of the management of dental anxiety in the context of the alternatives to managing the anxious and phobic dental patient. Presentations Taster presentations can be arranged for corporates or groups such as the BDA branch meetings or other dental groups seeking a speaker. Mentoring As mentioned above mentoring is now indicated for practitioners new to conscious sedation and has become an integral part of many aspects of learning within the field of dentistry. Mentoring is readily available in larger institutions and the community dental service for example but is less easily obtained for general practitioners. Therefore a visiting mentor, overseeing cases at practitioner’s own practices, with the mentee treating their own patients, is in many ways the ideal solution. Richard Charon can tailor such mentoring to your needs. This normally would require 2 full days, each patient requiring an hour to be set aside. Please contact Richard for further details.

Contact Richard Charon T: 07884 230 995