4.3.3.

16 Conscious sedation

Conscious sedation is primarily a modification of a patient's state of mind. Techniques in conscious

sedation must ensure that patients remain within verbal contact. Practitioners must be fully aware of,
and adopt, the GDC's guidance in relation to conscious sedation. Details of the standards concerned
can be found in the annex to Standards for Dental Professionals.

Essential requirements for practices using conscious sedation techniques include:

 An appropriately trained person, other than the operator, to monitor the patient and assist in
case of an emergency.

 Documentation for specific written consent from all patients.

 Clear, concise, and adequate pre- and post-operative patient information, in writing.

 Equipment that is serviced to manufacturers’ recommendations.

Essential requirements for practices using inhalation sedation include:

 A dedicated relative analgesia (RA) machine. Machines capable of delivering a potentially

anoxic mixture of gases must be equipped with an oxygen analyser and audible alarm.

 Oxygen failure cut-off to room air.

 Semi-disposable circuits.

 A range of sizes of nasal masks.

 Active or passive scavenging of waste gases.

 Adequate ventilation of the surgery.

Essential requirements for practices using intravenous sedation are:

 Weighing scales.

 A stethoscope and sphygmomanometer.

  A pulse oximeter.

 An indwelling intravenous line throughout the procedure when the intravenous route is used
to administer sedation.

 Specific antagonist drugs, particularly in relation to benzodiazepines, and practice staff with
the essential knowledge and skills to administer them.

 Outcomes 10 (Safety and suitability of premises) and 11 (safety, availability and suitability of
equipment) of the Care Quality Commission’s Essential standards of quality and safety
(2010).

Cross references:
Section 11 (Patient communication and treatment records) of the FFGDP(UK) Practice Questionnaire
Key Skill: KS 7.2

Further reading:
General Dental Council. Standards for Dental Professionals. London: GDC, 2005. Available via
www.gdc-uk.org/Current+registrants/Standards+for=Dental+Professionals/ as of March 2011.
British National Formulary (most recent edition). London: British Medical Association and the Royal
Pharmaceutical Society of Great Britain.
Department of Health. Conscious Sedation in the Provision of Dental Care: Report of an Expert Group
on Sedation for Dentistry, The Standing Dental Advisory Committee. London: Stationery Office, 2003.
Available via www.dh.gov.uk/PublicationsandStatistics as of September 2006.
Department of Health. Dental Conscious Sedation: A Practice Assessment Checklist. In CDO Update
January 2005. London: Stationery Office, 2005. Available via
www.dh.gov.uk/PublicationsandStatistics/Bulletins/ChiefDentalOfficersBulletin as of September 2006.
Scottish Dental Clinical Effectiveness Programme (CEP). Conscious Sedation in Dentistry: Dental
Clinical Guidance. Available at www.scottishdental.org/cep as of September 2006.
National Institute for Health and Clinical Excellence. Sedation in children and young people – NICE
clinical guideline 112 December 2010. Available from www.nice.org.uk/guidance/CG112 as of March
2011.
Dental Protection Ltd. Risk management module 17: Sedation. London: DPL Publications, 2006.
Available at www.dentalprotection.org/elearning as of March 2011.
Care Quality Commission. Essential standards of quality and safety. Accessed from
www.cqc.org.uk/registration at 28 December 2010