Dental mythbuster 10: Safe and effective conscious sedation

Page last updated: 3 July 2023
Organisations we regulate

Conscious sedation can help a patient when having dental treatment. There are several reasons why a patient may need sedation including anxiety, medical needs or if it is complex treatment.

We consider conscious sedation when we review the safe key question. This relates to:

Standards for conscious sedation in dental care

To demonstrate safe and effective care during sedation, providers must follow:

Standards for Conscious Sedation in Provision of Dental Care: Report of the Intercollegiate Advisory Committee for Sedation in Dentistry 2015 (updated March 2020)

Practitioners should have an awareness of:

Types of conscious sedation services

Sedation services may be commissioned through NHS dental services or provided under private contracts.

The two most common techniques generally adopted in the primary dental care setting are:

  • Inhalation sedation with nitrous oxide and oxygen (for children, young people and adults)
  • Intravenous sedation by administering a titrated dose of midazolam (for adults)

Other types of sedation include:

  • Oral and transmucosal sedation with midazolam for adults
  • Intravenous midazolam sedation for young people
  • Advanced techniques using a combination of drugs or routes and drugs such as ketamine, propofol and sevofluorane or midazolam for children

What we expect to see on inspection

Practice teams must be suitably trained and experienced. They must also maintain their competency in sedation.

During inspection we will explore:

  • the training and competency of the sedation team, including:
    • accredited training (if staff started to give sedation after the introduction of IACSD Standards) and evidence of clinical supervision
    • evidence of a clinical logbook and maintenance of competency
    • relevant continuing professional development
    • immediate life support and paediatric immediate life support (if applicable)
  • processes for reviewing critical incidents and ‘never events’ relevant to sedation
  • sedation-related audit and governance arrangements
  • how patients are assessed and prepared for conscious sedation
  • the sedation process, including monitoring, to ensure safe delivery
  • recovery, discharge and aftercare arrangements
  • the clinical environment, and whether it helps to provide safe care
  • whether sedation equipment is available, maintained and serviced according to the manufacturer’s instructions.

If a provider employs a visiting sedationist, we expect systems and process to check that:

  • they are suitably qualified and competent to provide sedation services
  • equipment and medicines used by the visiting sedationist are fit for purpose
  • they comply with the sedation standards.