Inhalation sedation and the dental implant patient

Dental implantology has become a vast and intricate global business, commercially, clinically and in terms of practice management and research.

A wide variety of implant fixture designs, procedures and equipment present the practitioner with many challenges of choice. Courses on every aspect of our chosen clinical area of interest range widely in their scope, depth and emphasis. Ultimately, however all of this is designed to improve the quality of life of our patients.

Yet in all of the complexity of implantology it is easy to overlook the patient as a person with all of the anxieties that often accompany dental treatment for them. It is a requirement of the GDC fitness to practice that patient’s anxiety is properly managed, furthermore the dental defence organisations have cautioned that a practitioner who fails to manage the patient’s anxiety adequately or refer to another who can do so, may leave themselves open to a legal challenge. Inhalation sedation is generally poorly taught at undergraduate level and in any event the teaching of conscious sedation throughout the UK is variable (Dental Sedation Teachers Group symposium , Birmingham 2007).

Practitioners with little or no experience of the technique may mistakenly believe that it is manly used in paediatric dentistry perhaps mainly confined to “special needs” cases and in the Community Dental Service. In the USA it has been estimated that approximately 50% of dental practitioners offer RA as an option where appropriate to anxious patients.

A recent (unpublished) survey has suggested that in the UK that number may be as few as 5% and is unlikely to be more than 15%. Richard Charon has a wealth of experience of utilising RA for adult patients in private practice receiving advanced restorative dentistry including implant placement and restoration.