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Authors: John Morgan, Bonnie F. Zimble
Behavior Management: The Patient Care Experience
 
for Patients with Disabilities:

Pharmocologic Methods of Sedation

Special Care in Dentistry
John Morgan, DDS
Tufts University School of Dental Medicine, 2008


There is little doubt that sedation plays an important role in this special field of dentistry. Like all patients, persons with developmental disabilities should have access to the various modes of sedation. However, dentists must not rely upon sedation as a substitute for patient management, or seek the “magic” pharmacologic agent or recipe that “works” for every patient. Following this logic, any patient with a disability who has uncontrollable movement or intense fear is likely to receive deep sedation, or even general anesthesia, for dental care.
  
Dentists who treat patients with disabilities should be aware of the danger of prescribing central nervous system depressants. The decision to use sedation should be based on patient need, safety, the procedure to be done and the physical status of patient.  The overriding consideration in using sedation is patient safety

The use of sedating agents by dentists requires specific training to assure patient safety. Further education and training well beyond the scope of this course is required. Guidelines and regulations vary by state; contact your state dental board for specific and current information. Below are some additional links:

Guidelines for the Teaching and Use of the Comprehensive Control of Anxiety and Pain in Dentistry as Adopted by the American Dental Association

American Dental Association Policy Statement: The Use of Conscious Sedation, Deep Sedation and General Anesthesia in Dentistry

American Academy of Pediatric Dentistry    

Commonwealth of Massachusetts, Board of Registration in Dentistry, Regulations Regarding Administration of General Anesthesia, Deep Sedation, Conscious Sedation, and Nitrous Oxide-Oxygen Sedation 

American Society of Anesthesiologists