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Can intravenous conscious sedation with midazolam be effective at facilitating surgical dentistry in adolescent orthodontic patients? A service evaluation

Lookup NU author(s): Ashleigh Stamp, Matthew Dorman, Dr Chris Vernazza, Guy Deeming, Claire Reid, Professor Nick Girdler

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Abstract

Surgical dentistry during orthodontic care often occurs in adolescence and may involve surgical removal or exposure of teeth. The invasive nature of treatment, combined with dental anxiety, means care is often provided under GA. Best-practice guidelines however endorse conscious sedation as an alternative, where appropriate. Although a limited number of studies have shown safe and effective use of intravenous conscious sedation (IVCS) with midazolam in this cohort, robust evidence to support routine its use is lacking.A retrospective service evaluation was undertaken reviewing clinical records of adolescents (aged 12-15 years) undergoing surgical exposure and/or surgical removal of teeth under IVCS midazolam. This aimed to assess whether IVCS with midazolam can effectively facilitate surgical dentistry in adolescent orthodontic patients in primary-care.174 adolescents (mean age 14.2 years) attended for treatment between 2009 and 2015. 98.9% (n=172) allowed cannulation with all surgical dentistry completed during a single visit. Midazolam dose ranged from 2-7mg with 79.1% patients having good or excellent co-operation and three minor adverse events occurring. This service evaluation shows IVCS midazolam can effectively facilitate surgical orthodontics in carefully selected adolescents. There is however a distinct need to further explore potential for this technique to provide a viable alternative to GA.


Publication metadata

Author(s): Stamp AJ, Dorman ML, Vernazza CR, Deeming G, Reid C, Wilson KE, Girdler NM

Publication type: Article

Publication status: Published

Journal: British Dental Journal

Year: 2017

Volume: 222

Issue: 2

Pages: 113-119

Print publication date: 01/01/2017

Online publication date: 27/01/2017

Acceptance date: 26/10/2016

Date deposited: 30/03/2017

ISSN (print): 0007-0610

ISSN (electronic): 1476-5373

Publisher: Nature Publishing Group

URL: http://dx.doi.org/10.1038/sj.bdj.2017.78

DOI: 10.1038/sj.bdj.2017.78


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