Retrospective audit of the efficacy and safety of the combined intranasal/intravenous midazolam sedation technique for the dental treatment of adults with learning disability.

The provision of dental care for adults with severe learning disability presents problems. The approach to treatment has often been provided under general anaesthesia tending to result in exodontia rather than restorative care. This paper presents an alternative to this option using conscious sedation.
A multi-centred retrospective audit was reported on using data from Canterbury, Warwick, Dorset and Cardiff. Patients included adults with varying degrees of disability for whom treatment using local anaesthesia, inhalation sedation, and the acceptance of intravenous cannulation was not possible. Sedation was provided by midazolam first administered by the intranasal followed by the intravenous route.
From a total of 222 episodes of sedation 128 (57.65%) accepted treatment well and 75 (33.78%) presented slight problems which did not compromise treatment. In 19 cases (8.55%) treatment with sedation was not possible and a referral was made for general anaesthesia.
Results showed that a range of different treatments were carried out including advanced restorative care. This paper proposes that the technique described is safe and effective in providing a good standard of dental care for adults with severe learning disability.
AuthorsM C G Manley, N J Ransford, D A Lewis, S A Thompson, M Forbes
JournalBritish dental journal (Br Dent J) Vol. 205 Issue 2 Pg. E3; discussion 84-5 (Jul 26 2008) ISSN: 1476-5373 [Electronic] England
PMID18545267 (Publication Type: Journal Article, Multicenter Study)
Chemical References
  • Aerosols
  • Hypnotics and Sedatives
  • Midazolam
  • Administration, Intranasal
  • Adult
  • Aerosols
  • Anesthesia, Dental (methods, statistics & numerical data)
  • Anesthesia, Intravenous
  • Conscious Sedation (methods, statistics & numerical data)
  • Dental Audit
  • Dental Care for Disabled (methods, statistics & numerical data)
  • General Practice, Dental (methods)
  • Great Britain
  • Humans
  • Hypnotics and Sedatives (administration & dosage)
  • Injections, Intravenous
  • Learning Disorders
  • Midazolam (administration & dosage)
  • Patient Acceptance of Health Care
  • Retrospective Studies
  • Treatment Outcome

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