Public Dental Service - Adult: Sedation

Sedation (>16 years)

IV sedation is suitable for anxious adults who would benefit from sedation and who are otherwise unable to accept operative care

Please provide details of what treatment has been attempted and/or details of the patient’s particular anxieties. If you have been unable to examine the patient, please specify a reason why this has not been possible and specify the reason you consider treatment may be necessary.

To minimise repeat visits, only straightforward, simple dental care is provided. Fillings are placed where possible, but teeth with extensive decay or advanced periodontal disease are extracted. Complex restorative work, such as endodontics, crowns and bridges are not offered under sedation or general anaesthetic.

If the patient that you refer is to have immediate replacement dentures fitted during sedation or GA, they will have their dentures made by their own dentist in practice and the dentures given to PDS before their appointment. In general, adults who are healthy or who have mild systemic disease and whose BMI falls within normal parameters are suitable to be treated with sedation in PDS clinics. PDS also has limited access to anaesthetist-led sedation so may be able to offer care to patients with complex medical histories in a hospital setting. Again, this decision would be made at the initial assessment appointment.

Sedation is not a substitute for failure of local anaesthetic.

Patients require an appropriate escort. If the patient does not have a suitable escort, it will not be possible to offer them IV sedation.

A patient with a history of benzodiazepine use (even prescribed) or drug misuse may be resistant to midazolam and may therefore not be suitable for sedation. Patients who misuse drugs and cannot be trusted to refrain from drug taking before or after sedation will not normally be offered sedation due to the risk of overdose / respiratory depression.

Sedation is not offered to pregnant patients.

Patients with disease that impact on their upper airway may not be suitable for sedation – these include - severe obesity, COPD, severe uncontrolled asthma, obstructive sleep apnoea, severe cerebral palsy, and muscular dystrophy

Please indicate whether it may be necessary to send a duplicate appointment?e.g., to Carer, Social Worker, Welfare Power of Attorney etc

Patients who can only attend premises via patient transport can be seen at Broxden, Kings Cross, or Springfield. There are wheelchair platforms and bariatric facilities at Broxden, Kings Cross and Springfield.

In all cases, the initial appointment will be for assessment only. Treatment plans or modalities should not be agreed in advance as these may lead to unrealistic expectations on the patient’s part.

PDS accept referrals from residents of Angus, Dundee, Perth and Kinross and North Fife.

Referrals are NOT accepted for patients who live outside this area, but whose GDP is located within Tayside.

Please send all referrals to PDS via SCI Gateway and attach all relevant radiographs and clinical photographs. Please give as much information as possible. Failure to complete all relevant fields will delay the referral process. Please provide a current phone number for the patient.

Select – new message – Tayside – Tayside Dental Service – Sedation.
Choose location (Broxden (Perth), Springfield (Arbroath), Kings Cross (Dundee).