Raymond Dionne, DDS, MS, PhD
East Carolina University
Disclosures: Aegis Dental Network: Consultant, Honorarium; Charleston Laboratories: Consultant, Honorarium; Novartis Consumer Health: Consultant, Honorarium
The safety of sedation and anesthesia has been controversial for decades and has been the focus of a Consensus Development Conference held at NIH (Laskin and Dionne, 1986), workshops (Dionne et al. 2006) and large clinical trials to identify drugs, doses and combinations that optimize the relationship between clinical efficacy and patient safety (Dionne et al. JADA 2006). A recent case series to re-examine the safety of sedation resulted in a preliminary finding of N=39 deaths reported in the public domain. Most of the deaths in the series were attributed to respiratory depression, consistent with the administration of drugs that suppress respiration at the doses administered. The ADA revised their guidelines in 2016 for teaching the various levels of sedation which usually translates into regulations by state dental boards for training and emergency preparedness. What is often omitted is consideration of the drugs and doses that have evidence to support their safety when administered by dentists in an outpatient setting. The objective of this program is to review the evidence and rationale for minimizing adverse events associated with providing enteral sedation, and to present clinical strategies for effectively managing anxious patients with drugs that provide a wide margin of safety.