SAAD DIGEST VOLUME 40(I) 2024


STORY BEHIND THE COVER

Pain and Anxiety Control

The cover illustration was created by DALL·E 2, an artificial intelligence text-to-image model developed by OpenAI, the creators of ChatGPT. The image reminds us that pain and anxiety control is our attempt to influence the interaction of the 86 billion neurons that make up a human brain. Although we may, at times, wish that was a mechanistic, predictable process we are conscious that the brain is our body's most complex organ and this explains some of the challenges we face in adapting our patients' emotional and cognitive response to treatment.


3 Remimazolam compared to midazolam for dental sedation: an umbrella review

9 A review of the awareness and use of airway assessment techniques in conscious sedation in dentistry

15 Improving safety and efficiency in special care dentistry through quality improvement of patient information in the Belfast Trust

19 Patient experiences and outcomes following intravenous sedation in an oral surgery setting

23 An investigation of bispectral index monitoring when providing intravenous sedation for adults with severe cognitive disability

28 Are we providing an effective sedation service? An evaluation of a new conscious sedation service in primary special dental care

33 An audit of the use of flumazenil for sedation within the Special Care Dentistry Department (CDS Cycle 7) and seven-year comparison

37 Unsuccessful conscious sedation on patients with a learning disability and / or autism: a multi-site service evaluation

42 The effectiveness of dental nurse led Cognitive Behavioural Therapy (CBT) on the dentally anxious patient: a service evaluation

47 Dental treatment for a 15-year-old patient with Nicolaides- Baraitser Syndrome, under intravenous sedation with midazolam: a case report

50 The use of inhalation sedation to manage delayed eruption of permanent teeth, hypodontia and caries in a child patient

54 Case report: A paediatric patient with molar incisor hypomineralisation and hypodontia, treated with inhalation and intravenous sedation for extractions of deciduous and permanent molars

69 Dexmedetomidine: pharmacology and use as a sedative agent

77 Do children from more deprived backgrounds have a higher chance of becoming dentally anxious?



SAAD Trustees

Officers

President: Sadie Hughes BDS MFDS RCPS (Glas) MSc

President Elect: Yi Kwan Loo BDS MFDS RCS (Edin) DipConSed AFHEA MPaed Dent RCPS (Glasg)

Hon. Secretary: Manni Deol BDS MJDF PGCMedEd DipDSed

Hon. Treasurer: Paul Howlett BDS MFDS DipConSed

Course Director: Carole Boyle BDS FDS RCSEng MMedSci MSND RCSEd FDS RCSEd FDTFEd DipWSET

Communications Secretary: Frank Clough BDS MJDF RCS (Eng)

Editor: Nigel Robb TD PhD BDS FDS RCS(Ed) FDS(Rest Dent) FDS RCPS FDTF FHEA

Members

Leah Adams BDS MSc DipConSed

Frank Clough BDS MJDF RCS (Eng)

Christopher Holden BDS LDSRCS (Eng) DGDP(UK)

Thomas Lees BDS MFDS RCPS (Glas) DipConSed

Imran Suida BChD (Hons) MOralSurg MFDS RCPS (Glasg) PgCert healthcare ed PgCert healthcare leadership FHEA

Laleh Sharifian BDS (Lond.) MFDS RCS (Eng.) Dip D.Sed

Zahra Shehabi BDS MFDS MSc(Sed Spec Care) MSCD MSc (Management)

The SAAD Digest is published by the Society for the Advancement of Anaesthesia in Dentistry. The SAAD Newsletter is published electronically by the Society in Spring and Autumn.



SAAD Editorial Board

Fareed Ahmad BDS LDSRCS (Eng)

Stacey Clough BChD MFGDP (UK) MFDS RCS (Eng) MJDF MSpec Care Dent MSc CILT

Greg Gerrard BDS MFDS MSurgDent MSc

Jennifer Hare DHealthPsy CPsychol AFBPS

Yi Kwan Loo (Assistant Editor) BDS MFDS RCS (Edin) DipConSed AFHEA MPaed Dent RCPS (Glasg)

Christopher Mercer BDS FDS RCS (Eng) PhD FHEA

Akhila Muthukrishnan BDS MPhil FDSRCS FFDRCSI PGCME FHEA

Nigel Robb (Editor) TD PhD BDS FDS RCS(Ed) FDS(Rest Dent) FDS RCPS FDTF FHEA

Ben Smith BDS DipConSed

Fiona Trimingham BSc(Hons) MA MRSC CT(ABRSM)

Rosemary Whatling BSc BDS FDS RCS(Eng)(Paed Dent) MPaed Dent RCS (Eng) MClin Dent (Paed Dent) MFDS RCS (Eng)

Original articles and correspondence should be addressed to:

Fiona Trimingham

Tel: 01302 578 835 Email: Digest@saad.org.uk

Membership: £60 (UK) and £70 (international) per annum and includes the SAAD Digest and SAAD Newsletters, which are published on behalf of SAAD, 21 Portland Place, London W1B 1PY.

The opinions expressed in this and previous SAAD Digests and Newsletters are those of the authors and are not necessarily those of the Editorial Board nor of the SAAD Board of Trustees.

ISSN 0049-1160