Position Summary
Dentists must comply with the Dental Board of Australia’s registration standards to practise Conscious Sedation. It must remain available as a treatment option for the relief of dental patients’ anxiety and pain.
1.Background
1.1. Conscious Sedation in dentistry has been safely practised in Australia for many years under
various levels of regulation dependent upon jurisdiction.
1.2. Conscious Sedation provides access to care at a lower cost-of-service than general anaesthesia,
which can facilitate better access to care.
1.3. Both general anaesthesia and conscious sedation procedures encompass risk.
1.4. A Registration standard for conscious sedation has been adopted by the Board.
1.5. Until 2010, the ADA had recognised the ANZCA and RACDS document PS21 published in 2003. This was superseded by PS09 in 2022, followed by PG09(G) in 2023.
Definitions
1.6. MINIMAL SEDATION is a drug-induced state of diminished anxiety, during which patients are conscious and respond purposefully to verbal commands or light tactile stimulation. It includes the use of a single low dose oral medication or inhalation of gases for treating anxious patients, but not inducing a state of moderate sedation or deeper.
1.7. MODERATE SEDATION is a drug-induced state of depressed consciousness during which patients retain the ability to respond purposefully to verbal commands and tactile stimulation. It includes the use of intravenous sedation or a combination of inhalational and oral sedation.
1.8. DEEP SEDATION is a drug-induced state of depressed consciousness during which patients are not easily roused and may respond only to noxious stimulation.
1.9. GENERAL ANAESTHESIA is a drug-induced state of controlled unconsciousness accompanied by a partial or complete loss of protective reflexes including the inability to maintain an airway independently and continuously, and the inability to respond to physical stimulation or verbal command.
1.10. BOARD is the Dental Board of Australia.
1.11. CONSCIOUS SEDATION covers a spectrum of drug-induced states that range from minimal sedation to deep sedation.
2. Position
2.1. Patient safety should be the prime consideration in forming guidelines for Conscious Sedation.
2.2. Dentists with sufficient training and experience may utilise minimal sedation techniques.
2.3. Dentists who have met the registration standards of the Dental Board and have been endorsed to provide
conscious sedation may utilise moderate sedation techniques.
2.4. Regulation of conscious sedation in dental practice should be evidence-based.
2.5. The Board should adopt the ADA Recommended Guidelines for Conscious Sedation in
Dentistry.
2.6. Conscious Sedation needs to remain a treatment option for relief of anxiety and pain in dentistry.
2.7. Availability of Conscious Sedation services cannot replace the need for access to general
anaesthesia services in hospitals for dental purposes. Governments and private health funds must
provide adequate funding so that general anaesthesia services at hospitals for dental purposes
remains accessible.
