Vaseekaran Sivarajasingam, Claire Dunstan and Mick Allen
Cardiff and Vale University Health Board
Project Background:
There is a significant unmet need for dental care under conscious sedation, with approximately 10,200 adults in CAVUHB alone. Patients with dental anxiety present late with high treatment needs.
Lack of access to sedation services in Wales leads to overreliance on general anaesthesia (GA) and worsens existing health disparities.
Currently, there are no conscious sedation training programmes for dental teams in Wales.
Project Aims:
- To develop a Community of Practice in conscious sedation in CAVUHB
- To develop training programme for dentists and dental teams in conscious sedation in Wales
Project Outcomes:
In October 2023, a new primary care conscious sedation service commenced with new referral criteria and patient care pathways.
A new conscious sedation training programme was developed in collaboration with HEIW. This innovative programme combines didactic teaching and hands-on clinical experience to equip staff with essential skills and knowledge in conscious sedation techniques.
Conscious sedation services, CAVUHB.
New patient care pathway for adults and children in conscious sedation, CAVUHB.
Project Impact:
In secondary care, 130 patients would transition from GA to conscious sedation, with 111 receiving IV midazolam and 19 undergoing deep sedation, resulting in cost savings of £43,598 per annum and efficiency savings of 68 hours.
In primary care, the introduction of the new sedation service would make 275 additional capacity for adults and children eligible for treatment with conscious sedation.
In September 2024, Dental Core Trainees (DCTs) at CAVUHB will begin, HEIW certified, conscious sedation training marking the first program of its kind for DCTs in the UK.
Comparison between current practice and new sedation pathway showing increased sedation and decreased GA.
Support for the project
Andrew Dickenson, Chief Dental Officer, Wales
‘It is a significant development for dentistry and aligns with the current policy direction.’
‘Welcome development, especially in light of the dental reform programme and the recovery of services post-pandemic.’
‘This would provide an opportunity to include sedation training into the HEIW training programme….. and serve as an attraction to bring new dentists into Wales.’
‘It could support MCNs and the upskilling of dental teams, their staff and establish more interest for offering enhanced services in primary care.’
