Are Special Care Dentistry Services Prepared for a Global Disruption in Healthcare? A Call for a Wider Promotion of Dental Conscious Sedation Training.

Arkadiusz Dziedzic,Chris Dickinson,Hassan Abed,Marta Tanasiewicz,Bruna Picciani

doi:10.3390/healthcare8040419

Abstract

Recently, calls for prompt and smart reform of dental education and postgraduate training have been made, reflecting the current global healthcare needs and addressing the most common problems faced by dental care providers. Objectives: Herewith, we propose the enhancement of multilevel dental training in dental conscious sedation (DCS), in order to meet the increasing demands associated with current and post-pandemic times. The temporary suspension of general anaesthesia and hospital-based sedation provision in response to coronavirus disease 2019 (COVID-19) revealed the urgent need for more efficient utilization of a variety of forms of DCS. Whilst the global spread of Severe Acute Respiratory Syndrome novel coronavirus (SARS-CoV-2) has particularly challenged dental sedation teams in community services, the appropriate preparation for similar disruptions in future should be undertaken proactively. In response, dental schools and commissioners are obliged to implement innovations in teaching, with the development of new programs supporting trainer–trainee interactions and focusing on practical sedation skills. Conclusions: The joint efforts of educators, healthcare providers, and commissioners, as well as adequate and robust DCS training utilizing a variety of teaching methods, would allow our profession to face the growing demand for pain and anxiety control measures in light of the current situation, which may increase even further over time. Decision makers are urged to consider making training in DCS more accessible, meeting current healthcare demands, and equally providing essential support for the special dental care sector.

Highlights

Uninterrupted and efficient special care dentistry (SCD) provision depends upon the competent dental team members, their joined, mixed practical skills and independent arrangement, along with close cooperation with other specialists and medical professionals
For some groups of SCD patients, dental treatment under GA remains a viable option for the provision of efficient healthcare, and in selected cases, dental general anaesthesia (DGA) can often be the only alternative for the persons who are unable to cope with routine dental treatment provided by any other means [13]
The using broader provision of safe and dental conscious sedation requiressupport, adjustments in hampers the access to and severely disadvantages patients. This is the right time to initiate both further education of the profession and supportive clinical governance

Summary

Introduction

Uninterrupted and efficient special care dentistry (SCD) provision depends upon the competent dental team members, their joined, mixed practical skills and independent arrangement, along with close cooperation with other specialists and medical professionals. The temporary suspension and/or global reduction of general anaesthesia (GA) sessions and specialty training in anaesthesia, as well as deferred hospital-based sedation provision, along with a shortage of sedation-trained hospital personnel and limited alternatives of anxiety management options for dental patients revealed the urgent need to be better prepared for mass healthcare disruption and any such situation in future [3]. Whilst the uninterrupted provision of adequate anxiety control is an integral element of clinical dentistry, the utilization of a variety of forms of dental conscious sedation (DCS) is required, which comprises oral, intranasal/transmucosal inhalation, and intravenous sedation, or hybrid and combined methods [4,5,6] (Table 1). The therapeutic goals of sedation in the dental and medical field are anxiety relief, reduction of psychological stress, and post-operative amnesia for traumatic procedure or event

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