FDI World Dental Federation Research Articles

Conscious sedation guidance

This guidance is intended to promote good clinical practice for the provision in dentistry of conscious sedation that is both safe and effective. It is not a recipe book for sedation and therefore does not include details of drug dosages. The recommendations are applicable to all patients receiving conscious sedation, to facilitate the provision of any type of dental treatment whether it is delivered in a dental practice, a community dental service clinic or a hospital setting. It also covers the provision of conscious sedation for dental treatment provided on a domiciliary basis. Specifically excluded from this guidance, however, are patients who require assisted ventilation, intensive care sedation, premedication for general anaesthesia, postoperative analgesia, sedation in palliative care, night sedation and sedation in the home setting other than for the provision of dental treatment on a domiciliary basis. Existing guidelines, relevant systematic reviews, policy documents, legislation or other recommendations were reviewed and appraised for their quality of development, evidence base and applicability to the remit of the guidance under development. To supplement this information, key questions were formulated by the Guidance Development Group and used as the basis for designing systematic literature search strategies to identify further research evidence that may address these questions, including unpublished work where relevant. The following internet sites were searched for guidelines: New Zealand Guidelines Group, Canadian Collaboration on Clinical Practice Guidelines in Dentistry, National Guidelines Clearinghouse, FDI World Dental Federation, National Electronic Library for Health Guideline Finder, and Medline. The Cochrane Library was searched for systematic reviews and Medline, Embase and the Cochrane Library for studies to address key questions. The searches were supplemented by material already known to members of the Guidance Development Group. Titles and abstracts of the identified references were screened for relevance independently by two researchers who were not members of the Guidance Development Group. Disagreement about the inclusion of specific individual references for further consideration was resolved by discussion and if necessary the opinion of a third researcher was sought. Included references were appraised and data was abstracted independently by two researchers using a specifically designed data-abstraction form. This information was then checked for inconsistencies, which were resolved by discussion, and used to construct evidence tables. The evidence tables were presented to the Guidance Development Group to inform their decision-making and their recommendations related to the key question under consideration. Levels of evidence were assigned by two researchers who were not members of the Guidance Development Group. Formulation of each recommendation was achieved by consensus reached through discussion, drawing on the broad range of interest and experience of sedation related to dentistry within the membership of the Guidance Development Group. Consultation and peer review were conducted prior to publication. A draft of the guidance was the subject of discussion at the Dental Sedation Teachers Group annual symposium in April 2004. Subsequently, approximately 100 copies were distributed throughout the UK to a range of professional organisations and individuals who have an interest in dental sedation, and comments were requested. In addition, all dentists in Scotland who recently claimed the National Health Service allowance for treatment with sedation were invited to comment. The consultation draft was also made available on the group's website ( www.scottishdental.org/cep ). All comments received through this consultation were considered and the guidance was amended accordingly prior to peer review. Further amendments were made in response to feedback from peer reviewers before publication. The guidance will be reviewed in 2 years' time (2008) and if there have been significant changes it will be updated accordingly. The detailed guidance make 48 recommendations in a range of areas: A number of recommendations were made regarding the future conduct and reporting of clinical trials. The following areas were highlighted as requiring further high-quality research: The complete guidance is available for download at www.scottishdental.org/cep/guidance/dentalsedation.htm .

Guidelines and the Killer Bs

We have recently seen the launch of a major new dental guideline from the Scottish Intercollegiate Guidelines Network (SIGN), which we have summarised in this issue. The development of clinical guidelines in healthcare is an expanding industry. Hibble et al1 found 855 different guidelines in general medical practices in Cambridge and Huntingdon Health Authority. There were 243 single-page and 195 two-page guidelines, representing a pile 68 cm high and weighing 28 kg! The number and volume in dentistry is similarly sizeable, as a visit to the FDI World Dental Federation guideline database (www.fdiworldental.org/resources/2_0guidelines.html) will confirm.

Cutting edge research that will impact future oral health care

This paper has been approved by the FDI Science Committee, comprising ProfessorLP Samaranayake (Chair) Professor Martin Tyas (Vice-Chair), Professor R Biffar,Professor J Clarkson (IADR), Dr PL Fan, Professor A Jokstad Professor H Magloire andProfessor H Suda.The views expressed in this article are those of the authors and/or presenters anddo not necessarily represent any policy positions of the IADR or the FDI.Correspondence to: Professor Asbjorn Jokstad, FDI Scientific Affairs Manager, FDI WorldDental Federation, 13 Chemin du Levant, l’Avant Centre, F-01210 Ferney-Voltaire,France. Email: science@fdiworldental.org

What is the FDI World Dental Federation?

What is the FDI World Dental Federation?

BDA nominates John Hunt as President of the FDI World Dental Federation

BDA nominates John Hunt as President of the FDI World Dental Federation

Dental aid organisations: baseline data about their reality today

To collect basic data about non-governmental dental aid organisations on a global scale and thus contribute to a better understanding of their diversity, activities and limitations. Data was collected through a mailed questionnaire to all organisations listed by the FDI World Dental Federation. A second questionnaire was e-mailed to those organisations identified as non-governmental organisations (NGO) by the first questionnaire. The response rate to the first questionnaire to detect NGOs was 36.2%, to the second e-mailed form 84.4%. About two thirds of NGOs originated in developed countries, one third responded from developing countries. The majority had been established after 1980. Developed countries dental NGOs tended to have larger membership and disposed of greater budgets. In general, income was generated predominantly from donations and own resources. The workforce was primarily based on volunteers. High priority activities: service provision, education and training, technical assistance, community development. Measures for quality assurance showed low complexity. Frequent areas of problems were associated with funding and staff. Collaborative links with other stakeholders in development were weak and focussed on information exchange. Recommendations for NGOs, donors, FDI and future research are developed.

The FDI World Dental Federation web-site

The FDI World Dental Federation web-site contains information about the organisation itself, about congresses and dental manufacturers, and has a special area for dental professionals. The authors feel that this web-site is an interesting and valuable electronic portal for general dental practitioners and dental researchers, as well as for national dental organisations. The site contains a tremendous amount of information. Some recommendations are offered to further improve this informative and well-constructed web-site.

Address by the President of the FDI World Dental Federation Clive B. Ross, BDS, FDSRCS, FRACDS, FICD, FACD at the Opening Ceremony*

Address by the President of the FDI World Dental Federation Clive B. Ross, BDS, FDSRCS, FRACDS, FICD, FACD at the Opening Ceremony*