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Saturday, 26 February, 2000, 03:17 GMT
Dentist training 'inadequate'

Dental equipment
Many patients opt for sedation instead of anaesthesia

Dental students do not receive adequate training in how to sedate anxious patients, according to a report.

Increasing numbers of patients are requesting "conscious sedation" instead of anaesthesia when they go to the dentist.

The number of sedations carried out in England and Wales increased from 13,500 in 1998 to 17,200 last year.

Sedation teaching seems to have been afforded a low priority by many dental schools

Dr Nick Girdler, Newcastle Dental School
But the British Dental Association (BDA) has found that many dental students graduate without a thorough grounding in the techniques.

The BDA report found wide variation in the quality of training at dental schools across the UK.

Conscious sedation involves either an injection of a drug similar to Valium in the back of the hand, or inhaling gas and air.

It is seen as a much safer alternative to giving patients a general anaesthetic, as they are sleepy but conscious.

They do not feel or remember the experience afterwards.

On Thursday, a sheriff's report in Scotland highlighted the dangers of general anaesthetic after a 10-year-old boy died.

Darren Denholm died of a heart attack after being given a general anaesthetic for treatment on a rotten tooth.

The sheriff heading the inquiry said dentists should only be allowed to use general anaesthetic in a hospital with an intensive care ward.

Limited hands-on experience

The BDA report found that students are given an average of just four lecturers and two seminars on sedation throughout the whole of their training.

They only experience hands-on training in two cases of inhaled sedation and just one of intravenous sedation.

An expert working party in 1990 recommended that students should undertake 10 inhalation and five intravenous cases.

Staff at dental schools said lack of funding, insufficient time and facilities and teaching shortages were to blame for the problems.

Report author Dr Nick Girdler, of the Newcastle Dental School, said: "It is clear that the number of sedation cases being undertaken by students falls far short of those recommended.

"It is now possible in the light of this survey to provide substantive evidence that undergraduate training is indeed inadequate.

"Sedation teaching seems to have been afforded a low priority by many dental schools."

Dr Anthony Kravitz, the chairman of the BDA's General Dental Services Committee, said the number of sedation training courses should be increased.

"We have called on the government for additional funding for alternative methods of anxiety control for nervous patients such as sedation and increased training for dentists to provide this.

"So far, however, the Department of Health has declined to make any changes ahead of its review of general anaesthesia in dentistry, which began over 10 months ago.

"We are expecting it to publish the results of this review over the next few weeks."

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See also:
05 Aug 99 |  Health
Nervous dental patients denied treatment
24 Feb 00 |  Scotland
Dental death action call
24 Feb 00 |  Scotland
Dental inquiry report welcomed

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