The IOSN ( Index of Sedation Need)

SAAD have published a questionnaire aimed at assessing a patient's level of anxiety. The IOSN ( Index of Sedation Need).

This was originally developed as a means to assess the need for sedation resources amongst local populations for NHS commissioning.

However if could be used , especially by inexperienced practitioners to help assess a patient's needs for conscious sedation or to direct a patient towards alternative methods for managing their anxiety or indeed phobia.

It pulls together the MDAS (Modified dental anxiety score) which could be used on its own as an indicator of the degree of anxiety the patient experiences, with additional complicating medical factors and treatment complexity all of which combine to produce the need for sedation.

E.g. a patient with an ASA score of I or II with only a minimal level of anxiety my be escalated into a category needing sedation, if the treatment is complex, lengthy or may be deemed be unpleasant by its nature.

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New document available for download:
Standards for Postgraduate Education

These new recommendations are likely to have a major impact on the training and validation of competency requirements for those wishing to offer Inhalaton Sedation/ RA to their patients.

GDC Scope of Practice 2008

Link to the full document

Important changes

Compulsory DCP registration from July 2008 means that regulations governing the specific treatment modalities or tasks which DCPs can undertake have been lifted. This will have implications for administration of Inhalation Sedation/ RA.

In general DCPs may now provide any treatment for which they are qualified or for which they have received appropriate training, although there is still a propsed list of treatments allocated to each class of DCP.

The proposal now is to open up the possibilities for Dental Therapists being able to provide treatment whilst administering Inhalation Sedation.

The following is a quote from the Introduction of the GDC's document Scope of Practice 2008

Introduction

The statutory registration of dental care professionals (DCPs) is a fundamental development in dentistry. It means that from July this year everyone involved in the clinical care of a patient must be registered with the GDC, with the privileges and responsibilities that being a registrant brings. The legislation which opened up registration to DCPs also brought about other significant changes in the way that registrants work and the requirements placed upon them.

For example, any registrant can now own a dental practice and carry on the “business of dentistry”. One of the changes was to remove the lists of ‘permitted duties’ for dental hygienists and dental therapists, which restricted the types of treatment that hygienists and therapists were able to provide. The old lists were set out in Regulations made under the Dentists Act and expanding them to try to keep pace with contemporary practice was a laborious process requiring approval by both Houses of Parliament, which was not in keeping with the spirit of proportionate regulation.

The lists were replaced by a requirement for all registrants to work within their training and competence, which was similar to the system in place for dentists. There was also a requirement for registrants only to delegate tasks if they were satisfied that the person to whom they were delegating was trained and competent for the task concerned.

The idea was that the GDC curricula in Developing the Dental Team would set out the skills that could be expected of a newly qualified member of each group and that these could then be expanded during a registrant’s career by means of further training or experience – again similar to the system in place for dentists. As new treatment methods and skills came along, those which became established could be added to the relevant curriculum and so become part of the skill set of that group."

See Page 15 regarding proposed  Dental Tharapist duties.