Increasing conscious sedation use for dental treatments: a cost and consequences analysis

Aims To evaluate the costs and outcomes of increasing conscious sedation (CS) use for adults undergoing a dental procedure in secondary care.Methods A cost-consequence analysis comparing the increased CS use under a new model and current practice was undertaken from a UK National Health Service perspective. Costs included treatment room/bed, staff and drugs. Clinical outcomes, total procedure time and resources were considered. Data sources included theatre data, published literature and expert opinion. A sensitivity analysis excluding staff costs was conducted.Results In current practice, 1,321 patients had a dental procedure under general anaesthetic (GA) (n = 529) or CS (n = 792) from April 2022 to March 2023. It was estimated to incur £1,817,227, where GA contributed 60% of the total annual costs, and yielded 1,297 (98%) successful cases, and 20 (1%) adverse events. The new model would incur total annual costs of £1,773,629, representing a cost-saving of £43,598, compared to current practice. A total of 107 hours of theatre time and 79 hours of anaesthetist time would be freed. The change in clinical outcomes was modest. The cost-saving finding was robust in the sensitivity analysis.Conclusion Increasing CS use potentially offers cost savings. Expanding CS dental services could reduce over-reliance on GA, free up high-cost resources and help address the long waiting time for dental procedures.