Conscious sedation in primary dental care, England: a comprehensive review

Aims The aim of this study was to identify which dental providers, registered with the Care Quality Commission (CQC), provide conscious sedation, establishing what techniques they employ, which patient groups they treat, while beginning to determine the level of risk associated with sedation provision through assessment of compliance during inspection.Methods Firstly, a short, three-question, Checkbox survey was distributed to dental providers, registered with CQC, via email. Secondly, CQC inspection reports, for all dental providers found not to meet regulations, were thematically analysed for non-compliance. The results were analysed using Microsoft Excel.Results In total, 8,536 survey responses were received resulting in a response rate of 81.3%. Results confirmed 20.6% of dental providers offer a conscious sedation service with most (89.6%) using the benzodiazepine midazolam and treating adult patients (63.7%). Just over 5% of dental practices deliver advanced sedation techniques and 37.8% use a peripatetic (visiting) sedationist. Between September 2021 and August 2025, 2,906 dental providers were inspected with 488 practices failing to meet one or more regulations, with 69 delivering sedation. Common aspects of non-compliance included lack of evidence of sedation and/or life support training and inadequate patient monitoring.Conclusions Demand for conscious sedation in dentistry is high, with over one-fifth of dental providers offering the service. In the main, most services deliver standard techniques, using midazolam only, nitrous oxide and treating adult and paediatric patients, respectively. Nevertheless, providers outlined a range of offerings. On the whole, sedation provision in dental practice is delivered safely in compliance with national standards. There are, however, aspects that increase the risk of adverse outcomes and it is therefore essential practitioners familiarise themselves with relevant guidelines and standards and align their practise with such.