CE1862: Mastering Adult Minimal Sedation

Scott C. Dickinson, DMD; Mark Donaldson, BSP, RPH, PHARMD, FASHP, FACHE; Jason H. Goodchild, DMD

lecture and dental tools icon Lecture & Hands-on

Course Description

Providing dental care to anxious and fearful patients continues to be a major challenge facing dentists. Despite advances in management techniques and treatment delivery, patients’ preexisting opinions and experiences contribute to dental anxiety and fear. Feelings of apprehension create psychological obstacles that prevent dental patients from seeking and receiving care. Of the current techniques to facilitate coping or to minimize procedure apprehension, in-office enteral sedation or oral conscious sedation has garnered the most attention.

Dental fear is a learned response. Family, friends, and popular media can influence patients’ attitudes toward dentistry; this attitude manifests in a cycle of fear that is characterized by avoidance of care and dental pathology. Dentists have used numerous techniques to improve patient comfort during treatment, employing distraction techniques, calming dialogue, and positive reinforcement to manage anxious patients who otherwise would use the “white-knuckle” technique.

In recent years, the use of oral benzodiazepines such as triazolam and lorazepam (with or without nitrous oxide) for the diminution of perioperative anxiety and fear in dental patients has increased. State dental boards, in response, have changed or developed new regulations outlining the training and equipment needed for in-office adult minimal oral and inhalational sedation. Although state regulations for the provision of in-office adult minimal oral and inhalational sedation vary widely with respect to training and pharmacological strategies, consonance exists on the use of inherently safe drugs, the use of pulse oximetry, and the availability of emergency equipment including pharmacologic antagonists.

This dynamic lecture will cover both the science and art of oral conscious sedation in an interactive and engaging multimedia presentation. The pharmacological basis of therapeutics will be addressed, taking the principles of academia into the realm of clinical practice. Treatment strategies and protocols will be discussed in a comprehensive, case-based approach.

Course Objectives

As a result of attending this class, you will be able to:

  • Describe the continuum of consciousness.
  • List the characteristics of the ideal sedative for in-office use.
  • Match the right drug at the right dose to the right patient and the right procedure.
  • Discuss the advantages and disadvantages of oral conscious sedation versus other modalities.
  • List the characteristics of the ideal sedative for in-office use.
  • Describe the mechanism of action and pharmacological properties of the benzodiazepine family of medications.

Course Schedule of Topics Each Day

Part 1 — Friday, March 8, 2019

  • Pharmacology of Oral Sedatives and their Utilization with Nitrous Oxide
  • Minimal Oral Sedation Protocols and Patient Management
  • Beyond Sedation: Appropriate Analgesic Prescribing
  • Beyond Sedation: How Sedation can improve your Local Anesthesia success
  • Beyond Sedation: Pain mechanisms and Appropriate Analgesic Prescribing
  • Beyond Sedation: Local Anesthesia Update
  • Keeping Patients Safe: Flumazenil & Naloxone
  • Minimal Sedation Regulations and Other Regulatory Considerations

Part 2 —Saturday and Sunday, March 9-10, 2019

  • Clinically-Useful Pharmacology
  • Patient Assessment and Risk Management
  • Applied Physiology & Anatomy of Respiration
  • Nitrous Oxide and Oxygen Pharmacology
  • Indications and contraindications for the use of Nitrous Oxide
  • Nitrous Oxide Equipment: Plumbed and Portable
  • Incremental and Rapid Induction Administration Techniques
  • Nitrous Oxide Contamination and Scavenging, When Fail-Safe Isn’t Safe
  • Keeping Patients Safe: Monitoring
  • Keeping Patients Safe: The Dental Emergency Kit
  • Tips and Tricks for Additional Pain and Anxiety Control
  • Avoiding Drug Interactions

Instructors

Scott DickinsonScott C. Dickinson received his undergraduate degree from St. Lawrence University and his dental degree from the University of Pennsylvania, School of Dental Medicine. After graduation he completed an AEGD while serving in the U.S. Army. During this time Dr. Dickinson received training on and regularly used nitrous oxide and oxygen, oral, and intravenous sedation techniques. During his service in the Army he performed the duties of both a flight surgeon and a general practicing dentist. After leaving the Military he entered private practice where he served as the Vice President of Clinical Support for Aspen Dental Management. In this role he was responsible for the training, new dentist orientation, and continuing education needs of both the company and the over 700 doctors it associates with. He now maintains an active general dental practice in Pensacola Florida where he regularly uses sedation techniques to more comfortably treat his patients.

Mark DonaldsonMark Donaldson received his baccalaureate degree from the University of British Columbia and his Doctorate in Clinical Pharmacy from the University of Washington. He completed a residency at Vancouver General Hospital, and has practiced as a clinical pharmacy specialist, clinical coordinator and director of pharmacy services at many healthcare organizations in both Canada and the United States. He is currently the Associate Principal of Clinical Pharmacy for Vizient’s Advisory Solutions, and lives in Whitefish, Montana.

Dr. Donaldson is a Clinical Professor in the Department of Pharmacy at the University of Montana in Missoula, and Clinical Associate Professor in the School of Dentistry at the Oregon Health & Sciences University in Portland, Oregon. He has a special interest in dental pharmacology and has lectured internationally to both dental and medical practitioners. He has spent the last 20 years focusing on dental pharmacology and dental therapeutics, and is a leader in the field.

Dr. Donaldson has published numerous peer-reviewed works and textbook chapters. He currently serves on the Editorial Board for the Journal Healthcare Executive and the Journal of the American Dental Association and is a reviewer for over ten other different journals. He is board certified in healthcare management and is the Past-President and current Regent of the American College of Healthcare Executives’ Montana Chapter. Dr. Donaldson was named as the 2014 recipient of the Bowl of Hygeia for the state of Montana and is the 2016 recipient of the Dr. Thaddeus V. Weclew Award. This award is conferred upon an individual who has made outstanding contributions to the medical, dental and pharmacy literature.

Jason GoodchildJason Goodchild is a graduate of Dickinson College in Carlisle, PA. He received his dental training at the University of Pennsylvania School of Dental Medicine. Dr. Goodchild serves as Associate Professor & Chairman of the Department of Diagnostic Sciences at Creighton University School of Dentistry (Omaha, NE). Recently, he joined the Premier Dental Products Company in Plymouth Meeting, PA as the Director of Clinical Affairs. He has published numerous articles and lectures internationally on the topics of treatment planning, treatment of medical complex patients, restorative dentistry, pharmacology, emergency medicine in dentistry, enteral sedation dentistry, and dental photography. He has been an invited speaker for the Academy of General Dentistry and American Association of Dental Examiners. He is a reviewer for the Journal of the American Dental Association, General Dentistry, and Quintessence International. Dr. Goodchild maintains a private general dental practice in Havertown, PA.

Disclosures:

  • Drs. Dickinson, Donaldson and Goodchild have no relevant financial relationships to disclose.
  • The staff of the University of Washington Office of Continuing Dental Education have no relevant financial relationships to disclose.

Course Logistics

DATE:
Friday, Saturday and/or Sunday, March 8-10, 2019 (attend any day, or combination thereof)

LOCATION:
Friday:
The Mountaineers Club
7700 Sand Point Way NE
Seattle, WA 98115

Saturday and Sunday:
University of Washington
Health Sciences Center
Turner Auditorium, Room D-209 and D-2 Clinic

Seattle, Washington 98195

TARGET AUDIENCE:
This course is applicable for all dental professionals interested in providing minimal sedation in their office.

REGISTER:
Download Course Application Form
or
Register Online (available until the Wednesday before the course).

TIMES:
Registration and Continental Breakfast: 8:00am – 8:30am
Course: 8:30am – 4:30pm

TUITION – price includes lunch:
Until March 6, 2019(after, $25 more)
$449/Dentist per day
$299/Staff per day
$404/Current Dental Alumni Member per day

* This course is eligible for a 10% tuition discount if you are a current member of the UW Dental Alumni Association.

CREDITS:
7 hours per day


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The University of Washington is an ADA CERP Recognized Provider.
ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

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The University of Washington is a member of the Association for Continuing Dental Education.

University of Washington designates this activity for 7 continuing education credits per day.