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New service helps teenagers terrified of the dentist

Many people are scared of going to the dentist, but thanks to a new service pioneered at the University Dental Hospital of Manchester, terrified teenagers are now facing treatment with a smile.

Consultant in paediatric dentistry Claire Stevens and consultant paediatric anaesthetist Sian Rolfe set up a research study to look at using intravenous (IV) sedation to help anxious teenagers cope with treatment.

Dental HospitalTheir team began the 12-month study in November 2010, to assess whether sedation with the drug propofol was a viable alternative to 'happy air' (inhalation sedation) or a full general anaesthetic for young people aged 12-16 being treated at the Dental Hospital.

The study had 50 participants, all of whom were very anxious to the point of some needing psychiatric care.  Only two of the 50 patients failed to have their treatment, due to fear of having a drip inserted into their arm, and Claire is working with them to overcome this.

The overall results of the study have astounded the team, and led to the setting up of a permanent IV sedation service, which is fully booked five months ahead for initial appointments.  The team is hoping to expand the service to accommodate demand.

"We were amazed by how well the patients responded, and when questioned 100% said they would have the sedation again for future treatment," said Claire.  "There was just one missed appointment over a 12 month period, compared with a usual 'did not attend' rate of 9%. Word about the sedation service has spread, mainly due to our study featuring in the 'Children's Hospital' TV series. Many young people have referred themselves to us directly because they knew more about the service than their dentist!

"The patient benefits include being able to carry out more treatment in a session than we would with inhalation sedation, and a better all round experience.  We can help even the most anxious patients, instead of these young people being ignored and possibly suffering severe dental problems later in life."

One happy patient said it was "the afternoon of my life", while other comments include "I knew what was happening but wasn't bothered, all I could think was I'm chuffed with myself for doing it" and "This stuff is amazing, I actually enjoyed the treatment."

The sedation service has also reduced pressure on the waiting list for general anaesthetics, and generated additional income for the hospital so it is self-funding.

The initial research study was funded by a £13,000 Research for Patient Benefit grant from Central Manchester University Hospitals NHS Foundation Trust and the NIHR Manchester Biomedical Research Centre.  Claire gave a presentation at the Trust's annual Research and Innovation Conference on 22nd November, for which she won joint first prize.

Together with Sian, she is writing a research paper about the study, which will be the theme of a national Dental Sedation Teachers' conference in May 2012.  Trainee doctors from across the NW are also joining the team on a rotation basis to learn about the service.

For more information about the IV sedation service, patients and their families can contact Claire.stevens@cmft.nhs.uk.