“Relative analgesia using nitrous oxide on its own is excluded from this standard for all dental practitioners”
Questions from members often result in MIPS’ advisors having to review current guidelines, recommendations and regulatory requirements.
A recent enquiry from a dental member regarding the administration of nitrous oxide was a case in point. The enquiry did not precisely outline the scenario in which this agent was to be used, and this is significant in the light of current guidelines.
To practice in the area of conscious sedation a Dental Board of Australia endorsement is not only preferred, it is mandatory. The endorsement is specific only for that area of practice in conscious sedation. The important statement within the document is that “relative analgesia using nitrous oxide on its own is excluded from this standard for all dental practitioners”.
So the short answer to the member’s enquiry is that whilst an endorsement is mandatory for any form of conscious sedation, with particular reference to nitrous oxide used in the context of relative analgesia, the endorsement is not required.
There are other factors to consider however. The wise practitioner will recognise that even with relative analgesia, the effects on the individual patient can vary. If the effects are indeed more profound than is intended, it is imperative that the practitioner recognises this, acts accordingly, and has in place the appropriate equipment and protocols to deal with the situation.
Standards and guidelines are important, but it is important to remember that although some procedures are excluded from the guidelines (for example relative analgesia), it does not mean that an adequate and acceptable level of competency is not required for those practitioners involved in the areas of relative analgesia and sedation, or working on patients under general analgesia. As a result familiarity and an understanding of the Dental Board of Australia, Guidelines on conscious sedation forms essential reading. Practitioners should always consider the Dental Board scope of practice considerations as well.
All members are encouraged to check the AHPRA guidelines and if further clarification is required, MIPS clinico-legal advisors may be contacted for further discussion on 1800 061 113.