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BDJOpen 2016;10.1038/bdjopen.2016.2http://www.nature.com/articles/bdjopen20162

Some patients receiving primary dental care may occasionally require conscious sedation – for example, sedation can help to support anxious patients or those undergoing long or difficult procedures. In England, there is a limit to the amount of sedation which can be provided in primary dental care due to NHS commissioning restrictions. However, research indicates that the need for sedation services in dentistry may be higher than the current limit.

The research published in this article from BDJ Open investigates the provision of sedation in primary dental care in England by looking at patterns relating to where patients come from, their socioeconomic status, and the type of care they are receiving. As the article's authors point out when there is a limited volume of care commissioned, it is particularly important to ensure that population needs are being met fairly.

This study examined the data for all patients receiving conscious sedation under NHS primary dental care in England from 2012–2014. The analysis of this large cohort reveals a marked socio-economic effect on the uptake of sedation – the most deprived showing the highest uptake, particularly in children and young people. Indeed, 6-12-year-olds accounted for almost one quarter of cases. This worrying trend correlates with the social gradient seen in relation to dental caries and hospital admissions for extractions among children.

The researchers also found that there were significant regional variations relating to the provision of sedation. Interestingly, though the South of England showed the highest level of provision, it had the lowest level of uptake for children. It would have been expected that higher levels of sedation would have been provided in the North of England, where oral health needs are highest.

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