Evaluation of postgraduate training in inhalation sedation in France

Objectives: Formal postgraduate training in dental sedation became available in France in 2002 (a one year University Diploma in Conscious Sedation in Dentistry). This study aimed to validate the teaching of inhalation sedation of these courses. Methods: All dentists qualifying with a diploma in 2003 and 2004 from four faculties (Universities of Clermont Ferrand, Nancy, Marseille and Strasbourg) provided standardised data regarding all acts of sedation since qualifying. Forty-eight dentists performed 1140 administrations of inhalation sedation for 701 patients using a 50% nitrous oxide/ oxygen premix. Data collected included completion of planned dental treatment (success/ failure), behavioural evaluation at five points throughout the session (modified Venham scale) and adverse events. Results were compared with those previously reported by a group of experts (1205 sedation sessions) using the same technique and criteria. Results: The newly qualified dentists were able to complete the planned dental treatment for 91% of the sedation sessions, compared to 93% for experts. Mean patient cooperation was significantly improved between the start of induction and the treatment periods (Wilcoxon, p<0.0001). No major adverse effect was recorded and minor adverse events were rare – notably nausea and vomiting (4.8% of sedation sessions compared to 5.0% of sessions for experts). Conclusion: Despite having little experience in sedation techniques, high levels of effectiveness, tolerance and security were attained. The training programme was thus validated and data was provided to support the argument for legalisation of nitrous oxide sedation in general dental practice in France.