Relative Analgesia in Practice Part Four

Dental treatment for those who don’t feel they require being “knocked out”

This is something I come across a lot. A patient who is obviously nervous, really isn’t looking forward to a procedure but has decided to go through it anyway. Maybe the patient feels that they “should” be brave, it’s what’s expected of them as a patient.

Dare I say, I’ve been in a position myself when I’ve been in hospital, about to have an unpleasant procedure and feeling guilty asking for anaesthesia. I’ve had dental treatment before where I’ve asked for sedation and I’ve been told “ahh, you don’t need that”.

I am a great believer in healthcare guilt and have written about it many times before. Patients often feel guilty that they have let their oral health slide. They feel guilty asking for help, asking for pain relief. They feel like they are going to get a bollocking from their dentist or hygienist. (By the way, if you think that your team doesn’t think like that, how many times have you heard a team member say “how could Mrs X let her teeth get that bad! It happens in my practice sometimes)

If the culture in the practice changes, great things can be acheived for patient comfort. For example, rather than offering sedation as an option for implants, simply saying “we tend to use sedation for this procedure” makes the patient feel like their comfort is very much caterered for and not something that they have to opt in to.

RA is great for this. For the patient who is to undergo an extraction for example, saying “we often give happy air for extractions as it makes it much comfortable” rather than the standard line “we offer sedation for nervous people”

Dr Rob Endicott is a General Dentist and Sedationist based in Stratford upon Avon, carrying out dentistry for patients under sedation almost every day.

Saturday March 23rd sees the training centre at Stratford Dental ( hosting an RA training day with Dr Richard Charon, the RA Coach ( for the whole dental team.


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