Estimating the need for dental sedation. 2. Using IOSN as a health needs assessment tool

Key Points The overall need for sedation appears to be around 5% of dental attenders. Referral of those who usually do not need sedation may be appropriate for complex treatments or particular medical needs. Medical history, patient reported anxiety and treatment complexity are important to consider when referring for sedation. The IOSN system can be deployed by commissioners within populations to assess treatment need. Aim This service evaluation assessed the need for sedation in a population of dental attenders (n = 607) in the North West of England. Methods Using the novel IOSN tool, three clinical domains of sedation need were assessed: treatment complexity, medical and behavioural indicators and patient reported anxiety using the Modified Dental Anxiety Scale. Results The findings suggest that 5% of the population are likely to require a course of treatment under sedation at some time. All three clinical domains contributed to the IOSN score and indication of treatment need. Females were 3.8 times more likely than males to be placed within the high need for sedation group. Factors such as age, deprivation and practice location were not associated with the need for sedation. Conclusions Primary care trusts (PCTs) need health needs assessment data in order to commission effectively and in line with World Class Commissioning guidelines. This study provides both an indicative figure of need as well as a tool by which individual PCTs can undertake local health needs assessment work. Caution should be taken with the figure as a total need within a population as the study has only included those patients that attended dental practices.