The Intercollegiate Advisory Committee for Sedation in Dentistry (IACSD) sets the current standards for clinical use and training for dentists and doctors providing sedation, in all environments, for dentistry in the UK.
The IACSD comprises of The Faculty of Dental Surgery of the Royal College of Surgeons of Edinburgh (FDS RCSEd), The Faculty of Dental Surgery of the Royal College of Surgeons of England (FDS RCS), The Faculty of General Dental Practice (FGDP UK), The Dental Faculty of the Royal College of Physicians and Surgeons of Glasgow (FDS RCPSG) and The Royal College of Anaesthetists (RCoA).
This is the overarching dental standards document for conscious sedation for dentistry from which devolved professional guidance may be predicated. The current standards statement pre-dates Remimazolam authorisation.
The advice below sets out the expected standard of clinical use and training to enable safe use of Remimazolam until an established evidence base becomes available. Those providing conscious sedation for dentistry will be expected to comply with this standard.
- Remimazolam, titrated intravenously as a single drug in adults, shall be used adhering to the same clinical standards and training required for midazolam.
- The technique is classified as an operator-sedationist technique.
- An appropriate adult escort is required for post-sedation care, in the same way as for the use of intravenous midazolam.
- Remimazolam and midazolam should not be used in combination or sequentially on a routine basis and without adequate justification for the same episode of sedation in primary care.
- Remimazolam should be reconstituted, drawn up and clearly labelled by the clinician administering the drug.
- Providers of intravenous conscious sedation for dentistry, trained and experienced in the use of midazolam to IACSD standards, do not require further supervised clinical experience. However, clinicians must consult the manufacturer’s product literature and have knowledge of pharmacology, dosing and indications together with an understanding of how these fit with the IACSD standards. Evidence of this can be gained through CPD courses with appropriately set aims and objectives.
Please note that this information is for patients over eighteen years of age. Our advice is that this drug should not yet be used in younger patients until further evidence becomes available.
You can access IACSD's full report here.