Clinical practices and education of intravenous moderate/deep sedation in Japan

Abstract

Safety and comfort during dental procedures are the key factors for high quality dentistry and fundamentals for patient satisfaction. Systemic managements such as general anesthesia and moderate/deep sedation are widely applied to dental outpatients for safe and comfortable dentistry by dentists in Japan. For intravenous moderate sedation, midazolam, propofol and their combination are common choices for dental outpatients. Sometimes deep sedation is required especially in patients with intellectually disability, severe fear/anxiety or severe gaging reflex. Some of these patients may undergo general anesthesia instead of intravenous sedation. The Japanese Dental Society of Anesthesiology (JDSA) established “Practice Guidelines for Intravenous Conscious Sedation in Dentistry” in 2017, and these guidelines become standard for routine clinical practices. In Japan, dental school has 6-year curriculum. Lectures and preclinical practices are given to 4th grade students and clinical practices are to 5th grade students. They learn wide range of knowledge and skills for systemic management of dental patients. JDSA has two board systems for dental anesthesiologists; Japanese Board of Dental Anesthesiology (JBDA) and Board Certified Dental Anesthesiology Specialist (BCDAS). BCDAS is authorized by the Ministry of Health, Labour and Welfare, Japan since 2006. The author would expect the development of dental anesthesiology field in Russia and the progress of anesthesiology collaboration system in dental and medical field.