Q. I treat anxious adult patients with RA and have recently been advised that they must always attend the surgery with an escort. Is this really the case?

The Department of Health guidance Conscious Sedation in the Provision of Dental Care states in section 15 that for an adult receiving nitrous oxide/oxygen inhalation sedation the requirement that a responsible adult escort must accompany the patient home is less rigid and each patient must be assessed individually.

Further into the document, at section 18.2 it advises that adult patients who have received nitrous oxide and oxygen inhalation sedation may leave unaccompanied at the discretion of the sedationist.

In accordance with this guidance therefore it is not mandatory for an adult receiving nitrous oxide/oxygen inhalation sedation to be accompanied home by a responsible adult and this decision is subject to discretion. However, it is important to ensure that pre and postoperative assessments are recorded in the records to support the decision to proceed with treatment and discharge without the presence of an accompanying responsible adult. If you ask your dental nurse or the receptionist to telephone the patient to see that they are safely home and comfortable after their treatment you should also note their response in the record. It is also a great way to demonstrate the caring ethos of the practice.