Arranging a sedation or anaesthesia session

In short: your practice sends a booking enquiry or phones. You and the anaesthetist then agree the setting, the treatment, the depth of sedation or anaesthesia and who supplies what. Patient details travel only by a secure channel agreed with you. Before the session the anaesthetist reviews each patient and discusses consent and the anaesthetic fee with them directly. On the day your dentist treats while the anaesthetist manages the anaesthetic, the monitoring and recovery.

Who arranges a session

The Australian Dental Anaesthetic Group provides anaesthesia and sedation for dental treatment arranged with dental practices in Victoria. Enquiries usually come from the dentist or oral and maxillofacial surgeon who will treat the patients, or from the practice manager who runs the appointment book.

Because the anaesthetic is planned around the dental treatment, a session is set up between the practice and the anaesthetist. Patients come into it through their dentist.

The seven stages

1. Booking enquiry

   Your practice

   Use the booking enquiry form or phone. Say which practice you are, the suburb, who to contact and their role, the days or dates you are considering, roughly how many patients and what kinds of treatment. No patient details at this stage, not even first names.

2. Planning conversation

   Your practice and the anaesthetist

   You talk through the treatment you intend to provide, how long each appointment is likely to run, the depth of sedation or anaesthesia that would suit it, and how your treatment room and recovery space are laid out. You also settle how referrals will be sent and which members of your team will help on the day.

3. Before a first session at your practice

   Your practice and the anaesthetist

   The room, equipment, recovery arrangements and emergency plan are checked against ANZCA's professional documents and the Victorian Department of Health requirements for anaesthesia in a dental practice. Who supplies each item, and who fills each role, is agreed before the first patient is booked. The detail is on the page for practice teams.

4. Referring each patient

   Your practice

   Each patient's details and history go through the secure channel you agreed. If you think someone may need a hospital setting instead, say so in the referral; the anaesthetist makes that decision once they have reviewed the patient.

5. Assessment and consent

   The anaesthetist

   Before the session the anaesthetist reviews each patient's health with them, or with a parent or guardian, explains the plan with its risks and alternatives, and gives individual instructions about eating, drinking and medicines. ANZCA counts the financial side as part of consent, so the anaesthetic fee is explained to the patient directly. It is separate from your practice's fees.

6. Session day

   Your practice and the anaesthetist

   Your dentist provides the treatment. The anaesthetist gives the sedation or anaesthetic, monitors the patient throughout and oversees recovery. Under ANZCA's sedation guideline, discharge is authorised by the practitioner managing the sedation, and patients leave in the care of a responsible adult.

7. After the session

   Your practice and the anaesthetist

   Dental aftercare stays with your practice. Anything about the anaesthetic that your practice or the patient's GP should know is passed on. Before the first session, agree who a patient should call if they have a question about the anaesthetic once they are home.

Agreeing the depth of sedation

ANZCA’s sedation guideline describes a continuum from minimal sedation to deep sedation, which “may inadvertently progress to general anaesthesia”, and asks for management and rescue plans to be prepared before sedation starts. So the depth you have in mind for each type of treatment is agreed at the planning stage, and the room, equipment and escalation plan are prepared for a patient who goes deeper than intended. The anaesthetist decides what is appropriate for each patient after assessing them.

If you would like to explain the levels to patients, Sleep Dental’s plain-English guide to the levels of sedation is written for them.

The documents behind each stage

These are the Australian documents a session is planned against. Reading them before a first session makes the planning conversation quicker.

The arrangements that apply to your practice are discussed with you before a first session, rather than assumed.

In an emergency, call 000. This information is general and does not replace advice from your treating practitioner.