Risk evaluation and patient assessment in sedation

Risk assessment gives a good clinical guide to the understanding of our patients' medical problems. The dentist can cope with problems related to patients belonging to risks group 1 and 2, but not to groups 3 or 4. The results of studies on risks, morbidity, and mortality in anaesthesia teach us that the human factor and technical error provoke complications, morbidity and mortality, seemingly unnecessarily. Case history and a simple physical examination, primarily concentrated on respiration and circulation, are of greatest importance. Main risks during conscious sedation are regurgitation and aspiration of fluid and smaller objects, such as a broken dentist's drill or a cardiac complication. Most feared is the risk of of a reinfarcation. The aim of sedation is to reduce anxiety and restlessness. Of greatest importance is thorough patient information and a good doctor–patient contact.