SAAD Digest 

March 2025
Volume: 41
Issue: 1
DOI: 10.63507/YRDN4650

Title: Dentist-led conscious sedation with remimazolam in a frail older adult

Author(s):  K. Wyncoll, L. Charles, X. Yeo, H. Hossenally, S. Clough

Abstract: 

Special care dentistry manages patients with multiple co-morbidities that present challenges for delivery of dental care. Treatment planning in this cohort requires a holistic and flexible approach. A 69-year-old male patient presented with multiple carious retained roots suspected to be causing pain. The patient was non-verbal and had a severe learning disability, dysphagia and frailty. 

Initially, a general anaesthetic was planned to complete comprehensive dental care. However, by the day of the procedure, the patient’s frailty had deteriorated and he was not deemed fit for a general anaesthetic. To avoid a loss of theatre space and clinical activity, as well as to facilitate completion of the required dental treatment, the dental team worked with the anaesthetic team, adapting the treatment plan to perform intravenous sedation in theatre with the novel benzodiazepine remimazolam. 

This case highlights the dynamic nature of treatment planning in frail multi-morbid patients where the clinical picture can change significantly between appointments. Frailty is becoming ever more pertinent with our ageing population. This case demonstrates the use of intravenous sedation with remimazolam as a potential solution in these cases.

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Articles from Digest 41(1)