Northern Irish dental staff are at risk of being exposed to dangerous levels of nitrous oxide due to insufficient training and sub-standard inhalation sedation equipment and maintenance.

The Department of Health has issued an NIAIC (Northern Ireland Adverse Incident Centre) Alert for all dental healthcare workers involved with inhalation sedation to carry out an urgent review of training and equipment.

The alert states: “Recent monitoring tests of waste nitrous oxide in some community dental facilities have highlighted that the selected control measures, including mechanical systems, in place to reduce waste gas levels may not be sufficient in some cases. This was highlighted by widely varying levels of nitrous oxide exposure recorded on monitors carried by a dentist during different procedures.

“Given that the selected control measures (ventilation and scavenging systems) did not change and deemed operating to specification, the variance in exposure levels suggest other risks need to be addressed e.g. differences in working practice and/or patient compliance.”

Janet Pickles of R A Medical Services, the UK supplier of a comprehensive range of inhalation and scavenging equipment, said that she has for some time now been concerned with regard to the status of existing equipment in Northern Ireland, specifically scavenging. Attempts to relay this concern have met with various obstacles and she said that the NIAIC Alert comes as little surprise.

She said: “Because of this alert, I have already been approached for help and advice and will do everything I can to help alleviate the problem. The situation is not beyond resolution and, as the use of inhalation sedation for paediatrics and special needs patients is so valued, any form of restriction or ban on inhalation sedation could be disastrous for patients and staff alike.

“We all know that the waiting lists for dental GA are already appalling – I am sure nobody wishes to add to the level of misery already occasioned by these figures.”

To download the NIAIC Alert, visit www.health-ni.gov.uk/publications/niaic-alerts-nias-publications
To read Janet Pickles’ article on sedation training, click here.

Tags: Janet Pickles, RA Medical Services, Sedation