Quality of available internet information regarding IV
sedation for dental treatment
Claudia Heggie,*
1
Sarah L. McKernon
2
and Laura Gartshore
3
Introduction
Single drug intravenous (IV) sedation is widely
used in the provision of dental treatment
for highly anxious or phobic patients.
1
Additionally, the use of IV sedation for special
care patients, for patients with certain medical
conditions or in complex dental treatments is
widely accepted.
2
Discussion of ‘all aspects’ of conscious
sedation and provision of written instructions
is a fundamental part of assessment and the
consent process for patients for sedation.
3
In
the process of informed consent, information
must be provided to patients outlining the
risks and benefits of proposed treatments.
Indeed, aſter the Montgomery case in 2015,
the burden of weight rests with healthcare
providers to ensure patients are provided
with suitable information.
4
Patients cannot
make informed healthcare decisions without
sufficient information on which to base their
decisions; however, healthcare professionals
may frequently underestimate patients’
ability to understand information.
6
The
patient-clinician relationship oſten involves
a perceived mismatch in power, with the
physician traditionally perceived as autocratic
and the patient vulnerable.
7
Healthcare information is now one of the most
commonly searched topics on the internet.
8
A
recent survey in the United States demonstrated
that 80% of the internet-using population
had searched for health-related information.
9
A systematic review of the quality of health
information on the internet found that 70% of
accepted studies concluded that the quality of
information available presents a problem for
patients and healthcare professionals.
10
Patients
may benefit from the provision of patient
information leaflets in relation to planned
healthcare procedures; however, evidence is
contradictory as to whether leaflets provided
at the time of consultation aid knowledge
retention.
11,12,13,14,15
It might be expected that
online information of poor quality could
lead to mistrust of dental professionals and
to confusion for patients. It is important that
healthcare professionals acknowledge this and
guide patients to appropriate web sources if they
wish to seek further information.
16
ere is research in the literature regarding
the quality of internet information available
for a variety of oral conditions; however, no
comparative research could be found regarding
the quality of sedation-related information.
17,18
If patients are known to search for health
information online, it is important that they have
access to appropriate information, particularly
given that IV sedation is part of a wider range
of sedation modalities and that pre- and post-
operative instructions are required. Providers
of IV sedation should be producing credible,
quality information to empower patients to
make decisions about their care.
e aim of this study was to determine the
affiliation, location, format and quality of the
information available to patients on the internet
regarding IV sedation for dental treatment.
A study to determine the quality of information
available to patients on the internet regarding
intravenous sedation for dental treatment.
To consider the role of the internet for patients
seeking care and how this may impact on their
decision-making.
To consider what we can do as dental professionals
to improve the overall quality of available internet
information regarding intravenous sedation.
Key points
Abstract
Aim Evaluate the content and quality of internet information for patients regarding intravenous sedation in dentistry.
Methodology Google was queried with predefined search terms that might be chosen by patients wishing to seek
information: ‘dental IV sedation OR dental intravenous sedation OR dental sedation’. The first hundred search results were
identified. Invalid hyperlinks and duplicates were excluded. Providers, format and location of information were extracted.
For webpages detailing treatment options, the DISCERN instrument and JAMA benchmark were used to determine the
quality of the information provided.
Results Of the first hundred search results, 89 webpages met the initial inclusion criteria. A majority (79%) originated
from dental providers. Information was commonly presented as patient information leaflets. Of the 78 webpages detailing
treatment options, 3% of webpages received a maximum DISCERN score of 5 and 64% a score of 1. No webpages fulfilled
all JAMA criteria and 89% met only one criterion. Secondary care providers scored higher in both scales; however, this
represents only 5% of the information available.
Conclusion The internet is a commonly accessed information resource for patients. The quality of internet information available
regarding intravenous sedation in dentistry is suboptimal. There is a need for more high-quality information resources.
1
DCT;
2
Clinical Lecturer and Specialist in Oral Surgery;
3
Senior Lecturer and Honorary Consultant in Paediatric
Dentistry, Liverpool University Dental Hospital, Liverpool,
L3 5PS, UK.
*Correspondence to: Claudia Heggie
Email address: claudia.heggie@nhs.net
Refereed Paper.
Accepted 20 November 2019
https://doi.org/10.1038/s41415-020-1258-7
BRITISH DENTAL JOURNAL | VOLUME 228 NO. 4 | FEBRUARY 28 2020 279
RESEARCH
© The Author(s), under exclusive licence to British Dental Association 2020