Adolescent Intravenous Sedation Service

AVIS teamWelcome to the AIVS site!  We are a dedicated team who provide treatment for young people who are anxious about the prospect of dental care. This service began in November 2010 and has since been successfully treating 3 patients per week under the care of Consultant Paediatric Dentist Claire Stevens and Consultant Paediatric Anaesthetist, Dr Sian Rolfe. The AIVS cares for young people between the ages of 12-16. We use intravenous propofol sedation to help patients with severe anxiety to accept dental treatment, which may be of a restorative or surgical nature. 

What is propofol?

Propofol is a medicine which is usually used during general anaesthesia (operations when you are asleep) but when we use it in lower concentrations it acts as a sedative to help our patients feel really relaxed.  Of our first 50 patients who came to the service, we were able to successfully treat 48 of them (the other two have gone to a psychologist to talk about their worries and prepare them further for their next visit).

Will I be asleep?

No, you will not be asleep.  You will feel really, really relaxed - so much so that you will not be worried about treatment.  You will still be talking to us throughout treatment so you remain in control of what happens but sometimes you might forget some of the visit and it will seem a lot shorter than it really was!

Is it safe?

We have a lovely Anaesthetist called Sian who will be there to look after you and keep you safe.  Propofol is only dangerous when it is not used properly and the patient is not closely monitored.  All of our patients have been safely treated. 

What happens when I come to the Dental Hospital?

Your first visit will be an assessment visit to see Claire Stevens, Consultant in Paediatric Dentistry.  Claire will talk to you about your concerns, examine your teeth, take x-rays if needed and then discuss the treatment which can be provided.  If you are happy to go ahead, you will be given information to follow and asked to sign a consent form.  We think it is important for you to sign your own consent form, after all, it is your mouth and you need to be ready to try to get things fixed.  Find out more about the consent process. 

What happens at the treatment appointment?

You will be asked to attend about half an hour before your treatment time.  This is so that the nurses can check you are fit and well and that you have followed the pre-operative instructions.  We will then apply some topical anaesthetic cream to the back of each of your hands so that the skin goes numb.  Claire and Sian will also come and say hello, so you have an opportunity to ask any last minute questions.  When you are ready, we will bring you to your own private treatment suite.  We will take the cream off your hands and put something called a cannula into the back of one of your hands.  This is a plastic tube which allows us to give you medicine straight into your veins.  Often you won't be able to feel that this is happening because of the numbing cream but at worse, it feels like a cat scratch. We then attach you to some monitoring equipment and you are ready to go! 

When the propofol infusion starts, it can feel a bit stingy as it travels up your arm.  This only lasts for a short time and soon you will find that you start to relax.  The feeling of propofol sedation is really pleasant.  Our patients tell us that they feel happy and extremely relaxed.  Once you are comfortably sedated we can begin your treatment.  This usually lasts 45-60 minutes so depending on how much work you need, you may require a few visits to the AIVS.  When treatment has been completed, we will transfer you to the recovery room where you can relax until you are ready to go home.  This is usually about 30 minutes after your treatment has finished. 

Can my parent come in with me?

Yes, you can bring someone into the treatment suite with you.  Once you are relaxed we will ask them to return to the waiting room until you go into recovery.  You will need to have a sensible adult to take care of you and you will need to get either a taxi or be driven home.

What kinds of treatment do you do?

We can complete pretty much any dental treatment within the AIVS - fillings, taking out teeth (including before orthodontic treatment), cleaning teeth and also dental surgery.

How can I get referred to the AIVS?

You can ask your dentist to refer you to Mrs Claire Stevens, Consultant in Paediatric Dentistry, University Dental Hospital of Manchester, Higher Cambridge Street, Manchester.  M15 6FH.  It is really helpful if they mention AIVS in their referral letter.    

Is there anyone I can contact?  I have a few questions.

If would like to find out more, please email Claire directly on claire.stevens@cmft.nhs.uk.  We'd also welcome any feedback about this site. 

Thank you!Dental charity logo

The AIVS team would like to acknowledge the University Dental Hospital of Manchester Charity and the Research for Patient Benefit Grant we received in 2010 which supported us to complete research in this innovative field.  

Dental suite 4