Oral Sedation Monitoring in Elderly Dental Patients Using the Ramsay Sedation Scale

Abstract

Oral sedatives are frequently used in geriatric dentistry for relaxation, patient cooperation, procedural 
concerns, and for potential medically compromised elderly patients requiring more complex dental 
procedures. Elderly patients are at greater risk for sedation complications due to physiological changes 
related to aging, pre-existing comorbidities, and polypharmacy. Monitoring sedation can help manage 
unexpected sedation levels and also identify potential safety concerns. The Ramsay Sedation Scale (RSS) 
is a reliable and straightforward clinical guide that provides a standard assessment and documentation of 
sedation levels in real-time. This study investigates RSS as a tool for applied sedation monitoring in the 
context of oral sedation for elderly dental patients. For our research, we identified elderly patients aged 
65 years and older who were undergoing dental treatment with oral sedatives. Participants were followed 
using RSS scale modifications at regular intervals, both preoperatively, intraoperatively, and 
postoperatively. We assessed the depth of sedation of the participants, adverse events related to sedation, 
and the satisfaction of the clinician utilizing RSS. The study's findings indicated that RSS is capable of 
providing consistent and easily understandable assessments that correlate with clinical observations. The 
majority of patients achieved moderate sedation (RSS 3–4), which enabled successful treatment while 
ensuring patient safety. The use of RSS enabled the recognition of oversedation more quickly, allowing 
for faster intervention and treatment. Practitioners reported greater confidence in managing sedation 
issues and in interprofessional communication within healthcare teams. In summary, the Ramsay Sedation 
Scale is an appropriate non-invasive for monitoring oral sedation in elderly dental patients, representing 
enhanced safety and control in geriatric dentistry for sedation practices.