Advice for patients and GPs for requests to prescribe sedatives prior to dental procedures and claustrophobia before an MRI
GPs will not issue prescriptions for sedating medications (such as diazepam) prior to dental procedures.
Dentists should not direct patients to GPs requesting they prescribes sedating medications, such as diazepam.
If a dentist wishes to prescribe sedating medications for anxious patients that dentist should be responsible for issuing the prescription. The dental practitioner’s formulary, which is the list of drugs a dentist can prescribe is found on the BNF dental practitioners formulary, includes Diazepam Tablets and Oral Solution.
If the dentist is treating a patient within their practice NHS contract, then the prescription should be on a FP14D form.
If the dentist is treating a patient privately, they should issue a private prescription.
Dentists can access a patient’s summary care record via the DERs/Rego electronic referral system for NHS England Southeast dental referrals.
Dentists may contact a GP for information or advice, if, for example the patient has a complex medical history.
Claustrophobia and refusal to have MRI scans
GPs will not issue prescriptions for sedating medications (such as diazepam) prior to MRI scans.
It’s estimated that every year, approximately two million MRI scans worldwide are not performed because of patients refusing to be scanned or terminating the scan early due to claustrophobia.
There are many resources online that can help prepare patients on what to expect during a scan including step by step explanations and videos of MRIs being performed. In more severe cases, the NHS website suggests that mild sedatives are an option for people with severe MRI anxiety. However, the MDU would recommend members to carefully consider the 2018 Royal College of Radiologists’ guidance, Sedation, analgesia and anesthesia in the radiology department, which states that a ‘trained and credentialed team should administer sedation and analgesia.’
There is also an emphasis on thorough pre-procedure assessment, planning and monitoring.
This means that the GP is not the right person to prescribe these medications. If they are needed, then this needs to be discussed with the radiology team.
