Syncope in Dental Practices: A Systematic Review on Aetiology and Management

This systematic review aimed to give an overview of the current evidence surrounding aetiology and management in terms treatment prevention syncope dental practices. Alongside occurrence, practitioner's competence, association between local anaesthetics were discussed. An electronic search EMBASE, Web Science, PubMed, Cochrane databases a hand performed by 2 independent reviewers identify studies up November 2019. Eligibility criteria applied relevant data was extracted. Inclusion covered all types under anaesthesia or conscious sedation wide range oral health care workers their Risk bias included assessed using methodological tools recommend Zeng et al.1 No restrictions made exclude papers from qualitive analysis based on risk assessment. The yielded total 18 for qualitative analysis. With exception one prospective cohort study, articles considered having high bias. Meta-analysis showed that dentists encountered average 1.2 cases per year. male gender (RR = 2.69 [1.03, 7.02]), fear 3.55 [2.22, 5.70]), refusal non-acute situations (OR 12.9) use premedication 4.70, [1.30, 16.90]) increased syncope. Treatment underreported as both solely discussed study. supine recovery position with raised legs oxygen administration (15l/min) presented effective treatment. Medical Risk-Related History (MRRH) system proposed protocol, yet this protocol ineffective reducing incidence rates (p 0.27). majority (79.2%) able diagnose syncope, most (86%) lacked skills appropriate Only 57,6% practices equipped cylinder. Syncope is common emergency Nonetheless, vast do not seem competent nor prepared manage emergency. Psychogenic factors play important role provoking Placing patient reclined combination seems regaining consciousness. Although valuable many aspects, assessment medical history taking proven result fewer episodes. strength these conclusions low GRADE guidelines.2