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Sexual hallucinations during conscious sedation for dentistry - an update of the phenomenon

Abstract

Background Sexual hallucinations have been suggested as an infrequent side effect during sedation and cases can result in sexual assault allegations. The aim of this article is to review the literature on this rare side effect during sedation.

Methods Publications were chosen using inclusion criteria: hallucinations and/or alleged sexual assaults and/or paradoxical reactions to either sedation or anaesthesia, that were of a sexual nature. Non-English language papers were excluded. Studies were analysed for: methodological quality, sedative agent, dose, population, treatment undertaken and outcome of the hallucination.

Results Twenty-eight publications were reviewed. There was literature discussing sexual hallucinations to midazolam (13 studies), propofol (12 studies) and nitrous oxide (three studies). This side effect to sedative agents has a low incidence and can depend on factors like the sedation agent, dosage and type of procedure undertaken.

Conclusions Current literature suggests that on rare occasions, sedation may induce sexual hallucinations and higher dosages are more likely to be implicated. In an occurrence of this side effect, presence of a third party and record-keeping is essential. Thorough patient assessment, appropriate clinician training and adhering to national dental sedation guidelines will help maintain the excellent safety record of UK dental sedation.

Key points

  • Sexual hallucinations during conscious sedation for dentistry are rare but an existent side effect.

  • This article highlights the importance of following the existing sedation guidelines and makes recommendations to consider in the event of a sexual hallucination occurring.

  • Contains a critical review of relevant publications discussing sexual hallucinations due to sedative agents, some of which have resulted in allegations of sexual assault against dentists and doctors.

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Correspondence to Alex Orchard.

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Orchard, A., Heidari, E. Sexual hallucinations during conscious sedation for dentistry - an update of the phenomenon. Br Dent J (2021). https://doi.org/10.1038/s41415-021-3423-z

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