British Association of Dental Therapists

Information sourced May 2020
https://bnf.nice.org.uk/guidance/prescribing-in-dental-practice.html

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Insufficient blood supply to the brain results in loss of consciousness. The commonest cause is a vasovagal attack or simple faint (syncope) due to emotional stress.

Symptoms and signs

• Patient feels faint
• Low blood pressure
• Pallor and sweating
• Yawning and slow pulse
• Nausea and vomiting
• Dilated pupils
• Muscular twitching

Management

• Lay the patient as flat as is reasonably comfortable and, in the absence of associated breathlessness, raise the legs to improve cerebral circulation
• Loosen any tight clothing around the neck
• Once consciousness is regained, give sugar in water or a cup of sweet tea

Other possible causes

Postural hypotension can be a consequence of rising abruptly or of standing upright for too long; antihypertensive drugs predispose to this. When rising, susceptible patients should take their time. Management is as for a vasovagal attack.

Under stressful circumstances, some patients hyperventilate. This gives rise to feelings of faintness but does not usually result in syncope. In most cases reassurance is all that is necessary; rebreathing from cupped hands or a bag may be helpful but calls for careful supervision.

Adrenal insufficiency or arrhythmias are other possible causes of syncope.