Opioid Safety, Respiratory Compromise

Why Have Low Safety Standards for Dental Anesthesia?

In their article, “Why Have Low Safety Standards for Dental Anesthesia?,” Annie Kaplan, MD, Michael Wong, JD, and Patricia Salber, MD, MBA provide an update on the effort to pass Caleb’s Law and improve safety standards for dental anesthesia.

The law was modified during the legislative process, signed into law and became effective in California as of January 1, 2017. It provided for collection of  adverse event data, instituted a disclosure that anesthesia in dentistry is practiced differently than in medicine, and asked that the California dental board do a study on the safety for children undergoing anesthesia in dentistry and make recommendations to improve safety.

6-year old Caleb Sears stopped breathing after receiving several different kinds of IV anesthetics during tooth extraction.

6-year old Caleb Sears stopped breathing after receiving several different kinds of IV anesthetics during tooth extraction.

The complete Dental Board met last December and discussed the study and proposed recommendations. One of the recommendations they voted to approve required, for children under age seven undergoing deep sedation or general anesthesia, that there always be a dedicated qualified anesthesia provider who is tasked with the administration and monitoring of the patient through the recovery period.

However, the dental lobby, led by the California Association of Oral and Maxillofacial Surgeons, introduced a competing bill that they claimed codified “some” of the recommendations. Notably, the dental lobby’s bill did not require a separate trained anesthesia provider to monitor children, even for the highest risk and youngest patients, ages 0 to 6-years old. Their bill and current practice would continue to allow for an unlicensed dental assistant to monitor patients of all ages.

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To read the full article in the TheDoctorWeighsIn, please click here.

One thought on “Why Have Low Safety Standards for Dental Anesthesia?

  1. Michael Wong

    The American Dental Association Council on Dental Education and Licensure endorses the monitoring of dental patients undergoing sedation and, in particular, the use of capnography to monitoring these patients – http://bit.ly/2lkXxUT:

    “believes the use of capnography in all office-based procedures requiring moderate, deep or general anesthesia aids the provider and offers an important measure of safety for the patient. The use of such capnography monitoring equipment for office-based anesthesia-related procedures has been shown to provide real benefits for the provider and a safer experience for patients. Capnography, long the standard of care in the hospital OR, has been greatly improved and is quickly becoming an important asset in the ambulatory surgical setting as well.”

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