Report: Danger at the Dentist
An ABC News investigation has claimed that "inadequately trained" dentists are putting American children at risk by sedating them for even routine tooth cleaning and cavity treatments. The report said that some of these dentists are doing this to enhance profits.
According to the report, the Raven Maria Blaco Foundation has said that more than a dozen children have died after being sedated by dentists.
The foundation was started after eight-year-old Raven Blaco died after her dentist gave her "three times the average range" of sedatives, according to the Virginia Board of Dentistry. That dentist has since retired.
Blaco's family started the foundation to "alert parents to the potential dangers of the increasingly widespread use of oral sedatives on patients as young as 18-months old."
But could the problem lie in the training dentists receive? The Brian Ross investigation found that some states require only a weekend-long course for dentists to be certified in the administration of oral sedatives.
According to the report, sedation for routine procedures can make it safer to work on young patients whose anxiety can make it difficult or dangerous to use high speed drills and other equipment.
But, they say, it takes extensive training to learn how to administer sedation safely and be prepared to deal with emergencies.
"This is something that is being presented to the practitioners, the dental community, as a very easy thing to do, and nothing could be further from the truth," said Dr. Norbert Kaminski, a dental anesthesiologist in suburban Detroit, who has sought tougher standards for dentists who use sedation on patients.
A national spokesperson for the American Academy of Pediatric Dentistry, Dr. Indru Punwani of the University of Illinois, said a weekend course is "inadequate" for preparing dentists to deal with emergencies that can arise through the use of oral sedatives.
"I don't believe it can be done," said Dr. Punwani of the promise of the popular weekend courses to train dentists.
Dentists following the sedation guidelines of the AAPD have never been tied to a death, said Dr. Punwani.
Since the report, the American Dental Association has prepared a list of Questions parents should ask their child's dentist about anesthesia and sedation:
PRIOR TO THE PROCEDURE:
Who will provide the preoperative evaluation of my child including their past medical history such as allergies, current prescription medications and previous illnesses and hospitalizations?
What is the recommended time that my child should be without food or drink prior to the procedure (with the exception of necessary medications taken with a sip of water)?
Will any sedation medication be given to my child at home prior to their coming to the office and, if so, how should they be monitored?
What training and experience does the sedation/anesthesia provider have in providing the level of sedation or anesthesia that is planned for the procedure? Does this training and experience meet all of the standards of the ADA Guidelines for the Use of Sedation and General Anesthesia by Dentists?
Does the staff assisting in the procedure have current training in emergency resuscitation procedures, such as Basic Life Support for Healthcare Providers, and other advanced resuscitation courses as recommended by the ADA Guidelines? Is this training regularly renewed?
Does the state dental board require a special sedation/anesthesia permit or license that allows for the sedation/anesthesia provider to administer this specific level of sedation or anesthesia in the dental office?
DURING THE PROCEDURE:
In addition to the use of local anesthesia (numbing), what level of sedation or general anesthesia will be given to my child? Is it minimal sedation (relaxed and awake), moderate sedation (sleepy but awake), deep sedation (barely awake) or general anesthesia (unconscious)?
How will my child be monitored before, during and after the procedure until the child is released to go home? Are the appropriate emergency medications and equipment immediately available if needed, and does the office have a written emergency response plan for managing medical emergencies?
AFTER THE PROCEDURE
Will the sedation/anesthesia provider give me instructions and emergency contact information if there are any concerns or complications after returning home?