Following the tragic death of a 3-year-old patient in California, parent concerns about their children reached an all-time high in one of the most unlikely places this summer—the dentist's office. Recognizing that nothing can erase the jolting shock of the incident, the American Academy of Pediatrics (AAP) and the American Academy of Pediatric Dentistry (AAPD) begun to address the question that has been on so many parents' minds: why?
While there were undoubtedly external factors at play during the incident in California, a comparison of common practices between the AAP and AAPD has revealed an overarching problem with state-to-state sedation regulations in pediatric dentistry. In particular, the comparison uncovered a general deficiency in training and staffing during dental sedation. Though the practice model endorsed by the AAPD for deeply sedated children is one in which a specific person has dedicated responsibility “to constantly observe the patient’s vital signs...and [should be] capable of assisting with any emergency event," in reality, the model can be much different given the considerable state-to-state variability in anesthesia requirements for dentistry. According to the AAP, many states allow a “single-operator” model in which a dentist holding a state-issued anesthesia permit may serve a dual role during procedures as both the administer sedatives/anesthetics and the acting dentist. Though presumably sufficient in a procedure free of complications, this model fails to account for rare, but possible, complications.
As a powerful voice for pediatric patients, the AAPD is staged to play a vital role in efforts to update state regulations. Striving to combat the outdated single-operator model, the AAPD has recently issued significant clarifications to its guidelines for pediatric sedation. The new guidelines now require procedures to take place under the supervision of a licensed anesthesia provider who is separate from the operating dentist. This clarification ensures pediatric patients are given the proper attention during delicate procedures and have the necessary support in the event of complications, making each child's safety and well-being the highest priority.
At Spring & Sprout, our specialists only recommend treatment under sedation or general anesthesia with the support of qualified professionals and after careful consideration of your child's age, treatment needs, behavior, and medical history. As explained by Dr. Willenberg's team from Spring & Sprout Pediatric Dentistry, "We understand that trusting us with your precious children is no small thing, and it is an honor and a privilege to care for them—one we do not take lightly." Whether during a routine exam or a necessary treatment, our specialists are here to serve you and your children by providing exceptional dental care with compassion and care, so please, don't hesitate to speak to your child's specialist about any questions or concerns you may have regarding their treatment.