IV sedation during dentistry continues to be an increasingly controversial topic in 2024. Anesthesia and sedation failures in the dental office have made headlines for patient injury and even deaths.
Regulations on who administers anesthesia in the dental office varies widely, there is little oversight in this area. The Dental Tribune spoke with a leading voice on the subject, Dr Rita Agarwal, who explains what the single operator model and why it is an issue.
The single operator or surgeon/anaesthetist or operator/anaesthetist model—it has several names—occurs when the dentist or oral surgeon is performing the dental procedure or procedures and also providing the anaesthesia or sedation. This is a model that does not occur in medicine.
Occasionally a physician will perform a procedure and supervise or be responsible for the sedation, but they have at the very least a trained nurse to assist them. While a dentist or oral surgeon may have a dental assistant to help monitor the patient, a dental assistant has very minimal medical training.
In anaesthesiology, we focus on the ability to rescue. If a patient were to have a problem with his or her breathing, blood pressure, heart rate or cardiac system, it is necessary to have people in the room who can help resuscitate him or her. One person, no matter how good or well trained, cannot do it alone. It’s really about having the appropriate training, attention and priorities. Medicine and anaesthesiology in particular figured this out years ago and went from a culture of blame and shame (i.e. it is the individual’s fault) to looking at systemic factors and trying to improve care for everyone
This is why so many dental offices are partnering with Certified Registered Nurse Anesthetists (CRNA). Someone who is qualified/certified to administer the sedation and monitor vital signs during the procedure, for the safest and most effective form of sedation.
Blue Sky Solutions Anesthesia Associates follows the strict American Dental Association guidelines and protocols throughout the procedure. Prior to your appointment, Certified, Registered and Licensed Nurse Anesthesiologist Dwayne Thibeault will work closely with you to determine the best course of treatment and answer any questions.
