Pediatric dental sedation has been under some scrutiny lately, and for good reason. There have been some tragic cases when the right protocols are not followed.
The American Academy of Pediatrics and the American Academy of Pediatric Dentistry have issued new guidelines requiring a certified anesthesiologist or certified registered Nurse anesthetist CRNA, trained in emergency response and have the proper equipment to monitor vital signs, will be present the entire time a child is under sedation.
“The guidelines go right down to safety equipment that must be available and all types of things for procedures — preoperative, things to do during the operation, and post-operative procedures,” says Kevin J. Donly, DDS, a professor and chair of the Department of Developmental Dentistry at the University of Texas Health San Antonio and a former officer for the AAPD.
“It never has gotten sufficient attention,” Debbie Hagan told WebMD, who advocates for families of children who have been harmed in dental offices. “The only time you hear about it in the news is usually after there has been a devastating outcome; even then, it will be a local news report, with a reference to maybe one other incident.
Children who need complicated dental work, not able to sit in a dentist’s chair for an extended period of time, those with disabilities, autism, and Down syndrome are good candidates for dental sedation.
Parents should ask questions before their child is sedation according to WebMD
What medicines are you going to use to sedate my child?
Will there be a separate certified provider for general anesthesia in the room?
How will my child be monitored by a second medical specialist during the procedure should something go wrong?
How much training and experience have the personnel had in caring for kids my child’s age?
First of all, parents should verify that a certified anesthesiologist and a second trained emergency response medical specialist — such as a nurse — will be present, along with the dentist and any other assisting staff, as the AAP guidelines recommend.
The most important thing is for parents to really be aware of the difference in the personnel and to ask who will provide the sedation, who will help if something goes wrong.
