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The providers and risks of dental anesthesia and sedation

Very young children have the highest risks with anesthesia in dental office settings

Years ago, our pediatric dentist recommended anesthesia for one of our children who needed a routine filling. Before consenting, I had several questions that I wanted answered. I could tell by the responses of the dentists and her staff that they weren’t used to parents asking questions.

My concern over in-office dental anesthesia is the risk that something could go wrong. Many dental offices aren’t equipped with staff or supplies to handle a medical emergency. When something goes wrong when a patient is receiving dental anesthesia, it can go terribly wrong.

We’ve handled cases where pediatric dental patients died or suffered brain injury because of anesthesia complications during a procedure for a routine filling of a cavity. In some cases, the only thing that the dentist and staff were trained and prepared to do was call 911 and wait.

A study in the peer-reviewed journal of Pediatric Dentistry reported that:

• Patients three years old and younger have the greatest risk of an adverse event during administration of sedative and/or local anesthetic agents.

• There’s a high chance of an adverse event occurring at dental offices where sedatives or anesthetic care are provided.

• Some dentists and practitioners don’t adequately medically monitor patients.

Whether the patient is an adult or child, the manner in which sedation or anesthesia care is provided in the dental office is an important consideration. I think it’s something that should be covered as part of the informed consent discussion of the risks of any proposed treatment plan or procedure.

Who’s providing and monitoring anesthesia or sedation?

In many dental offices, its the dentist who provides anesthesia and sedation. Its up to the dentist to monitor the patients physiologic response to the medications while also performing the procedure. If the patient has a reaction to the medication, or experiences respiratory or cardiac symptoms, its up to the dentist to provide the emergency response.

Other dentists rely on a dedicated anesthesia provider. One option is a physician anesthesiologist. Another option is a certified registered nurse anesthetist (CRNA), who, as the job title indicates, is not a physician. The training and experience of these anesthesia providers varies widely. In some states, CRNAs are allowed to practice in office settings or operating rooms without any medical direction or supervision by a physician.

Yet another sedation and anesthesia option relied on by some dentists is the dental anesthesiologist. Dental anesthesiologists are dentists who complete a three-year clinical residency program in anesthesia affiliated with a hospital anesthesia program. This is an emerging field. The American Dental Association recently announced that the number of dental anesthesiologists in the United States has doubled in two years. There were zero dental anesthesiologists in 2018. In 2021, there were 97.

If you or someone you care for has been seriously injured because of anesthesia complications in the dental setting in Texas, then contact a top-rated experienced Texas medical malpractice lawyer for a free consultation about your potential case.

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him by calling 281-580-8800 or emailing him right now.


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