Recently, a death has occurred in Cambridge, Ontario, Canada, in a dental office. Details of the case have not yet been released, but a boy died after getting anesthetic and had a previously undetected heart condition. It seemed to have occurred sometime around late April, 2014, but the date may be off a bit. It appears that in this case the boy was brought to a hospital after the dental office in an attempt to save his life.
An interesting article over in the Cambridge times published June 27, 2014, by Gordon Paul, titled “Pediatric dental surgery with anesthesia should be done in hospitals, dentist says,” provides some comments on this case. See http://www.cambridgetimes.ca/news-story/4605070-pediatric-dental-surgery-with-anesthesia-should-be-done-in-hospitals-dentist-says/. In this article comments by Dr. Hanover who is on the political action committee of the Ontario Dental Association are provided.
“I think every pediatric dentist is most comfortable in a hospital. You’ve got the anesthetist, you’ve got a whole team of nurses, you’ve got crash carts, you’ve got ICUs … and in a dental office, you’ve got the dental anesthetist and maybe an RN. That’s the big difference.”
Dr. Hanover, says that he has performed dental surgery on thousands of children under general anesthesia, but he does not administer it himself. He states
“You talk to any anesthetist, doing kids is the most difficult thing you can do… Anything that happens happens very quickly and you’ve got to react very quickly. If a kid desaturates (low blood oxygen concentration), you’ve got less than a minute to get them going well. In an adult, you’ve got four minutes.”
Dr. Hanover, further discusses how very few hospitals in Canada provide dental anesthesia. His opinion is that the dentist should not administer the anesthesia. He feels the dentist should focus on the dentistry and doing two things at once can be difficult.
In the past I have written posts about anesthesia in an office based setting performed by an oral and maxillofacial surgeon, see for example, http://blog.teethremoval.com/anesthesia-in-the-oral-and-maxillofacial-surgeons-office/ and http://blog.teethremoval.com/anesthesia-in-the-oral-and-maxillofacial-surgeons-office/.
Another post I have written before also touches more closely to the views discussed by Dr. Hanover as a result of the young boy’s death in Canada, see Politics of Dental Anesthesiology. In this post it talks about how dental anesthesiology is not an American Dental Association (ADA) approved specialty. Note that the American Medical Association (AMA) also opposes operator anesthesia such as what an oral and maxillofacial surgeon does, see the post http://blog.teethremoval.com/american-medical-association-versus-american-association-of-oral-and-maxillofacial-surgeons/.