Reducing Anxiety among Pediatric Dental Patients

An interesting article titled “an Anxiety Reduction Program as an Alternative to General Anesthesia for the Anxious Pediatric Dental Patient” was presented on July 23, 2021, at the virtual session of the 2021 International Association for Dental Research (IADR)/AADR/CADR General Session written by Suher Baker and et al. The research set to investigate the efficacy of a systematic Anxiety Reduction Program (ARP) using progressive desensitization to reduce anxiety in children to a level that would allow dental treatment to be performed in-office without the use of general anesthesia. Dental anxiety has been covered on this site before see for example the post Dental Anxiety and Fear: Impact on Oral Health. Children are more likely to experience an unfavorable and unforeseen incident caused by an error or omission during dental treatment that has negative health consequencies. This is because children do … Read more

Illinois Man Dies From Too Much Anesthesia While Having Teeth Extracted

A 51 year old man from Illinois died after having five teeth extacted in July 2021. He had has teeth extracted by an oral surgeon in Lake County which is North of Chicago. During the procedure he was given as given a single dose of 200 milligrams propofol. There was no anesthesiologist present and the oral surgeon was the one also administrating the anesthesia. During the tooth extractions, the man stopped breathing and went into cardiac arrest. Emergency responders were called and when they arrived took the man to a hospital where he died the next day. According to statements from the Lake County Coroner there was too high of a dose of propofol given and this dose would cause a person to not breathe. Further, the oral surgeon did not supply supplemental oxygen until the tooth extractions were already … Read more

Has the FDA Warning for Children Under Three Affected General Anesthesia Use in Dentistry?

An interesting article titled “Prolonged General Anesthesia in a Pediatric Population” was presented on July 21, 2021, at the virtual session of the 2021 International Association for Dental Research (IADR)/AADR/CADR General Session written by Mary Younan and et al. The research sets to investigate if use of prolonged general anesthesia amongst pediatric dental patients has changed since 2016 when the Food and Drug Administration (FDA) came out with guidance that said 3 or more hours of anesthetic exposure, may be a risk factor for cognitive defects, particularly for pediatric patients under 3 years of age. The researchers attempeted to see if a difference exists in the proportion of pediatric dental cases with general anesthesia time 180 minutes pre-FDA to post-FDA warning and to use a root cause analysis to identify factors that contribute to prolonged general anestehsia exposure of children … Read more

Using Bupivacaine with Wisdom Teeth Removal Results in Less Opioids Prescribed

An interesting article titled “A Retrospective Cross-Sectional Study of the Effect of Liposomal Bupivacaine on Postoperative Opioid Prescribing After Third Molar Extraction,” written by Stuart E. Lieblich and et al. appears in the Journal of Oral and Maxillofacial Surgery (vol. 79, pp. 1401-1408, 2021). The study seeks to explore if patients who have lower wisdom teeth removed using liposomal bupivacaine need less opioids than those wo do not have liposomal bupivacaine. In the study the authors performed a retrospective study of patients who had undergone wisdom teeth extraction at 2 outpatient oral surgery centers in the United States. Patients had to have been at least 18 years of age and undergoing an elective wisdom tooth removal with 1 partial bony or full bony lower impacted wisdom tooth. A total of 600 patients who underwent wisdom teeth extracted were included in … Read more

Parents Sue After Three Year Old Kansas Boy Died from Dental Work

In July 2021, a three year old boy died after having dental work done in Kansas. A few months later the parents filed a lawsuit against the the dentist, the dental office, the nurse anesthetist, and the anesthesia company. The young boy needed to have some teeth removed due to a gum infection. He went with his mother to two dental offices in southwest Kansas to help choose a dental office. Ultimately a dental office was chosen in Wichita, Kansas which was four hours from their home. According to the timeline of events in the lawsuit, during the boy’s dental work he was given anesthesia with propofol and ketamine by the nurse anesthetist at 7:15 A.M. Around 8 AM the boy was given another dose of propofol by the nurse anesthetist. Around the same time the nurse anesthetist noticed an … Read more