Is it Safe for Children to Receive Sedation/Anesthesia from an Oral Surgeon or Dentist using a Single Provider/Operator Model?

Recently on this site there has been much discussion on updated guidelines put out by various groups that argue that children having deep sedation and anesthesia are not safely being served by dentists and oral surgeons using a single provider/operator model. Instead these guidelines call for a multi-provider model where the person doing the dental work or oral surgery and the person administering and monitoring the sedation/anesthesia are two separate individuals. See the posts AAOMS Pushes Back on Anesthesia Guidelines for Pediatric Patients and Updated Sedation Guidelines in Dentistry for Children for additional details. Some of the individuals leading the charge against the current anesthesia delivery model for children have published a new opinion piece titled “The Single-Clinician–Operator/Anesthetist Model for Dental Deep Sedation/Anesthesia: A Major Safety Issue for Children” published online in JAMA Pediatrics on Oct. 28, 2019 (written by … Read more

AAOMS Pushes Back on Anesthesia Guidelines for Pediatric Patients

Earlier this year in 2019, the American Society of Anesthesiologists (ASA), the Society for Pediatric Anesthesia (SPA), the American Society of Dentist Anesthesiologists (ASDA), the Society for Pediatric Sedation (SPS), the American Academy of Pediatric Dentistry (AAPD), and the American Academy of Pediatrics (AAP) put out updated guidelines regarding the use of deep sedation and general anesthesia for children at a dental facility. The ASA, SPA, ASDA, and SPS put out a separate distinct set of guidelines from the AAPD/AAP. These guidelines are available from https://www.asahq.org/advocacy-and-asapac/advocacy-topics/office-based-anesthesia-and-dental-anesthesia/joint-statement-pediatric-dental-sedation and the June 2019 edition of Pediatrics in an article titled “Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures” written by Coté and Wilson, which was previously discussed in the blog post Updated Sedation Guidelines in Dentistry for Children. The guidelines are slightly different but the … Read more

Case Reports Serve a Place in Dentistry

An interesting article titled “CASE REPORTS HAILED” appears in JADA in September 2014, written by Enihomo Obadan, Elsbeth Kalenderian, and Rachel B. Ramoni. The article discusses an article in an earlier 2014 JADA article that featured an interesting case report. The authors state “Almost becoming a lost art in the biomedical literature, case reports still hold tremendous opportunities for learning in dentistry. In addition to the obvious learning potential for the individual dental professional, the entire professional body advances in giant strides when there is cross-organizational learning among dental clinics through information sharing.” The authors then discuss how adverse dental events being reported by dentists would help make dental treatments safer for all. The authors feels this helps promote a culture of safety, as long as there is no fear of retribution when the report occurs by the dentists. The … Read more

The Culture of Safety in Oral and Maxilofacial Surgery

Previously in a post over at http://blog.teethremoval.com/upcoming-changes-to-joms-and-aaoms-in-2014/, I discussed how the Journal of Oral and Maxillofacial Surgery is introducing a new perspectives section which “…will offer essays written on topics of interest to our specialty, including health policy, clinical controversies, and education and research matters, as examples.” On of the first perspectives section is written by Suzanne Morse Buhrow and titled “Promoting a Culture of Safety in Oral and Maxillofacial Surgery: The Time Is Now!” in the February 2014 Journal of Oral and Maxilofacial Surgery, pp. 239-240. The article opens by discussing the origins of the patient safety movement in the 1980s after the Institute of Medicine said 98,000 patients will die and 1.5 million will be injured every year from preventable medical errors in the United States. The article mentions how the National Practitioner Data Bank in the U.S. … Read more

Improving Patient Safety: Updates on Oral and Maxillofacial Surgery

In a recent blog post I discussed how a few new videos have appeared in recent months related to oral and maxillofacial surgery Videos Related to Oral and Maxillofacial Surgery. The American Association of Oral and Maxillofacial Surgeons (AAOMS) has also updated several sections of their website in the last year or so. They now have a section titled Orthodontics and Oral Surgery where they have videos related to showcasing various techniques that oral and maxillofacial surgeons and orthodontists perform. In addition they have updated and written a new page titled “Culture of Safety“. The page is a welcome addition and discusses how safety is the number one priority in the oral and maxillofacial surgery office. Now I wanted to take a moment to respond to this page and some other developments I have seen lately across the blogosphere. 1) … Read more