An interesting article titled “How safe is deep sedation or general anesthesia while providing dental care?” appears in the Sept. 2015 issue of JADA (volume 146, issue 9, Pages 705–708) and written by Jeffrey D. Bennett and et al. The article discusses how deep sedation and general anesthesia are given daily in dental offices or practices and this is usually done by oral and maxillofacial surgeons and dentist anesthesiologists. Sedation and anesthesia is given to patients to be able to more easily perform procedures and keep the patient safe and comfortable. Unfortunately in rare cases problems can happen and hence the authors were interested in exploring this.
The authors state
“Using the available data and informational reports, the authors estimate that the incidence of death and brain injury associated with deep sedation or general anesthesia administered by all dentists most likely exceeds 1 per month.”
The authors feel that a patient safety database for anesthetic management in dentistry would provide a more complete assessment of the mortality and morbidity involved. This would be beneficial to developer safer anesthetic care.
The authors further state
“Optimization of patient care requires appropriate patient selection, selection of appropriate anesthetic agents, utilization of appropriate monitoring, and a highly trained anesthetic team. Achieving a highly trained anesthetic team requires emergency management preparation that can foster decision making, leadership, communication, and task management.”
I have discussed numerous deaths that unfortunately have occurred in a dental setting from deep sedation or anesthesia. See for example http://www.teethremoval.com/death.html and http://www.teethremoval.com/dental_deaths.html. It would be interesting to see a patient safety database be able to provide more accurate information and data to help increase safety in dental offices.
Before deciding whether to get anesthesia, it is important to know the risks. The truth is, not every situation calls for anesthetics. There are other options that are also effective.
You make an interesting point about a patient safety database. Knowing what to expect and the risks involved upfront is important, as you emphasized with this suggestion.
Conscious sedation is regarded as a safe target level of sedation because airway intervention is not required, ventilation is adequate, and cardiovascular function is maintained.