How Often Do Problems Occur with Dental Sedation in Children

An interesting article titled “Assessing the safety of deep sedation in outpatient pediatric oral health care,” written by Henal Alpesh Gandhi and et. al. appears in the Journal of the American Dental Association (2023). The article assesses the safety of deep sedation supported care with pediatric dental treatment carried out in an outpatient setting. It is estimated that in the US, 100,000 through 250,000 cases of pediatric dental procedures with sedation occur each year. Most of the cases of among kids 3 to 5 years old. Children are predisposed to deep sedation and d general anesthesia related respiratory problems because of age-related variations in anatomy and physiology. Some of the reasons children need deep sedation for dental health care include extent of dental disease and amount of treatment needed,limited ability of the child to cooperate, and intent to protect the … Read more

Lidocaine shot during dental treatment may have led to heart attack

An interesting article titled “Acute Myocardial Infarction After a Local Anesthetic Procedure in a Middle-Aged Patient” written by Lei Xiao and et al. appears in the American Journal of Medical sciences (2022). The article discusses how an injection of lidocaine into a 50 year old man during dental treatment possibly induced coronary artery spasm and led to acute myocardial infarction (AMI). In the article the authors discuss how a 50-year old man was admitted to a hospital complaining of chest distress, chest pain, and shortness of breath for the past four hours in March 2020. What had happened four hours earlier, was that the man with no history of high blood pressure, diabetes, atrial fibrillation, or high cholesterol visited a dentist and had a dental work performed. The man was not a smoker and had no known drug or food … Read more

How dentists can navigate ethical treatment decisions for patients

An interesting article titled “How to manage the principal-agent problem in dentistry,” appears in the June 2022 edition of the Journal of the American Dental Association (JADA) written by Ben Balev (no. 153, issue 6, pp. 588-589). The article discusses the principal-agent problem, in which the dentist operates as the agent for the patient who is the principal and there is an imbalance of power between the patient and the dentist in decision making. In the dentist-patient relationship, the dentist has specialized knowledge that the patient lacks, and the patient seeks to make up for their lack of knowledge by having the dentist help in oral health decisions. Such a relationship requires that the patient trusts that the dentist functions in their best interest. However, sometime the patient questions the dentists motives behind their treament recommendations. The patient may wonder … 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

Exploring events that should never happen in Dentistry

Recently a few interesting articles have been published to explore what are called never events or serious patient safety incidents that should not occur if appropriate preventive measures are implemented in dentistry. However, these articles and their analysis are all tailored to the U.K. The first article is titled “Patient safety in dentistry: development of a candidate ‘never event’ list for primary care” written by Black et al. in the British Dental Journal (vol. 222, no. 10, pp. 782-788, Published May 26, 2017). The second article is titled “Developing agreement on never events in primary care dentistry: an international eDelphi study,” written by Ensaldo-Carrasco et al. in the British Dental Journal (vol. 224, no. 9, pp. 733-740, Published May 11, 2018). Prior to these articles there was not much clear research done on never events in dentistry. The best article … Read more