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

The Single Operator Model of Sedation Leads to Caleb’s Law

Oral and maxillofacial surgeons who practice in the United States provide anesthesia differently than do others in the medical profession. This has been discussed before on this site in posts such as Updated Sedation Guidelines in Dentistry for Children. Oral and maxillofacial surgeons are allowed to provide anesthesia using what is known as a single operator model. The single operator model allows for one trained and certified operator in anesthesia to administer both the sedation and/or anesthesia and perform the dental work. In many of these cases with a single operator model a dental assistant with no medical training monitors the patient’s vital signs. All other doctors in medicine provide anesthesia using a dual operator model where there are at least two individuals who have training and up-to-date certification in patient rescue. Some patients and doctors/doctor groups in medicine do … Read more

Outcomes Data Registry for Dentistry

Using large amounts of data from many different dentists or surgeons is a way to improve the quality of healthcare. From such clinical data registries in healthcare many things can be gleaned regarding information about individual surgeries or medical devices. The American Association of Oral and Maxillofacial Surgeons (AAOMS) has recently launched OMS Quality Outcomes Registry or OMSQOR for short which is discussed on pages 7-12 of the March/April 2019 issue of AAOMS Today. The groundwork for OMSQOR actually began in 2014 and OMSQOR officially launched in January 2019. The way OMSQOR works is that treatment data from all members who participate will be collected in a national registry that will be used to help improve the quality of care and patient outcomes. Such quality data will allow for tracking surgical outcomes, complications, and possible gaps in treatment. OMSQOR will … Read more

Difference Between Oral Surgeons and Dentists

If a patient is in need of dental treatment there are different specialists to consider. Depending on the type of dental treatment being received a patient may be better off seeing a dentist or may be better off seeing an oral surgeon. Thus it is important to better understand the types of treatments a dentist and oral surgeon performs to be able to determine who to seek out. Treatments Performed by Dentists General dentists provide preventative care and maintenance. Preventive care includes performing dental cleanings, taking and interpreting x-rays, performing oral examinations, and monitoring the growth and development of teeth and jaws. Maintenance includes performing fillings of cavities, root canals for teeth that can not be restored, placing crowns, and other surgical procedures of the teeth, bone and soft tissues of the oral cavity. By seeing a dentist patients are … Read more