sedation

Oral and Maxillofacial Surgeons Using Simulation to Improve Preparedness for Adverse Events with Sedation and Anesthesia

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According to the July/August 2019 edition of AAOMS today (vol. 17, no 4) the American Association of Oral and Maxillofacial Surgeons (AAOMS) has launched a new National Simulation Program allowing for members and staff to practice techniques on manikins. This can allow for better preparedness by receiving feedback on areas that may require additional training. The same simulated events are given to all participants which allows for objective assessments. The courses can offer instant feedback and point out any deficiencies by the surgeon. The goal of such simulation is to improve patient outcomes. AAOMS currently offers simulation programs in Minnesota and South Carolina. A particular focus on the simulation is on training oral surgeons for preventing events that can be devastating such as a death or brain injury. Thus one focus of the simulation is on Basic Emergency Airway Management … Read more

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

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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

Profit Motives in Oral and Maxillofacial Surgery Utilizing Sedation

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Recently on this site it was discussed how guidelines have come out from the American Academy of Pediatric Dentistry (AAPD) and American Academy of Pediatrics (AAP) recommending when deep sedation or general anesthesia is given to children in dental offices there should be two trained individuals present. One individual should provide the dentistry and the other individual is responsible to administer the sedation or anesthesia and to observe the patient for any adverse events. This goes against the single provider model that has been advocated by the American Association of Oral and Maxillofacial Surgeons (AAOMS) and is typically utilized for wisdom teeth removal in the United States of America, where the oral surgeon performs both the dentistry and the administration of sedation or anesthesia. Some have criticized the AAOMS position of a single provider model for its focus on profit … Read more

Updated Sedation Guidelines in Dentistry for Children

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Recently new guidelines have been issued regarding the use of sedation for dental procedures performed on children. In the past on this site some scrutiny has been placed on sedation provided to children during dental procedures because of many deaths that have occurred, see for example What to Ask the Dentist Before Children Have Sedation and Pediatric Dental Death in Cambridge, Ontario, Canada Spurs Comments on Dental Anesthesia. In the June 2019 edition (vol. 143, no. 6) 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 updated guidelines for the use of sedation in dentistry is provided. These guidelines were updated for the American Academy of Pediatric Dentistry (AAPD) and American Academy of Pediatrics (AAP) for the first time in … Read more

Delivering Sedation in Dentistry

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It has become increasing popular to deliver sedation to patients receiving dental work. Sedation is defined as the deliberate drug-induced depression of consciousness used to reduce anxiety and awareness associated with unpleasant medical procedures. Sedation is used to reduce anxiety.  In some cases dentists or oral surgeons deliver both the dental work and the sedation, while in others there is a separate anesthesiologist to do so. One should always verify proper training and license prior to undertaking any sedation from a healthcare professional. Sedation is generally considered very safe as long as it is performed by an appropriately trained practitioner in a monitored environment. Sedation dentistry uses different approaches depending on personal choice and comfort. In the order of increasing anesthesia these are local anesthesia, minimal sedation, nitrous oxide/oxygen, moderate (conscious) sedation, deep sedation, and general anesthesia. A more thorough discussion … Read more