Many people are very familiar with medical malpractice, however, dental malpractice is often forgotten. Dental malpractice occurs when a dentist causes you personal injuries because they did not act within the acceptable standard of care. In fact, approximately one out of every seven malpractice claims involves a dentist or other dental health care professional.
One of the most prominent dental health care issues is the use of anesthesia and other forms of sedation, especially their use on children. An anesthesiologist needs to attend school for twelve years, including four years of college, four years of medical school and an additional four years in an anesthesiology residency. A dentist, on the other hand, now has an entire anesthesia industry offering quick training opportunities in anesthesiology. In the past five years over 18,000 dentists have attended weekend anesthesiology courses, designed to allow a dentist to begin anesthetizing patients. They promise new and current dentists a significant increase in their income. In fact, the use of anesthesia can increase a dentist’s annual income by tens of thousands of dollars, which they often need, with the extremely high cost of dentistry school.
Unfortunately, even well-trained dentists will likely have difficulties with anesthesia. Most dentists do not have the facilities or the experience with anesthesia to appropriately handle an emergency when one arises. Anesthesia can cause a number of different complications, some of which can be deadly.
Those in favor of using anesthesiology in dental procedures argue that a sedated patient means a safer procedure, particularly with children, especially when using high-speed drills and other equipment. However, reports indicate that 31 children have died after being sedated by dentists in the last fifteen years. Due to the low rate of reporting such deaths, and a lack of a national registry for dental deaths, the figure may actually be higher.
Over two-thirds of dentists offer orally conscious sedation as part of a routine dental procedure. While orally conscious sedation is advertised as a way to “sleep through the dental procedure,” the patient will be awake and alert during the procedure but will not have any memory of it. Until recently, it was only used on patients that were unresponsive to Novocaine. Now, it is being used on anyone that wants it.
Typically, patients are instructed to take an oral sedative about one hour prior to the appointment. Generally, dentists use Valium, Halcion, Ativan, Vistaril or Versed. However, if the dentist does not believe that one pill has achieved the desired effect, he or she may give the patient more, which can lead to problems. Orally conscious sedatives take longer to take effect than inhaled or intravenous sedation where the effects are almost instantaneous. By giving the patient more pills the dentist may inadvertently cause an overdose, if the pills take longer to sedate the patient than normal.
The American Dental Association put forth guidelines requiring dental sedation. They recommend limiting sedatives to only one dose on the day of treatment, and that dose should not exceed the maximum recommended dose of the medication required to achieve the intended level of sedation. It is important to note, however, that these guidelines are only intended for patients aged 8 and older. Therefore, any child younger than eight years old and anyone with health problems is under greater risk, even if the guidelines are followed, and should probably avoid sedation altogether if possible.
