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Deaths From Sedation Dentistry

Updated on June 27, 2011

Sedation in Dentistry a Growing Trend

Many people fear going to the dentist, and sedation dentistry seems to have become a growth industry.  More and more dentists are offering sedation and advertising as such through multiple mediums including the internet.  It is no wonder since offering something as simple as a pill or other oral sedative allows the dentist to charge anywhere from $300 to over $800 depending upon geographic location and the tolerance of the local market.  Furthermore, this charge is usually collected on the day of the procedure.  When my daughter needed intravenous sedation at the oral surgeon’s office to have a tooth pulled, I was required to write a check for $400 that day.

It is estimated that 85 million Americans avoid the dentist because of fear and anxiety.  While having sedation at the dentist sure sounds like a great idea, I think it is important to fully understand the risks if you are going to use sedative medications to assist you or a loved one through a particular procedure.  A study published in the October 2000 edition of the journal Pediatrics looked at the adverse effects of sedation medications.  Perhaps the most telling statement in the abstract of the article is that “dental specialists had the greatest frequency of negative outcomes associated with the use of 3 or more sedating medications.”

Consider a few of the news reports on deaths from sedation dentistry:

Four-year-old Javier Villa had gone to a dentist in Santa Ana, California to have some drilling done and was given an oral sedative called chloral hydrate. He was then strapped to a papoose board and his head restrained. Neither his blood pressure, pulse, nor breathing was monitored with any of the standard equipment. Javier stopped breathing and died at a hospital a few hours later.

Diamond Brownridge visited a dentist in Chicago to have some teeth filled and others capped. The five-year-old was given three sedatives, an oral agent, an intravenous one, and nitrous oxide which is commonly known as laughing gas. Neither the dentist nor his assistant recognized that Diamond had stopped breathing at some time during the 30 minute procedure. She died after four days on life support.

The family of Georgette Watson settled for $8.5 million after the Chicago area school principal died during a root canal in 2007. She had received a mixture of intravenous medications that ultimately caused her breathing to be shallow and irregular about 40 minutes into the procedure. Attempts to reverse the sedation and revive her were unsuccessful, and she ultimately went into cardiac arrest. She was pronounced dead at a local hospital.

You and Your Dentist

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What can you do to protect yourself?

  • Be honest about your own level of anxiety.  Yes, the thought of peacefully closing your eyes and waking up after the procedure is done is enticing.  But, if you can handle it without sedation or with a small amount of oral sedation, less is better.
  • Ask what kind of training, experience, or license the sedation dentist has.  Was it just a weekend course or was it more extensive training?  Does the state require any sort of license for sedation?
  • Ask what kind of medications the sedation dentist plans on using.  Not everyone is aware that the effect of sedation medications will not simply add to one another but the effect can be multiplied.  If the dentist plans on using multiple medications, the dosages should be reduced.
  • Ask what kind of monitoring will be used and who will be monitoring the monitors.  Several sedation deaths have occurred in the face of absolutely no patient monitors.  That is ridiculous and dangerous.  Everyone undergoing sedation should have their heart rate, breathing rate, blood pressure, and oxygen level monitored at all times.  Furthermore, it is best if someone trained is able to focus on just the patient and the sedation while the dentist performs the work.  It is too much to ask for the dentist to be focused on his or her work while trying to maintain the safe sedation of a patient.
  • Try to find out if the dentist has undergone disciplinary action.  This may be difficult to hunt down but sometimes the state board of dentistry will have some information.  Disciplinary actions will often give clues to the level of organization and attention to detail to which a professional ascribes.  Use this information if you can get it.

Although dental procedures can be anxiety provoking, sedation dentistry is a rapidly expanding option for many which provides a great deal of benefit; however, it is necessary to be aware of the risks as death from a simple visit to the dentist can occur.  By asking the appropriate questions of your sedation dentist and arming yourself with information and knowledge, you can avoid the potential complication of death from sedation dentistry.

Comments on Deaths from Sedation

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    • Kidgas profile image
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      Kidgas 5 years ago from Indianapolis

      I believe that many dentists are ill-prepared to handle or even diagnose an emergency especially in children. This article states there have been six children die from dental sedation since January 2010:

      http://chronicle.northcoastnow.com/2011/04/08/teen...

      Granted there are great benefits to having dental work done if the alternative is having nothing done. But I am sure that these parents wish they had known that death with sedation was a possibility.

      The head of pediatric dentistry at the University of Illinois at Chicago thinks it might be an increasing trend:

      http://www.drbicuspid.com/index.aspx?sec=sup&s...

      The bottom line is that the dentist needs to have a good knowledge of pharmacology and airway management along with a high index of suspicion. And the patient under heavy sedation should be monitored by an individual whose sole responsibility is monitoring the child.

      Finally, I would say that the risk of death from sedation or anesthesia is at best similar between other procedures and dentistry, although the numbers are from a time before the recent proliferation of sedation dentistry. I would suspect that once new data is gathered, the recent increase in reports of deaths will in fact represent a disturbing trend, given that many more deaths have been reported recently including two in Florida.

      http://flaglerlive.com/3967/children-deaths-dentis...

    • profile image

      Jonathan Campbell, DDS 5 years ago

      This article consolidates a few tragic instances making it seem like a dangerous treatment to be avoided at almost all costs and that it is only provided as another way to make money. It's inflammatory and attracts attention, but the reader is no better off for having read it.

      The incidence of complications with sedation for a dental procedure is lower than it is for other medical procedures. What most people find alarming is when they see the most common summary, "A child died while sedated for a filling." Fillings seem so benign. Some even think they're unnecessary and the tooth should just be pulled. The fact that a child died for a filling under the care of Dr. is startling to us all. The article fails to consider risk vs. reward.

      You will find a higher number of deaths and disability caused by untreated dental disease. Not being able to offer some form of sedation would make treating millions of patients impossible.

      The reader interested in sedation dentistry should know that it is safe. Many of the medications used are medications taken by people by themselves at home to on their own to cope with anxiety or to help them sleep. Learn about the different types of sedation and how to choose the best option: http://www.legacydental.com/Salt-Lake-City-Dentist...

    • Kidgas profile image
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      Kidgas 5 years ago from Indianapolis

      It is so sad. There was a recent lawsuit brought against an oral surgeon and anesthesiologist who died following complications during wisdom teeth extraction:

      http://www.baltimoresun.com/explore/howard/news/co...

    • profile image

      Heather Smith 5 years ago

      This dentists should not operate if they have no license because this awful stories are true. I do agree with Kidgas. When doing sedation, patient's vital sign should be monitored. Thank for the great post.

    • cosmeticdentalsa profile image

      cosmeticdentalsa 6 years ago from San Antonio TX

      Great post!

      As a cosmetic dentist I found that it's best to keep my patients awake and alert during my procedures. I am constantly in communication with my patients before and during the procedures to ease their minds and calm them down. I take special care to pay attention to body language and facial expressions for clues as to how they feel while in the chair.

      I refuse to use Sedation Dentistry because I know there are risks involved. Insurance companies know the risks as well. In fact, Malpractice insurance quotes actually double when dentists use general anesthesia.

      You can view more info on Sedation Dentistry at http://cosmeticdentalsa.com/sedation-dentist-san-a...

    • Kidgas profile image
      Author

      Kidgas 6 years ago from Indianapolis

      It is incredibly scary and unfortunate that some individuals are allowed to continue to practice despite some of the things that happen.

    • profile image

      Udayan Chattopadhyay 6 years ago

      This is scary. How can the dentist be callous while administrating such procedures? Don't they lose their licenses/source of livelihood for this?

    • Kidgas profile image
      Author

      Kidgas 6 years ago from Indianapolis

      Rachel,

      It is important to know what kind of experience and training your dentist has as well as the training and experience of anyone assigned to pay attention to you and your vital signs while sedated. Good luck with your surgery.

    • profile image

      Melissa Wexford 6 years ago

      Good God Man! Those are some crazy stories. Sedation Dentistry is tricky business and like any medical procedure can be really dangerous.

    • Rachel Rose profile image

      Rachel Rose 6 years ago from Ohio

      For the most part I can do without any assistance in seeing my dentist. However, this is a really important article to bear in mind when I have my dental surgery, (coming soon). Thanks. I will certainly discuss this with him.

    • Kidgas profile image
      Author

      Kidgas 7 years ago from Indianapolis

      It is good to be able to have that discussion with your dentist.

    • profile image

      Wanda Grossing 7 years ago

      A very good article. My general theory is that one should be awake throughout the dental procedure. However, there comes a time when sedation is necessary, you should then look for someone appropriately trained to offer the type of sedation that is required.

      My dentist, Chicago Dentist, http://www.bigsmiledental.com/ are so experienced when it comes to administering sedation, that they have an one-to-one chat with you about the entire procedure.

    • Kidgas profile image
      Author

      Kidgas 7 years ago from Indianapolis

      You are welcome, Randy.

    • profile image

      Randy Pigg 8 years ago

      Good sound advice.

      Thanks for posting.

    • Kidgas profile image
      Author

      Kidgas 8 years ago from Indianapolis

      I agree totally. It is important to check into the licensing requirements and training involved. Some people offer procedures just for the extra money without considering the full implications.

    • VivienneG profile image

      VivienneG 8 years ago from Florida

      Jesus. Those stories are awful.

      It is important to check if the dentist is licensed to do sedation. Plus, anyone undergoing sedation should have their vital signs monitored.

      Great hub. Very informative.