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How safe is deep sedation or general anesthesia while providing dental care?
J Am Dent Assoc 2015; 146(9):705-8JA

Abstract

BACKGROUND

Deep sedation and general anesthesia are administered daily in dental offices, most commonly by oral and maxillofacial surgeons and dentist anesthesiologists.

METHODS

The goal of deep sedation or general anesthesia is to establish a safe environment in which the patient is comfortable and cooperative. This requires meticulous care in which the practitioner balances the patient's depth of sedation and level of responsiveness while maintaining airway integrity, ventilation, and cardiovascular hemodynamics.

RESULTS

Using the available data and informational reports, the authors estimate that the incidence of death and brain injury associated with deep sedation or general anesthesia administered by all dentists most likely exceeds 1 per month.

CONCLUSIONS

Airway compromise is a significant contributing factor to anesthetic complications. The American Society of Anesthesiology closed claim analysis also concluded that human error contributed highly to anesthetic mishaps. The establishment of a patient safety database for anesthetic management in dentistry would allow for a more complete assessment of morbidity and mortality that could direct efforts to further increase safe anesthetic care.

PRACTICAL IMPLICATIONS

Deep sedation and general anesthesia can be safely administered in the dental office. Optimization of patient care requires appropriate patient selection, selection of appropriate anesthetic agents, utilization of appropriate monitoring, and a highly trained anesthetic team. Achieving a highly trained anesthetic team requires emergency management preparation that can foster decision making, leadership, communication, and task management.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26314981

Citation

Bennett, Jeffrey D., et al. "How Safe Is Deep Sedation or General Anesthesia While Providing Dental Care?" Journal of the American Dental Association (1939), vol. 146, no. 9, 2015, pp. 705-8.
Bennett JD, Kramer KJ, Bosack RC. How safe is deep sedation or general anesthesia while providing dental care? J Am Dent Assoc. 2015;146(9):705-8.
Bennett, J. D., Kramer, K. J., & Bosack, R. C. (2015). How safe is deep sedation or general anesthesia while providing dental care? Journal of the American Dental Association (1939), 146(9), pp. 705-8. doi:10.1016/j.adaj.2015.04.005.
Bennett JD, Kramer KJ, Bosack RC. How Safe Is Deep Sedation or General Anesthesia While Providing Dental Care. J Am Dent Assoc. 2015;146(9):705-8. PubMed PMID: 26314981.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - How safe is deep sedation or general anesthesia while providing dental care? AU - Bennett,Jeffrey D, AU - Kramer,Kyle J, AU - Bosack,Robert C, PY - 2015/03/15/received PY - 2015/03/31/revised PY - 2015/04/02/accepted PY - 2015/8/29/entrez PY - 2015/9/1/pubmed PY - 2017/1/24/medline KW - Morbidity and mortality KW - deep sedation KW - general anesthesia KW - patient safety KW - risk assessment SP - 705 EP - 8 JF - Journal of the American Dental Association (1939) JO - J Am Dent Assoc VL - 146 IS - 9 N2 - BACKGROUND: Deep sedation and general anesthesia are administered daily in dental offices, most commonly by oral and maxillofacial surgeons and dentist anesthesiologists. METHODS: The goal of deep sedation or general anesthesia is to establish a safe environment in which the patient is comfortable and cooperative. This requires meticulous care in which the practitioner balances the patient's depth of sedation and level of responsiveness while maintaining airway integrity, ventilation, and cardiovascular hemodynamics. RESULTS: Using the available data and informational reports, the authors estimate that the incidence of death and brain injury associated with deep sedation or general anesthesia administered by all dentists most likely exceeds 1 per month. CONCLUSIONS: Airway compromise is a significant contributing factor to anesthetic complications. The American Society of Anesthesiology closed claim analysis also concluded that human error contributed highly to anesthetic mishaps. The establishment of a patient safety database for anesthetic management in dentistry would allow for a more complete assessment of morbidity and mortality that could direct efforts to further increase safe anesthetic care. PRACTICAL IMPLICATIONS: Deep sedation and general anesthesia can be safely administered in the dental office. Optimization of patient care requires appropriate patient selection, selection of appropriate anesthetic agents, utilization of appropriate monitoring, and a highly trained anesthetic team. Achieving a highly trained anesthetic team requires emergency management preparation that can foster decision making, leadership, communication, and task management. SN - 1943-4723 UR - https://www.unboundmedicine.com/medline/citation/26314981/How_safe_is_deep_sedation_or_general_anesthesia_while_providing_dental_care L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8177(15)00459-6 DB - PRIME DP - Unbound Medicine ER -