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Journal of Indian Society of Pedodontics and Preventive Dentistry Official publication of Indian Society of Pedodontics and Preventive Dentistry
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Year : 2017  |  Volume : 35  |  Issue : 2  |  Page : 184-185

Anesthesia-related mortality in pediatric patients in dental office setting

Department of Pedodontics and Preventive Dentistry, Dr. D. Y. Patil Vidyapeeth, Dr. D. Y. Patil Dental College and Hospital, Pune, Maharashtra, India

Date of Web Publication10-May-2017

Correspondence Address:
Fawaz Shamim Siddiqui
B-1, 21, Ravi Park, Jagtap Nagar, Wanawadi, Pune - 411 040, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JISPPD.JISPPD_108_16

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How to cite this article:
Siddiqui FS. Anesthesia-related mortality in pediatric patients in dental office setting. J Indian Soc Pedod Prev Dent 2017;35:184-5

How to cite this URL:
Siddiqui FS. Anesthesia-related mortality in pediatric patients in dental office setting. J Indian Soc Pedod Prev Dent [serial online] 2017 [cited 2022 Aug 17];35:184-5. Available from: http://www.jisppd.com/text.asp?2017/35/2/184/206028


Use of sedation and general anesthesia in the dental office setting is very widely used in the United States for treating and for taking intraoral periapical radiographs of very young child patients. General dentist along with dentist anesthetist are increasingly utilizing this technique because it is viewed as having lower-risk in community settings such as dental offices.[1] General anesthesia in dental office setting was found to be a very safe and successful procedure.[2] In spite of these findings and risk of medico-legal lawsuits, robust training requirement and health legislation in the United States, such mishap does occur and questions the safety of sedation or general anesthesia in the dental office setting.

While there might be more unreported death of children undergoing dental treatment under sedation in dental office setting, general anesthesia under hospital setting has emerged as the best approach. Even under general anesthesia most cases of anesthesia-related mortality in pediatric patient was associated with airway and cardio-circulatory events.[3] In India, the debate continues whether conscious sedation can be practiced in a dental office setting and whether general anesthesia is safe. There are no official guidelines by either Indian Dental Association or Indian Society of Pedodontics and Preventive Dentistry (ISPPD) on the argument. For example, mandatory certification for postgraduates in Basic Life support and Pediatric Advanced Cardiac Life Support. There are no national data on how many practitioners are using conscious sedation and therefore no account of adverse outcome and complications. Even general anesthesia in hospital setting has an inherent risk of death and complications in child patients. And even that data are amiss. The prevention of death in dental office setting related to local anesthesia, general anesthesia, or sedation requires data on an estimate of incidence and prevalence of mortality and morbidity related to it.

A review of current practices can help generate information on the most likely causes of death and therefore shape our curriculum to better prepare the upcoming generations of pedodontist to practice conscious sedation, local anesthesia, and general anesthesia safely and with confidence. I am certain that majority of us have not seen any respiratory or cardiac arrest child patient during our training, let alone put a stethoscope on a child patient's chest and we, therefore, fail to recognize impending medical emergencies. Our dependence on medical colleagues is overwhelming mainly due to our unpreparedness and lack of motivation to learn.

ISPPD is the national and the global face of pediatric dentistry in India. And, therefore, the initiative lies with this body to investigate, scrutinize, and provide recommendations on changing global practices in pediatric dentistry. Every experience is an opportunity to learn because learning curve never ends.

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Conflicts of interest

There are no conflicts of interest.

   References Top

Lee HH, Milgrom P, Starks H, Burke W. Trends in death associated with pediatric dental sedation and general anesthesia. Paediatr Anaesth 2013;23:741-6.  Back to cited text no. 1
Caputo AC. Providing deep sedation and general anesthesia for patients with special needs in the dental office-based setting. Spec Care Dentist 2009;29:26-30.  Back to cited text no. 2
Gonzalez LP, Pignaton W, Kusano PS, Pinheiro Modolo NS, Cerqueira Braz JR, Braz LG. Anesthesia-related mortality in pediatric patients: A systemic review. Clinics 2012;67:381-7.  Back to cited text no. 3


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