Oral surgeons in the Alberta province of Canada can no longer administer deep sedation or general anesthesia while providing dental treatment at the same time. This new declaration put forward by the Alberta Dental Association and College (ADAC) comes on the heels of a recent, highly-publicized case of a young girl who suffered brain damage and coma after undergoing a deep sedation procedure at her oral surgeon's office. The ADAC, which had previously been reviewing its sedation guidelines, issued the immediate moratorium on unassisted deep sedation dentistry, stating the viewpoint that deep and general anesthesia are an involved task requiring the full attention of the practitioner, and that the same clinician should not be conducting both anesthesia and dentistry at the same time. Over 44,680 dental procedures requiring general anesthesia were performed in non-hospital facilities last year in Alberta, and experts have no estimate on how this could impact access-to-care this year.
The American Dental Association made its own ruling on sedation dentistry recently. On October 24th, 2016, the ADA house of delegates voted to accept Resolution 37, a bill that proposed revisions to the guidelines directing dentists in the use of moderate sedation, but not deep or general anesthesia. The proposal was vehemently opposed by a coalition of mostly general dentists, including DOCS Education, arguing that it will limit access-to-care for those who experience dental fear, and dramatically increase the price of sedation treatment without any scientific evidence indicating an increase in safety. Under the new regulations, dentists who wish to provide moderate oral sedation must take a 60-hour sedation course plus 20 live patient experiences.
State dental boards take time to fully implement ADA guidelines and during this interval, a grandfather clause allows dentists who complete training under the previous requirements (24 hour course with three live patients, such as DOCS) to obtain a current moderate enteral sedation permit. These permits will remain valid once the grandfather period has terminated.
Most states adopt regulations based on the ADA's recommendation within four years. Due to the controversy surrounding Resolution 37, however, some states may reject the ADA's ruling and move to adopt separate regulations surrounding sedation and anesthesia that more closely reflect their constituents’ wishes. The ripple effect of Resolution 37 remains to be seen.
For more information on what Resolution 37 means for you, click here.
Gerein, K. (2016, November 01). Alberta dental college tightens policies on deep sedation procedures. Retrieved November 16, 2016, from http://edmontonjournal.com/news/local-news/alberta-dental-college-tightens-policies-on-deep-sedation-procedures
Kent, F. (2016, October 31). Dental sedation expert 'frustrated beyond imagination' over anesthesia rules. Retrieved November 16, 2016, from http://globalnews.ca/news/3032798/dental-sedation-expert-frustrated-beyond-imagination-over-anesthesia-rules/
Solana, K. (2016, November 07). ADA House of Delegates adopt revisions in sedation, anesthesia guidelines. Retrieved November 16, 2016, from www.ada.org
The information contained in this, or any case study post in Incisor should never be considered a proper replacement for necessary training and/or education regarding adult oral conscious sedation. Regulations regarding sedation vary by state. This is an educational and informational piece. DOCS Education accepts no liability whatsoever for any damages resulting from any direct or indirect recipient's use of or failure to use any of the information contained herein. DOCS Education would be happy to answer any questions or concerns mailed to us at 106 Lenora Street, Seattle, WA 98121. Please print a copy of this posting and include it with your question or request.