Pacific Coast Society of Orthodontists Bulletin Fall 2017 - 50

Practice Management Diary

Responding to the New Taboo
of Pediatric Dental Sedation
Dr. Jeffrey Nichelini
American Canyon, CA

Our colleagues in the specialties of pediatric dentistry and oral surgery have recently been coping
with a media assault on the practice of sedation.
Numerous tragic events and national headlines
have brought the risks of these procedures front
and center, and the coverage has neither been
fair nor balanced. It can be hard to look at a topic
like this objectively, because the tragedy of needless child deaths cannot be overstated; however,
sensationalized media coverage has justified a
blanket condemnation of an entire industry due
to a few isolated events.
On July 9, 2017, NBC's Sunday Night with Megyn
Kelly aired a piece entitled "Children at Risk? Kids
and Sedation at the Dentist's Office." The segment focused solely on a couple of these tragic
incidents, and made the repeated accusation that
financial gain is the primary motivating factor for
dentists to provide sedation. Sadly, the indications and benefits of sedation treatment were
never mentioned, and interviews with the current and former presidents of the American
Academy of Pediatric Dentistry (AAPD) were cut
from the final story.
As a consequence of stories like these, dental
sedation has now become relevant to my orthodontic practice. I have had to field questions from
concerned parents who are either nervous about
protocols for extraction procedures or probing
for information regarding suggestions made by
another provider. These questions always make
me uncomfortable, because I do not want to
interfere with the decisions of colleagues; at the
same time, I do not want my patients to feel that
their concerns are falling on deaf ears.
To date, I have generally responded to questions
on this topic by reaffirming my faith in the abilities of other providers and encouraging parents
not to be shy in questioning those providers. Fortunately, in response to the Megyn Kelly piece,
the AAPD sent its members a list of talking
points to help educate parents and calm fears
regarding dental sedation. These talking points

may be helpful for us, too. The following points
are taken directly from an AAPD e-mail to its
members:

 The AAPD has guidelines in place that are coendorsed by the American Academy of Pediatrics that reflect the highest safety measures
for children undergoing sedation and/or anesthesia. It is paramount that every health
provider discuss the risks and benefits of
anesthesia with parents and caregivers
regarding the need for anesthesia services.
 The AAPD supports state regulations that
limit the practice of deep sedation and general anesthesia to qualified, appropriately
trained individuals.

 It is important that patients be fully informed
and have trust in their dentist. If patients are
not satisfied with their dentist's answers to
these or other questions, they should consult
with another dentist. There are many dentists
fully trained and qualified in the use of sedation and anesthesia, and AAPD can help
patients find one in their area.

 The use of effective sedative and anesthetic
techniques has enabled thousands of children
to safely undergo dental treatments they
might otherwise be unable to receive. Dentistry has been at the forefront of ensuring
patient safety with regard to sedation and
anesthesia, and statistics show that dental
anesthesia is very safe. The American Dental
Association and the AAPD have developed
guidelines for sedation education, training,
and use.
This list of talking points should help reassure
parents that their kids are in good hands,
because it not only reinforces that sedation practices are highly regulated for patient safety, but
that the guidelines were developed with the
input of pediatricians. Hopefully there will be no
further headlines to keep dental sedation in the
news, and our colleagues can focus on keeping
kids healthy. 

PCSO Bulletin  Fall 2017

Table of Contents for the Digital Edition of Pacific Coast Society of Orthodontists Bulletin Fall 2017