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Physicians Endorse Guidelines for Deep Sedation and Anesthesia During Dental Procedures for Kids

The American Academy of Pediatrics (AAP) issued guidelines in June for deep sedation and anesthesia of children undergoing dental procedures that now have the endorsement of four additional health organizations. 

In a joint statement, the American Society of Anesthesiologists (ASA), the Society for Pediatric Anesthesia, the American Society of Dentist Anesthesiologists, and the Society for Pediatric Sedation join the AAP in endorsing guidelines that recommend that at least two people with specific training and credentials should be present with a pediatric patient undergoing deep sedation or general anesthesia for dental treatment in a dental facility or hospital.

The recommendations can be found in the 2019 clinical report, “Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures,” which were co-written by the American Academy of Pediatric Dentistry (AAPD).  The guidelines also clarify that deep sedation or general anesthesia must be administered by a qualified anesthesia provider (a physician anesthesiologist, certified registered nurse anesthetist, dentist anesthesiologist or second oral surgeon).

The six health organizations recommend that pediatric patients requiring deep sedation or general anesthesia for dental procedures require a second, well-trained professional capable of monitoring the patient, managing the airway, establishing venous access for the administration of rescue medications, and resuscitation.

This approach, called the multi-provider team-based safe practice model, requires that the dental surgeon and the professional who is monitoring and sedating the patient are two distinct individuals with separate tasks. 

“We are pleased with the support from these influential health organizations on dental sedation guidelines, which take into account the unique vulnerabilities of children,” said Kyle Yasuda, M.D., president of the AAP. “As health care providers, we share a desire for children to receive close supervised care led by a team of skilled professionals.”

“We’re excited to be working with these important health care groups to take an important step in furthering the safety of children who undergo deep sedation and general anesthesia for dental procedures,” said ASA President Linda J. Mason, M.D., FASA. 

“There are real risks associated with one dental provider doing both the procedure and monitoring the patient’s vitals,” said Mason. “Our collective endorsement of the guidelines illustrates the necessity of having a dedicated, qualified anesthesia provider monitor the child to reduce the risk of adverse events and to manage any complications.”

Source: American Academy of Pediatrics

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