Anesthesia Groups Endorse Updated AAP Advice on Dental Sedation

Megan Brooks

August 01, 2019

Updated recommendations on deep sedation and anesthesia in children undergoing dental procedures issued by the American Academy of Pediatrics (AAP) last spring have been endorsed by 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 the guidance. The recommendations were co-written by the American Academy of Pediatric Dentistry (AAPD).

"We are pleased with the support from these influential health organizations on dental sedation guidelines, which take into account the unique vulnerabilities of children," AAP President Kyle Yasuda, MD, said in an AAP news release. "As health care providers, we share a desire for children to receive close supervised care led by a team of skilled professionals."

Reducing "Real Risks"

The updated 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," published online May 28 in Pediatrics.

They recommend that at least two people with specific training and credentials be present with a pediatric patient undergoing deep sedation or general anesthesia for dental treatment in a dental facility or hospital.

They also clarify that deep sedation or general anesthesia must be administered by a qualified anesthesia provider, who may include a medical anesthesiologist, certified registered nurse anesthetist, dentist anesthesiologist, or second oral surgeon.

One of the two trained people required for sedation must be an independent observer who is not involved with performing or assisting with the dental procedure. The observer's sole responsibility is to constantly observe the patient's vital signs and to be skilled to assist with any medical emergency.

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

Both the independent observer and the operating dentist must be certified in Pediatric Advanced Life Support. Prior guidelines called for the presence of at least one trained person with the Pediatric Advanced Life Support certification.

"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," ASA President Linda J. Mason, MD, said in the AAP press release.

"There are real risks associated with one dental provider doing both the procedure and monitoring the patient's vitals. 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," said Mason.

Pediatrics. 2019(143):e20191000. Full text

Follow Medscape on Facebook, Twitter, Instagram, and YouTube.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....