A retrospective study in Anesthesia Progress examines the important relationship between dentist anesthesiologists and general practice dental residents and their patients who were moderately or deeply sedated as part of their dental procedure.
Another term for moderate or deep sedation, is monitored anesthesia care, and this was reviewed in 100 randomly selected cases, and the authors found an occurrence of only 5 instances of morbidity (eg, nausea, vomiting). In addition, these morbidities were minor and either self-limiting or easy to control. Thus, sedation was found overall to be effective and safe. A key factor in the successful treatments was the presence of a dentist anesthesiologist, who collaborated with second-year general practice dental residents in administering sedation care. Although 15% to 30% of the US population experiences dental fear, especially special-needs and phobic patients, very few general dentists have training or experience in advanced anesthesiology techniques used to address this fear and to minimize pain. Furthermore, the ADA has not recognized dental anesthesiology as an official specialty of dentistry in the United States. The good news is that the Commission on Dental Accreditation (CODA), which is associated with the ADA, has taken action to help address this gap between the lack of knowledge and experience of dentists and the increasing needs of those fearful of undergoing dental procedures. The CODA now includes dental anesthesiology residency programs as part of its accreditation process. In addition, guidelines for using sedation methods and for teaching these methods to students and dentists have been adopted by the ADA. Dentist anesthesiologists, as teachers and overseers, have an important role to play in the optimal treatment of patients in need of monitored anesthesia care. As dentists increase their knowledge of sedation techniques, it will be possible to help ever-greater numbers of fearful patients receive high-quality dentistry.
(Source: Anesthesia Progress, 2008, Volume 55, Issue 4, Allen Press, January 8, 2009)
