American children are being put at risk by inadequately trained dentists who often seek to enhance profits by sedating their young patients for even routine tooth cleaning and cavity treatments, an ABC News investigation has found.
In many cases, even well-trained dentists have been unable or ill-equipped to handle emergencies with young patients.
More than a dozen children have died after being sedated by dentists, according to the Raven Maria Blanco Foundation, which seeks to alert parents to the potential dangers of the increasingly widespread use of oral sedatives on patients as young as 18-months old.
There is no national registry of dental deaths, and some experts say many deaths go unreported or are never officially tied to dental sedation.
Eight-year old Raven Blanco died after her dentist, Dr. Michael Hechtkopf, gave her "three times the average range" of sedatives, according to a medical examiner.
The dentist had his license restricted for three months and was ordered to complete seven hours of continuing education in record keeping and risk management. He has since retired.
A lawyer for Dr. Hechtkopf said the dentist "regretted" what happened.
Raven's parents, Robin and Mario Blanco, set up a foundation in their daughter's name to urge dentists to be better prepared for emergencies and to warn parents that what happened to their daughter could happen to others.
They told ABC News, in an interview to be broadcast tonight on "World News with Diane Sawyer" and "Nightline," that parents assume that a dentists "should know what he's doing and that's not always the case."
The ABC News investigation found a patchwork of state regulations with some states requiring only a weekend-long course for dentists to be certified in the administration of oral sedatives.
"Who thinks that they're gonna take their daughter to the dentist and never bring her home?" said Ommettress Travis of Chicago, whose five-year-old daughter Diamond died after being sedated prior to have cavities filled and teeth capped.
The Illinois Board of Dentistry found that Diamond's dentist, Dr. Hicham Riba, administered an excessive dose of sedatives to the kindergarten-aged girl and "demonstrated a complete lack of understanding of conscious sedation" despite having performed thousands of procedures over nine years.
Leading dental professionals say sedation for routine procedures can make it safer to work on young patients whose anxiety can make it difficult or dangerous to use high speed drills and other equipment.
But, they say, it takes extensive training to learn how to administer sedation safely and be prepared to deal with emergencies.
"This is something that is being presented to the practitioners, the dental community, as a very easy thing to do, and nothing could be further from the truth," said Dr. Norbert Kaminski, a dental anesthesiologist in suburban Detroit, who has sought tougher standards for dentists who use sedation on patients.
In the last five years, more than 18,000 dentists across the country have signed-up for weekend-long courses in oral sedation that are set up in local hotel ballrooms and promise to add tens of thousands of dollars to the bottom line.
"Pain-free dentistry can means tens of thousands of dollars of extra income in your pocket annually, and as much as half a million extra in your pocket at retirement," wrote Dr. Michael Silverman, a dentist who runs a company that offers weekend-long training sessions for dentists in the use of oral sedation.
A national spokesperson for the American Academy of Pediatric Dentistry, Dr. Indru Punwani of the University of Illinois, said a weekend course is "inadequate" for preparing dentists to deal with emergencies that can arise through the use of oral sedatives.
"I don't believe it can be done," said Dr. Punwani of the promise of the popular weekend courses to train dentists.
Dentists following the sedation guidelines of the AAPD have never been tied to a death, said Dr. Punwani.
Dr. Silverman declined to be interviewed by ABC News, but in a written response said, "Everyone who has attended and completed any of our DOCS Education courses knows that safety is by far our top concern and emphasis."
The program brochure says of its single dose sedation course: "Give us three days, and we'll teach you both adult and pediatric protocols -- serving patients from ages 5 to 95 -- that you can take home and implement immediately."
In its brochure, the program also recommends but does not require dentists to also enroll in a separate "pediatric advanced life support" course.
This ABC News investigation began after a woman who said she was the grandmother of a young girl who died after an overdose of sedation at the dental office contacted Brian Ross through The Blotter Tip Line. If you have or someone you know has a story that could add to this investigation, contact the Brian Ross Unit by CLICKING HERE.
An earlier version of this report attributed the finding concerning the amount of sedatives given to Raven Blanco to the Virginia Dentistry Board, which only reported the findings of the medical examiner in their investigative documents. The actual autopsy report was the work of the medical examiner.