As detailed in a report on "Nightline" Thursday, an ABC News investigation found that 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.
There is no national registry of dental deaths, but according to the Raven Maria Blanco Foundation, more than a dozen children have died after being sedated by dentists. Some experts say many deaths go unreported or are never officially tied to dental sedation.
To lessen the risk for young patients, the American Dental Association has prepared the following list of questions that parents and guardians should ask about sedation or anesthesia for children.
Questions to Ask Your Dentist about Anesthesia and Sedation for Your Child
The ADA offers the following questions that parents and guardians should ask concerning in-office sedation or general anesthesia for their children provided either by the dentist or by a separate sedation/anesthetic practitioner in that dental office. The ADA recommends talking to your dentist about any concerns you might have about the treatment plan prior, during and after the procedure:
Prior to the procedure:
• Who will provide the preoperative evaluation of my child including their past medical history such as allergies, current prescription medications and previous illnesses and hospitalizations?
• What is the recommended time that my child should be without food or drink prior to the procedure (with the exception of necessary medications taken with a sip of water)?
• Will any sedation medication be given to my child at home prior to their coming to the office and, if so, how should they be monitored?
• What training and experience does the sedation/anesthesia provider have in providing the level of sedation or anesthesia that is planned for the procedure? Does this training and experience meet all of the standards of the ADA Guidelines for the Use of Sedation and General Anesthesia by Dentists?
• Does the staff assisting in the procedure have current training in emergency resuscitation procedures, such as Basic Life Support for Healthcare Providers, and other advanced resuscitation courses as recommended by the ADA Guidelines? Is this training regularly renewed?
• Does the state dental board require a special sedation/anesthesia permit or license that allows for the sedation/anesthesia provider to administer this specific level of sedation or anesthesia in the dental office?
During the procedure:
• In addition to the use of local anesthesia (numbing), what level of sedation or general anesthesia will be given to my child? Is it minimal sedation (relaxed and awake), moderate sedation (sleepy but awake), deep sedation (barely awake) or general anesthesia (unconscious)?
• How will my child be monitored before, during and after the procedure until the child is released to go home? Are the appropriate emergency medications and equipment immediately available if needed, and does the office have a written emergency response plan for managing medical emergencies?
After the procedure:
• Will the sedation/anesthesia provider give me instructions and emergency contact information if there are any concerns or complications after returning home?
For more information on oral health topics for you or your family, please visit the American Dental Association's website www.MouthHealthy.org
The Raven Maria Blanco Foundation, which seeks to alert parents to the potential dangers of the use of oral sedatives on young patients, has its own recommended sedation checklist for parents. CLICK HERE for the foundation's "Pediatric Dental Care Checklist."
The foundation is named for eight-year old Raven Blanco of Chesapeake, Virginia, who 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 the 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.
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.