Dental News, Dental Trends

Dental anesthesia rules for children under debate.

July 20, 2017

In 2015, the Sears family lost their 6-year-old boy during a routine dental procedure. The anesthesia administered to Caleb by the oral surgeon—who was also performing the extraction—interrupted the child’s breathing, raising questions about sedation protocol for children and prompting the family to lobby for tighter regulations.

Oral surgeons are the only medical professionals authorized to both administer anesthesia and perform surgery on their patients. In the medical field, an anesthesiologist works with the surgeon and must remain present during surgery in order to monitor the patient’s response to sedation. Proponents of this rule argue that separating the duties of the surgeon and anesthesiologist is critical to maintaining a safe and stable surgery environment.

Caleb’s death put the Sears family on the path of advocacy for a similar rule in oral surgery. Along with the California chapter of the American Academy of Pediatrics and the state’s dental board, they lobbied the California state legislature to pass a bill requiring oral surgeries on children to include a second highly trained professional.

According to a recent article in the San Francisco Chronicle, the proposed legislation, sometimes referred to as Caleb’s Law, has been under consideration for two years but was recently shelved.

Opponents to the draft legislation argued that the presence of an additional professional was no guarantee, citing two recent cases in California of infant deaths during surgery performed with an anesthesiologist present. They also worried that the tighter restrictions would increase the cost of care, making it less accessible to families.

Do the rules need to change for oral surgery performed in young children? This'll be something we should keep in mind regarding safety for children undergoing oral surgery.