Pediatric anesthesia is always a sensitive topic.
Anesthesia for children can be deadly, and there are kids who have tragically lost their lives due to dental procedures gone wrong.
In addition to meeting general dental anesthesia requirements, California is one of nine states which require a permit for pediatric sedation. Different states have different ages defined as pediatric, but in California, the permit covers children ages 13 and under. According to the Dental Board of California (DBC), practitioners must have appropriately sized equipment for young patients and also require a current Advanced Cardiac Life Support (ACLS) certificate.
Currently, 20 states require dentists who perform anesthesia on kids to also obtain Pediatric Advanced Life Support (PALS) certification. California is not one of those states.
Dental assistants can't administer anesthesia but can assist in monitoring the patient and assist in caring for a patient under sedation. California requires all dental assistants to maintain current certification in Basic Life Support (BLS) and specifies the duties and education for assistants participating in sedation and anesthesia care.
The biggest difference between the anesthesia process at the dentist and going under anesthesia at the hospital is, dentists and oral surgeons in California are not required to have an individual present to administer and monitor anesthesia. In fact, no state in the country requires a separate person for anesthesia during dental procedures for adults and children, according to the DBC.
The state doesn't require the presence of a specific number of staff for anesthesia or moderate sedation procedures. Most times, dentists are multi-tasking with anesthesia and the dental procedure.
There is also no requirement to have a registered nurse or medical professional during an anesthesia procedure at a dental office. The state does allow a physician anesthesiologist to work at dental offices but they must obtain a permit to do so.
In January, the DBC released a final report on a pediatric anesthesia study, at the request of Senator Jerry Hill (D-San Mateo) and as a requirement of Caleb's Law.
The report concluded that California's current laws are sufficient to provide protection to pediatric patients during dental sedation. However, the board gives several recommendations for improvements including requiring more personnel to be present during pediatric anesthesia.
AB-224, the Dentistry Anesthesia and Sedation bill, was introduced in January and if passed, would make changes to the current pediatric anesthesia laws, including requiring a pediatric endorsement of their general anesthesia permit and having more staff in the room during a procedure.
The goal of the bill is to ban the "operator-anesthetist" model of care for children during anesthesia. The bill will be voted this month.