undergoing deep sedation, it is recommended that an independent skilled
observer be present.
Academy of Pediatrics (AAP) has updated its guidance on sedation for dental
procedures in children in a clinical report written in conjunction with the
American Academy of Pediatric Dentistry.
“Guidelines for Monitoring and Management of Pediatric Patients Before, During and After Sedation for Diagnostic and Therapeutic Procedures,”, will be
published in the June 2019 issue of Pediatrics (May 28 online).
recommend that at least two people with specific training and credentials
should be present with a pediatric patient undergoing deep sedation or general
anesthesia for dental treatment in a dental facility or hospital. The report
also clarifies that the sedation should be administered by a qualified
anesthesia provider. The 2019 guidelines define a role of a qualified
anesthesia provider, who may include a medical anesthesiologist, certified
registered nurse anesthetist, dentist anesthesiologist or second oral surgeon.
dental procedures in children and teenagers is generally safe,” said Charles J.
lead author of the clinical report, who is a pediatrician and a pediatric
anesthesiologist. “However, we are aware of adverse outcomes when a single
dental provider simultaneously performs the procedure and administers deep
sedation or general anesthesia for dental procedures. These guidelines ensure
the safety of patients who undergo these procedures.”
Under the 2019 guidelines, one of the two trained people required for
sedation must be an independent observer who is not involved with performing or
assisting with the dental procedure. The observer’s sole responsibility is to
constantly observe the patient’s vital signs and to be skilled to assist with
any medical emergency. Both the independent observer and the operating
dentist must be certified in Pediatric Advanced Life Support.
The prior guidelines had called for the presence of at least one trained
person with the Pediatric Advanced Life Support certification.
The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org and follow us on Twitter @AmerAcadPeds