While I was growing up, my mother often repeated to me a warning that many mothers repeat to their children: "If something sounds too good to be true, it probably is."
Like most of my mother’s warnings, I put this one to the test at every opportunity; and like most of my mother’s warnings, I regretted every time that I did.
Today, dental patients are being offered a proposition that surely must sound too good to be true for them: pain-free dental treatment. This comes in the form of sedation dentistry, the latest craze to sweep the dental industry.
Through the use of various sedatives, administered either orally or intravenously (or a combination of both), sedation dentistry has the potential to end the anxiety and discomfort traditionally suffered by patients while receiving dental treatment.
However, it also has the potential to end a patient’s life.
A number of children have died from complications resulting from sedation dentistry. Consequently, proponents of the technique have recommended that its use be reserved only for adult patients. Beginning in 2007, however, sedation dentistry began claiming adult victims as well, often resulting in costly litigation.
The threat posed by sedation dentistry can be attributed to the combinations of drugs used in sedating a patient. Previously, such drugs were traditionally reserved only for use during the most pain-inducing of surgical procedures – not routine treatments. There is always an inherent risk, even if a relatively small one, associated with sedating a patient, and so doing so has generally been considered a last resort option. Using sedation techniques so much more liberally only unnecessarily exposes more patients to this underlying risk. Different bodies absorb different drugs at different rates, making the effects of drugs on a particular patient’s body difficult to predict, monitor, or address. For this reason, the ADA remains wary of endorsing sedation dentistry. As ADA spokesperson Joel Weaver explained, "Because there is such a wide variable in how rapidly or how slowly patients absorb drugs by the oral route, the ADA believes there is increasing potential for sedating patients to a level that is deeper than the dentist intended."
Furthermore, there remains the question of whether general dental practitioners can ever truly be fully equipped and prepared to handle what complications may occur from sedating patients. Hospitals have large staffs and the latest in state-of-the-art equipment on hand to treat a patient should complications arise from sedation. While a dentist may acquire basic training with regard to sedation practices, he or she simply will not be as capable of responding to complications as a well-equipped and extensively trained hospital staff would be. As Dr. Lee Winter, chief anesthesiologist at New York Downtown Hospital, put it, “There is no safety net when using sedation in an office.”
For dentists as well as patients, sedation dentistry is a prospect seemingly too good to be true. A practitioner that offers sedation dentistry has the potential to substantially increase the profitability of his or her business – not only by attracting new customers that might otherwise be too wary of the expected pain and anxiety to visit the dentist, but also by charging those customers sizable fees for this additional service. But at what costs could these profits come at? What hidden risks are being taken for the sake of them? |