Like most regulations, the new guidelines from the American Dental Association regarding the use of sedation and general anesthesia by dentists aren’t always immediately clear or easy to understand. Despite this, the recent decision to require dentists to use capnography equipment for procedures requiring moderate sedation, deep sedation and general anesthesia, as well as other guidelines for the use of general and oral anesthesia, have been put in place to increase patient care and safety.
To help get to the essence of these regulations, here are answers to some frequently asked questions.
What’s the goal of these guidelines?
- To ensure practitioners and staff are trained to administer the anesthetic and receive continuing education to keep them up to date on the latest sedation equipment, drugs and techniques
- To know the importance of physically evaluating a patient and the type, level and dosage of the anesthetic they receive
- To equip dentist offices with the appropriate monitoring and rescue equipment
What are the benefits of capnography?
Capnography, which is used to monitor a sedated patient by reading their exhaled carbon dioxide levels, has long been a standard of care in hospitals, ambulances and ERs. Many believe increasing its use in dental offices will prevent unnecessary deaths.
How will this affect my practice?
Part of the new regulations involve more careful screenings prior to sedation, which can require the patient to go through a few extra steps before an operation. Pedodontists may have to get a moderate sedation permit for children under 12.
If you do not have one already, you will have to acquire a capnography machine and ensure staff are properly trained. Some of the most widely used capnographs you might want to consider for your practice are Nonin’s RespSense II , the LifeSense II Capnograph and the Criticare nGenuity 8100EP1 CO2 monitor.
What are some references I can consult?
To better understand the standards for sedation in a dental practice, review these works:
- American Dental Association’s Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students
- American Dental Association’s Guidelines for the Use of Sedation and General Anesthesia by Dentists
- American Academy of Pediatric Dentistry’s Reference Manual: Guideline for Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures
- American Society of Anesthesiologists’ Practice Guidelines for Sedation and Analgesia by Non-Anesthesiologists
- American Association of Oral and Maxillofacial Surgeons’ Parameters of Care: Clinical Practice Guidelines for Oral and Maxillofacial Surgery: Anesthesia in Outpatient Facilities