On July 12, 2012 ABC News aired a segment on dentistry that featured the Raven Maria Blanco Foundation (RMBF) and its founder, Mario Blanco.
RMBF believes good dental health is an important and necessary component of general health. RMBF further believes various mechanisms of pain and anxiety control are necessary to achieve that end. These can range from local anesthesia (commonly called “Novocain” by the public) through various levels of sedation to true general anesthesia.
Contemporary dentistry faces many challenges: (1) the demographic makeup of patients is aging, (2) medical histories of patients are becoming increasingly complex and (3) dental procedures are more invasive and sophisticated. Coupled with the fact that dentistry takes place at the opening of the respiratory system (and is therefore always at risk of obstruction), medical emergencies will occur during the course of dental treatment.
The central objective of RMBF is to call attention of all members of the dental profession to the need to be prepared when a medical problem arises. We believe dental offices need to be prepared in six timeless areas we call The Six Links of Survival. The six links include: adequate training of the dentist, training of the entire staff, periodically holding mock emergency drills, having a written emergency plan, stocking appropriate medications and maintaining necessary emergency equipment. While the specifics of these areas will vary depending on the nature of a particular practice, RMBF has developed a basic framework that is applicable to all dental practices, even those that do not use local anesthetics such as orthodontists.
Three dental schools and numerous local dental associations have already adopted these guiding principles. However, RMBF believes they need to be implemented throughout the entire dental profession.
Currently, the American Dental Association (ADA) has guidelines, policies or position statement in over 60 areas of dentistry to assist dentists in practice. None addresses medical emergency preparedness. Instead, the ADA offers an assortment of journal articles on medical emergencies and urges its members to review them and then choose, on an ala carte basis, those concepts they believe would benefit their office. This approach is haphazard, at best.
RMBF has called upon the ADA to establish a standing body (i.e. committee) to establish and maintain guidelines in the area of medical emergency preparedness based on current science and developed by both practicing dentists and those from academia. To date, the ADA continues to believe the status quo is adequate. RMBF disagrees.
While RMBF remains committed to partnering with the ADA, as it already has with several dental schools, our experience has been that only through pressure from the public will change occur in the area of medical emergency preparedness by dentists.
The ABC News segment focused on pediatric dental office deaths that were a consequence of pediatric oral sedation. RMBF believes that fatalities and/or sedation complications are only a segment of the general issue of medical emergency preparedness. Sadly, serious academic research into the frequency, severity and type of medical emergencies occurring during dental treatment is lacking. However, given the number of death, it is reasonable to assume many more non-lethal problems are occurring. Our commitment is to foster a basic level of safety in all dental offices, not merely those offering sedation or anesthesia.
The ABC News segment was critical of a “three-day weekend course” on sedation techniques and the motives of the dentist that attended those courses. Many dental anesthesiologists, pediatric dentists, oral surgeons and other dentists have extensive training in a wide variety of sedation/anesthesia techniques. RMBF recognizes the services they provide are a vital component of meeting America’s dental health needs. While we neither endorse nor condemn any individual institution or business entity, we believe the ABC News story raised a legitimate question concerning the applicability of teaching pediatric oral sedation in such a limited time period without actual clinical practice. However, we feel ABC News was unfair to impugn the motives of the individual attendees at such courses. Merely, attending a course does not imply the attendee endorses the concepts of the presenter.
While RMBF is pleased that ABC News chose to present a segment on dental office safety, we wish to emphasize that they, not RMBF, had exclusive control of the content, perspectives and conclusions drawn by the piece. RMBF has (and will remain) committed to our core value of improving dental office safety through better medical emergency preparedness via The Six Links of Survival.
