FACT 1: Most medical emergencies occurring in dental offices are neither life-threatening nor cardiac in origin (Malamed, USC). To argue that CPR is all that is required is naïve and statistically wrong.
FACT 2: Calling 911 is NOT an emergency plan. Nationally, the AVERAGE response time for EMS is 11-15 minutes. Dental offices should be able to manage ANY medical emergency (diabetic shock, seizure, MI) for at least 30 minutes without outside assistance.
FACT 3: Currently, the American Dental Association has no standardized guidelines for medical emergency preparedness by dentists. If dentists do not have standards for medical emergencies, only the Board of Dentistry remains to protect the interests of the public.
Fact 4: Curiously, many offices have oxygen for ONLY non-breathing patients. Apparently, many dentists believe that when a patient is struggling for oxygen, the best strategy is to let them stop breathing before helping them.
FACT 5: Not all medical emergencies are complications of sedation/GA. Sharon Freudenberger, Associate Professor at CWRU Dental School was working on her son’s tooth when a piece of gauze slipped into his throat. Fortunately, she was prepared and her son is still alive. Unfortunately, a child in NJ died last week while receiving local anesthesia in an office that was already on probation for a previous death. Additionally, Dr. Yagiela, noted author and lecturer, stated that there has been a death in every state from local anesthesia.
FACT 6: Dental leaders in medical emergency management know medical emergencies routinely happen and have concerns about the profession’s state of readiness. Malamed has described the current state of affairs as, “Poor” and went on to state, “Office preparation is essential…” Haas said, “The successful management of a medical emergency is one of the great challenges in dentistry.” Rosenberg said, “Every dentist will likely manage a medical emergency during the course of their practice.”
FACT 7: With an aging population (some with complex medical histories) being offered increasingly complex and invasive dental procedures, it is reasonable to believe medical problems occurring during dental appointments are increasing in frequency. However, no academic research has been conducted by any US dental school for over 15 years. In the absence of evidence to the contrary and with a reasonable expectation that non-lethal emergencies are increasing, dental offices should be prepared for any unexpected circumstance.
FACT 8: RMBF provided an 8-hour CERP-approved CE program on MEP last year. The Virginia Dental Association endorsed and advertised the event. Tuition was deliberately low. Less than 12 dentists attended. It is difficult to argue that Virginia dentists are self-motivated to prepare themselves for medical emergencies.
FACT 9: Implementing the recommendations of the petition would not be a financial burden on Virginia dentists. Assuming a dental office had no current preparations for an emergency AND they were willing to do any of the work themselves (eg preparing an emergency manual), products for everything else cost less than $2,750.
FACT 10: The petition does NOT call for mandatory office inspections nor does it require any expense on the part of the commonwealth. Dentists would merely attest on an affidavit that they have complied with the requirements as part of license renewal. Of course, to provide false information to the board would carry heavy sanctions.
FACT 11: As expected, some rank-and-file Virginia dentists oppose the petition. However, no dental educator or nationally-known lecturer has publicly opposed the petition or any of the concepts contained in it.
FACT 12: If the Virginia dentists can protect the public without direct oversight from the dental board, it is their burden of proof to demonstrate that such means already exist.
