CDA-supported pediatric anesthesia bill moves forward

Of the three bills introduced in the Legislature early this year to improve safety in pediatric dental anesthesia, only Senate Bill 501 (Glazer, D-Orinda), which CDA supports, will advance in the current legislative session.  

The Assembly Business and Professions Committee on July 11 passed SB 501 on a bipartisan, unanimous vote.

“The goal of 501 has been the same since the very beginning and that has been to preserve and protect the health of our young people going through these procedures,” Sen. Steve Glazer said in the hearing. “I believe this bill accomplishes what the dental board has recommended and at the same time safeguards the ability of children to be seen in a safe and timely manner.”

SB 501, along with AB 224 (Thurmond, D-Richmond) and SB 392 (Bates, R-Laguna Niguel) were developed to address recommendations made by the Dental Board of California in a report it published in December 2016. The report stemmed from the death in 2015 of a 6-year-old boy who received dental treatment under general anesthesia.

CDA supports the dental board’s recommendations to increase and improve the board’s data collection, expand the board’s enforcement authority, define anesthesia by level of sedation and restructure the permitting system to ensure the appropriate level of expertise is always in the room with a patient. As CDA previously reported, SB 501 adopts a majority of the board’s recommendations and calls for a study analyzing how a requirement for an additional, separate anesthesia provider during the administration of general anesthesia or deep sedation in children under age 7 would impact access to and cost of dental care.

In addition, CDA, working with the bill’s author, proposed several amendments that would streamline the process for the new permits and align personnel and training requirements for minimal and moderate sedation with national guidelines. The amendments will improve implementation and help reduce any negative impact on access to care, which remains a concern for stakeholders.

“Access is a huge issue,” said Ariane Terlet, DDS, chief dental officer at La Clinica de La Raza in Oakland, who testified in support of the bill and noted that her clinics see children who come from the northern borders of California for treatment. “I’m in support of this bill because it will still help us maintain this access.”

“As we continue to move this bill forward, we want to look at safety, which is our top priority, but also at how we can increase prevention by getting more kids into a dental office. And we need to address coverage issues and barriers to care that lead to worsening dental decay that requires surgery, sometimes on an emergency basis,” said CDA Government Affairs Council Chair John Blake, DDS.

Assemblymember Tony Thurmond’s bill, AB 224, was also heard in July by the Senate Business and Professions Committee, but the author pulled the bill rather than have the committee vote against new amendments he introduced that concerned personnel requirements for deep sedation and general anesthesia. The language was similar to language the committee heard and did not pass at the April hearing.

Also, in the interest of having just one bill move forward to address pediatric anesthesia safety, Sen. Pat Bates has elected to hold her bill, SB 392.

“The board asked that we continue to research the collection of high-quality anesthesia-related data knowing that the current data is lacking,” Sen. Glazer said. “SB 501 enacts those recommendations of the board by strengthening training and staffing requirements for the administration for dental anesthesia to children … and collecting and preparing a report with hopefully more data,” Sen. Glazer said.

The bill is expected to reach Gov. Brown’s desk for a signature before Oct. 15.

CDA will keep members informed about the status of this bill and its implications for members on cda.org and in the CDA Update.

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Three bills that seek to improve safety in pediatric dental anesthesia are moving through the state Legislature, including CDA-supported Senate Bill 392 and Senate Bill 501. The three pieces of legislation passed out of policy committees following robust discussion at the Capitol, April 24-25, with CDA and other medical and dental organizations as well as individual stakeholders presenting testimony on the bills.

Making its way through the state Capitol is a key piece of legislation that, if passed, would improve infection control safety in dentistry. Assembly Bill 1277 calls for the Dental Board of California to amend the regulations on the minimum standards for infection control for certain dental procedures that expose the dental pulp and may create an opportunity for infection. CDA has taken a “support” position on the bill.