09/16/2016

Dental anesthesia bill heads to governor


A bill requiring the Dental Board of California to review the safety of pediatric dental anesthesia has been passed by the Legislature and is now headed to Gov. Jerry Brown's desk. The legislation stems from last year's tragic death of a boy who received dental treatment under general anesthesia.

Upon learning of this incident, the California Senate Business, Professions and Economic Development Committee called upon the dental board to investigate whether the state's laws, regulations and policies are appropriate to reduce the potential for injury or death from the administration of general anesthesia for pediatric dental patients. Since February, the board has been undertaking this investigation, including a review of all deaths related to pediatric dental anesthesia in the past five years, to identify best practices and opportunities for California to enhance patient safety.

During the process of the board's review, this legislation, Assembly Bill 2235 (Thurmond, D-Richmond) was introduced and CDA quickly expressed concern that the bill inaccurately portrayed the risks associated with general anesthesia in dentistry and proposed changes to clinical care that were not evidence-based or supported by data.

CDA worked with the author throughout the year to align the legislation with the dental board's process, and was able to secure changes that allowed CDA to move to a support position. At the time of Update publication, AB 2235 awaits the governor's signature or veto.

The final version of AB 2235 calls for a dental board review of current laws, regulations, safety statistics and policies to determine whether they are sufficient to protect minor patients from the potential for injury or death during the administration of general anesthesia. The bill also increases the detail that dentists must submit in the instance of an anesthesia-related death or adverse incident, allowing the board to collect better data. Furthermore, in an effort to provide additional information to parents, the bill specifies information that must be contained in the informed consent for pediatric dental anesthesia, all of which is in line with current practice.  

The board's review process provides the opportunity for a comprehensive, substantive approach to address concerns and ensures that state policies make safety the highest priority. The board released a draft report in July, which confirms that from 2010-15, pediatric dental anesthesia deaths in California were rare, and occurred in a variety of settings, including hospitals and dental practices, and under the care of different anesthesia professionals, including instances with a separate anesthesiologist present. The report also confirms that anesthesia always carries a risk, no matter the setting, situation or provider type and provides important information for formulating recommendations to improve safety.

The board is currently collecting stakeholder feedback in order to finalize recommendations for the final report, which is due to the Legislature by Jan. 1, 2017. CDA has been actively supporting this evidence-based approach and is committed to supporting legislative or regulatory changes identified through the board's analysis.

  • CDA will continue to keep members informed about this issue in the CDA Update.


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