Dental clinics across the country will have to carry out the procedures for conscious sedation only under the supervision of a qualified medical anesthesiologist capable of handling the responsibility and management of any pediatric/anesthetic emergency.
This is one of the prerequisites that the Dental Council of India (DCI) has set out for the dental clinics following the death of a child within minutes of being injected with anaesthesia during a dental procedure in Bangalore six months ago. The sedation drugs were used to calm the baby but he became unresponsive soon and died due to cardiac arrest. A case of medical negligence has been registered by the local police.
The sedation procedure will also have to be carried out in a fully equipped hospital facility, the DCI has laid down. However, the guidelines for conscious sedations released recently by the regulatory body for dental education in the country are conspicuously silent on the punishment in case of violation of the procedures. The guidelines approved by the General Body of the DCI in its meeting recently are also not clear how these would be implemented and monitored.
Sedation is becoming more common in dental procedures among patients, particularly children with caries. “It is also important that the parents of such children ask their dentists if they have proper emergency facilities in case of need,” said a DCI official admitting that action can be taken in case a complaint is filed.
Also, when in use, conscious sedation either in the academic or clinical set up, especially in pedodontic patients, the regulatory makes it mandatory to seek informed consent of the patient.
Any attempt at delivering and managing a dental patient either in academic institutions/dental practice/pediatric dental practice using procedures of either conscious sedation or general anesthesia without the consent of patient and responsibility of induction and management of procedure allotted to a qualified medical anesthesiologist maybe done so at their own risk as even the minutest risk cannot be overlooked, the guidelines added.
“Routine/local anesthesia is administered to patients who are wide awake and everything is under control. Moreover, we are trained for such procedures. But definitely conscious sedation for a child should be done in a well equipped hospital under the supervision of a trained anesthesiologist to handle any emergency if needed,” said dentist Sunil Motwani.