Morbidity and Mortality Involving Pediatric Dental Sedation- Non-Compliance Following Sedation Guidelines

This editorial serves to discuss the tragic occurrence of morbidity and mortalities reported with the use of pediatric dental sedation and its etiological factors. Literally thousands of in-office sedations for management of varying levels of childhood dental anxiety and uncooperative behavior are performed successfully on a daily basis throughout the U.S. Since 1985, safety guidelines which describe expectations and responsibilities of pediatric dental specialists to insure patient safety have been in place. These guidelines have been reviewed and updated by multiple health care disciplines since their inception. To date, when guidelines are implicitly followed, no reports of morbidity and mortality have been presented. In recent years, constraints have been placed by various state and institutional settings on the use of a few agents with long track records of safety due to misuse. One agent in particular has been removed from the marketplace and production for reasons related to excessive/inappropriate dosing. Non-compliance with safety guidelines appears to remain the common denominator across multiple levels to account for sedation mishaps. Suggestions are made to enhance favorable outcomes and minimize and eliminate adverse reactions and mismanagement.