Perspectives on anesthesia guidelines changes shared at Town Hall Forum

Rio Grande, Puerto Rico鈥擜 group of 12 organizations came together May 1 for a Town Hall Forum on the revisions approved last year to the ADA’s anesthesia guidelines documents.

Held during the annual meeting co-sponsored by the American Dental Society of Anesthesiology and American Society of Dentist Anesthesiologists, the forum gave the groups an opportunity to discuss changes to the ADA documents “Guidelines for the Use of Sedation and General Anesthesia by Dentists,” “Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students” and the “Policy Statement: The Use of Sedation and General Anesthesia by Dentists.” The ADA House of Delegates approved the revisions in 2007.

In addition to ADSA and ASDA, groups participating in the Town Hall Forum included the Academy of General Dentistry, American Academy of Pediatric Dentistry, American Academy of Periodontology, American Association of Nurse Anesthetists, American Association of Oral and Maxillofacial Surgeons, American Dental Education Association, Canadian Academy of Dental Anaesthesia, Dental Organization for Conscious Sedation, the federal dental services and Society for Ambulatory Anesthesia.

“One can imagine with such a disparate group that there would be a broad spectrum of commentary,” wrote Dr. Robert Peskin, speaker of the ADSA house of delegates, in a summary report. “Interestingly, there appeared to be a fair amount of agreement in that virtually all identified the overarching principle of safety as paramount in the delivery of anesthesia services to dental patients.”

Dr. Peskin added that ADSA “was especially pleased to hear” ADA President Mark Feldman’s announcement that ADSA’s Anesthesiology Research Foundation Inc. is the recipient of a $100,000 ADA Foundation grant to develop a new emergency management course for dentists administering sedation and anesthesia.

Dr. Feldman delivered the keynote address at the Town Hall Forum鈥攄iscussing the newer aspects of the guidelines, the comprehensive process associated with the guidelines changes, and the work of the Council on Dental Education and Licensure’s Committee on Anesthesiology. Dr. Feldman emphasized that for all levels of sedation and anesthesia, the guidelines recommend that dentists who are currently providing sedation and anesthesia in compliance with their state rules and/or regulations prior to adoption of the documents not be subject to the new educational recommendations.

ADSA’s Anesthesiology Research Foundation Inc. is in the process of developing the new emergency management course for dentists administering sedation and anesthesia. The course will help train dentists to recognize, treat and prevent complications and emergencies related sedation and general anesthesia, with special emphasis on patient monitoring and airway management.

“Right now we are in the design stage for this course,” said Dr. Morton Rosenberg, a member of the CDEL Committee on Anesthesiology and the liaison between the ADA and ADSA on the course development. “The curriculum is divided into two components鈥攖he didactic portion that is offered online and a live, eight-hour presentation that includes laboratory and simulation experiences.”

Phase I involves design of a Web site and trial of the course in three locations, Phase II includes a study to correlate participants’ simulation training with their clinical competency and Phase III is the analysis of video documentation of clinical skills demonstrated by the course participants and development of a pediatric module with collaboration with experts in this area.

The ADA Foundation and ADA are expected to partner to make the course widely available in 2009, and state dental boards will be encouraged to accept this course as an alternative to currently required emergency certification courses for dental professionals.