Survey finds variations in general anesthesia, sedation practices among dental care providers

A wide variation has been found in the training for and practice of sedation and general anesthesia within the dental profession in the United States. Safe, effective pain and anxiety control techniques are an essential part of dentistry. A survey designed to be a snapshot of common practices provides insight into this limited area of research.

An article in the June issue of the journal Anesthesia Progress reports the results of a survey of 717 providers. The questionnaire-based survey, conducted from April 2008 to December 2008, investigated training, practice characteristics, and anesthesia techniques of dental care providers.

A universal instructional standard for sedation and general anesthesia is lacking in the training requirements of US dental boards, although similarities do exist. Most commonly, training was through oral surgery residencies. Overall, respondents reported that 33% of their postgraduate instruction was hospital-based.

Thirty-five percent of dental anesthesia assistants were without formal training, closely followed by 33.5% who received training through an American Association of Oral Maxillofacial Surgeons program. A much lower 7.3% were trained through an American Dental Society of Anesthesiology program.

Other aspects of the survey included types of patients and procedures for which sedation or general anesthesia were used. The questionnaire also asked which medication agents were most commonly used and how they were administered. Postanesthesia care was most commonly found to be given by the actual provider (51.7% of cases), but a nurse or assistant often provided recovery care as well (45%).

Most survey respondents, nearly 82%, were both dentist and anesthetist for their practice, a long-established tradition. However, the authors note that recent state regulations as well as anesthesia education in US dental schools are now limiting this method of practice.