Recently Diane Sawyer has released this news report, it is a decent report but also very misleading. Here is the link the to news report: http://abcnews.go.com/Blotter/death-greed-dentist-american-children-risk/ Not to make enemies of the media, but sometimes they can be very ridiculous, and they don’t represent the full facts and both sides of the situation. Dr. Punwani, the AAPD representative and head of pediatric dentistry at UIC, was grilled for 4 hours asking the same questions over in different ways until they get an answer suitable for “broadcast” to capture the attention of the viewers. After all that, they only produced only a 10 sec blip of the interview. They would refuse to report what kind of training the dentist have that consumers should be looking for to provide safe and adequate anesthesia to children who are uncooperative to the dentistry. At the same time they produced a report are few months ago: http://www.insideedition.com/news/8092/inside-edition-investigates-the-use-of-papoose-boards-by-dentists.aspx So basically, there are no longer a treatment method for uncooperative children?! Since both methods are vilified by the media there is a no win situation for treating young uncooperative children. Do they report that caries are on the rise for children? Children are at risk for dental infections that can potentially cause meningitis, or Ludwig angina which both are deadly. The truth is, there are a few bad apples in the mix ruining it for the rest. Yes there are some inadequately trained dentist, and yes the trained practitioners can make mistakes because they are human, and yes even physicians, lawyers, dentists, politicians, journalists are ALL human and there are always bad apples somewhere in the mix. If someone is perfect, I should be on my knees worshiping them and I am not worthy.
Here is American Association of Pediatric Dentist response to the story that ABC will refuse to report : http://www.aapd.org/aapd_responds_to_abc_news_story_on_drbicuspidcom/ . Here’s the other response to the papoose board, http://www.aapd.org/aapd_update_on_inside_edition_story/?F_All=y. As a Dentist Anesthesiologist, I still support these methods of treating children as long as the dentist is properly trained in those methods and follow the AAPD guidelines.
There are also good news on some oral medication Chloral Hydrate. It has been discontinued as a oral suspension for oral sedation use. http://www.ashp.org/DrugShortages/NotAvailable/bulletin.aspx?id=902 I know some people may disagree, but having done some research for Dr. Yagiela, I have to agree with Dr. Yagiela Chloral Hydrate is a dangerous drug and have a very small window of therapeutic value. Yeah, it can be used safely, but in most circumstances its hard to use it right. There has been case studies where the drug can last 48 hours, and a lot of problem arises on the recovery phase. The drug can have the patient lapse back into the deep sedation state which can cause airway issues. Majority of the deaths surrounding dentistry with oral sedation, Chloral Hydrate was used. Right now I would recommend the use of Midazolam, and Vistaril, Nitrous Oxide, as single agent or combination for oral conscious sedation.