Should Sleep Dentistry Be Avoided?

04-26-2012

Should Sleep Dentistry Be Avoided?

Many people feel that visits to the dentist can be (deservedly or not) nerve-wracking and scary. The idea of being able to sleep through dental procedures sounds like a dream come true. There is a growing trend of dentists advertising sleep dentistry for the above reasons. Indeed, sleep dentistry sounds even more attractive, because these sleep dentistry techniques don't make the patient unconscious (such as general anesthesia would), but instead place patients into a highly relaxed state, resulting in most cases of no memory of the procedure. This sounds like the perfect solution, right? Wrong! There are too many potentially life-threatening risks for general anesthesia to be used indiscriminately.


What Are the Risks in Sleep Dentistry?

Simply put, it's dangerous, with significant risks. There are multiple cases of patients dying through the use of general anesthesia.

  • A patient's medical history can pose risks, including allergic, or cross-reactive with other medications, or even unanticipated bad reactions with medical conditions.
  • Sometimes the patient may be totally unaware of pertinent medical conditions (for example, inner ear infections or heart arrhythmia) until it's too late.
  • Dentists are required by California law to undergo extensive training in anesthesiology, a Board-certified inspection of the practice's team and equipment, and a reevaluation every six years. Most dentists have done this, but not all. And even these safeguards haven't prevented patient deaths.

You Mentioned That Patients Have Died From General Anesthesia, How Does This Happen?

There are multiple reasons for anesthesia related deaths. I had a recent patient who's daughter died 30 years ago due to general anesthesia in Yorba Linda. She had cerebral palsy and needed two fillings and a cleaning. The dentist and anesthesiologist felt it was necessary to use general anesthesia. While she was under, she went into cardiac arrest and died. She's not sure if the dentist is still practicing today. This was not an isolated incident either, there are plenty of cases where patients have died from sleep dentistry.

Click to read through a list of dental related deaths. Many of which involve general anesthesia.

Conclusion

For a vast number of dental procedures, the answer is no. Going to the dentist can be scary for some. But I believe people tend to fear what they don't understand. I always try to explain thoroughly, traditional local dental anesthesia will most assuredly control pain (and therefore fear of pain). I believe that sleep dentistry risks far outweigh the benefits and, for the procedures I perform, never recommend it to my patients.