CDA Essentials 2018 • Volume 5 • Issue 6

S upporting Y our P ractice What to tell patients about the risks of Deep sedation and general anesthesia Dr. Alia El-Mowafy BDS,MSc (Dental Anaesthesia),Dip ADBA In recent years, media reports of patients suffering severe complications, including death, while under sedation and general anesthesia for dental treatment may have raised concerns about the risk involved in these procedures. A new study by researchers at the University of Toronto (U of T), due to be published in the fall, aimed to estimate the risk. The study examined mortality and morbidity reports associated with dentistry under deep sedation or general anesthesia in Ontario dental offices. The overall finding of the study, explains Dr. Alia El-Mowafy, dental anesthesiologist and the principal investigator of the research team, is that dentistry under deep sedation and general anesthesia in the office-based environment has an excellent safety record. alia.el.mowaf y@ gmail.com Theviewsexpressedarethoseoftheauthor anddonotnecessarilyreflecttheopinions orofficialpoliciesoftheCanadianDental Association. 31 Issue 6 | 2018 | As a profession, it’s our responsibility to monitor our outcomes and that way we can take action to reduce the number of patient harm events to as close to zero as possible. Context To determine the prevalence of death and severe complications, the research team first analyzed mortality and morbidity data over 20 years, from 1996–2015, using data from the Chief Coroner of Ontario, the Professional Liability Program, and the Royal College of Dental Surgeons of Ontario (RCDSO). Next, using data obtained from clinician surveys, they estimated the number of anesthetics administered over the 20-year period by clinicians who were registered with RCDSO to administer deep sedation and general anesthesia in dental offices. Comparing these two pools of data, the total number of incidents and the total number of anesthetics administered in Ontario within the same time period allowed the prevalence of mortality and morbidity to be estimated. In Ontario, dentists aren’t required to report critical incidents. According to Dr. El-Mowafy, at the time the U of T team undertook this study, there was a 20-year absence of data on mortality for dentistry performed in Ontario offices under deep sedation and general anesthesia. In addition, serious complications for dentistry under deep sedation or general anesthesia had never been investigated in Ontario. “This data is really important for both clinicians and patients,” she stresses. “It enriches the informed consent process and it ensures that patients are receiving up-to- date information about the risks involved in the procedure.” Ensuring patient safety is another key objective. “I think the incident reports we gather in this type of research are vital to patient safety because they give clinicians