On December 3, three-year-old Finley Puleo Boyle of Hawaii had a heart attack while visiting the dentist fell into a coma, and died a month later. As the toddler had no underlying problems with her heart, the medical examiner ruled that the sedatives she received before her root canals and cavity fillings were what most likely killed her, causing her heart attack.
“Immediately following the lidocaine injection, the decedent became unresponsive and went into cardiopulmonary arrest,” wrote Dr. Christopher Happy, the Chief Medical Examiner. According to Dr. Happy, Boyle received five different drugs prior to her dental procedures, which included laughing gas, a local anesthetic, amongst a few others.
However, dental sedation has caused the death of at least 31 children over the past 15 or so years. The issue some claim is that dentists simply don’t have the necessary amount of training to be sedating patients, let alone children. Yet, dental sedation can bring in thousands more in revenue for dentists.
However, there have been significant strides over the past few decades to improve the safety of patients being sedated, which includes systematic reviews of the prevalence of adverse events, as well as the institution of guidelines backed by the American Academy of Pediatrics (AAP), the American Academy of Pediatric Dentistry (AAPD), and the American Society of Anesthesiologists (ASA). These guidelines have been rigorously updated over the years, and according to Evan R. Horton, Assistant Professor of Pharmacy Practice at Massachusetts College of Pharmacy andamp; Health Sciences, “the reported incidence of morbidity from sedation has been reduced from 1 per 10,000 to 1 per 60,000.”
Some dentists have come to the defense of their profession, explaining that sedation is often routine for small children as a result of their anxiety of surgical equipment like drills, scalpels, and CAT scan equipment, which can be quite stressful and intimidating for children despite how common they are. They also added that dentists need to have proficient and extensive training to have the ability to safely administer sedatives.
About 18,000 dentists since 2007 have traveled across the country to take weekend-long training dental sedation training courses. “This is something that is being presented to the practitioners, the dental community, as a very easy thing to do,” said dental anesthesiologist Dr. Robert Kaminski. “Nothing could be further from the truth.”
While the toddler was in a coma, her parents filed a negligence lawsuit. The death, however, has been classified as just an accident, as the allegations were “unproven.” However, the practice where Boyle received treatment is now closed forever.
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