Supplemental Oxygen Concentrations and the Use of Suction to Mitigate Risk of Oral Surgical Fires Using a Laboratory Model.

Intraoral oxygen pooling during dental sedation, especially using supplemental oxygen, is associated with an increased risk of spontaneous perioperative fire. The purpose of this in vitro study was to examine the effectiveness of intraoral suctioning for reducing oxygen pooling to safe levels during a simulated dental procedure. Phase one: Twenty trials were completed for each of the three suctioning devices: high-volume evacuation (HVE), fixed tip saliva ejector (SE), and Yankauer suction (YS).

Comparison of Oropharyngeal Oxygen Pooling and Suctioning During Intubated and Nonintubated Dental Office-Based Anesthesia.

Objective: The risk of a spontaneous surgical fire increases as oxygen concentrations surrounding the surgical site rise above the normal atmospheric level of 21%. Previously published in vitro findings imply this phenomenon (termed oxygen pooling) occurs during dental procedures under sedation and general anesthesia; however, it has not been clinically documented.

Methods: Thirty-one children classified as American Society of Anesthesiologists I and II between 2 and 6 years of age undergoing office-based general anesthesia for complete dental rehabilitation were monitored for intraoral ambient oxygen concentration, end-tidal CO2, and respiratory rate changes immediately following nasotracheal intubation or insertion of nasopharyngeal airways, followed by high-speed suctioning of the oral cavity during simulated dental treatment.

Preventing Dental Surgical Fires: Characterizing Nasal-Cannulated Supplemental Oxygen Pooling in an In Situ Dental Procedure.

Objectives: Surgical operatory fires continue to occur in the United States, often with devastating consequences. Because more than 21% concentrations of oxygen are necessary for the onset of such combustion, this study examined fluctuations of surgical site oxygen levels. Better understanding how these more than 21% concentrations occur will not only add to surgical fire prevention efforts generally but also potentially reduce patient or staff harm and practitioner liability as well.

Advancing the Safe Delivery of Office-Based Dental Anesthesia and Sedation: A Comprehensive and Critical Compendium.

The provision for and administration of dental office-based sedation and anesthesia requires considerations and preparations that are unique to dentistry and unlike that of any other office-based and nonoperating room procedures. Anesthesia providers who have only performed dental cases in an operating room are often unaware of the idiosyncrasies and risks associated with performing sedation and anesthesia in the dental office. This article explores the demographics, patient characteristics, morbidity, mortality, and clinical concerns with an in-depth discussion of the dental operating environment.

Point: A 21st-century paradigm for the recognition of dental specialties in the United States: Historical review, lessons learned, looking forward.

Background: Specialty-based practice is a fundamental component of US medicine and dentistry, yet the recognition of new dental specialties has markedly diminished in the past 50 years while medical specialization has flourished.

Methods: This article reviews the history of specialty development while focusing on the underlying scientific, educational, and cultural changes in both professions. The process of dental specialty recognition is also examined.

Comparison of Intubated Versus Nonintubated Airway Management in Children Under General Anesthesia Provided by Dentist Anesthesiologists.

Use of general anesthesia (GA) for comprehensive dental treatment of children is an essential health benefit. Pediatric dentists utilize dentist anesthesiologists to provide GA for dental rehabilitation of severe early childhood caries. Dentist anesthesiologists deliver GA using intubated or nonintubated GA.