My mom informed me that my 5 year old niece has 7 cavities at her first dentist appointment today, and that the dentist suggested to put her under to properly deal with them since she’s so young and will likely be terrified. So of course I had to look into it a little deeper…
Obviously I found some pretty alarming information. But the thing I found craziest was this little snippet here from an “official” publication on pubmed. It is titled
Now if you’ve ever attempted to dig deeper into an “official” publication from pubmed, you’d soon realize that is just isn’t catered to the average person. You need to be part of a supported organization to even access the information they have. Luckily this particular publication is hosted at a place that is publicly accessible so go ahead and click that link.
Early childhood caries (ECC) is the single most common chronic childhood disease. In the treatment of ECC, children are often given moderate sedation or general anesthesia. An estimated 100 000 to 250 000 pediatric dental sedations are performed annually in the United States. The most common medications are benzodiazepines, opioids, local anesthetics, and nitrous oxide. All are associated with serious adverse events, including hypoxemia, respiratory depression, airway obstruction, and death. There is no mandated reporting of adverse events or deaths, so we don’t know how often these occur.
Now right there in the very first paragraph any logical person should have some alarm bells going off at this point.
There is no mandated reporting of adverse events or deaths, so we don’t know how often these occur.
Why the hell would there not be mandated reporting for something that is literally using drugs and processes when
All are associated with serious adverse events, including hypoxemia, respiratory depression, airway obstruction, and death.
Seems to me that they are trying to hide something.
The average number that I’ve been coming across seems to be around 1 death in 100,000 patients.
Death was the most important side effect of anaesthesia in dentistry. In this article we reviewed more than 20 studies with adequate data focusing on death associated with dental procedures since 1955 and found 218 deaths out of 71,435,282 patients (3 deaths per 1,000,000 persons) with the mortality rate of 1:327,684. In addition, mortality rate per million has dropped to half (6.2 per 1,000,000 vs. 3 per 1,000,000) since 1955 till the last report in 2012 without any sex predilection. In children, most cases died in the age of two to five years. Hypoxia was the most common cause of death, and cardiovascular, respiratory, and endocrine disorders, hepatic cirrhosis, septicaemia, and bacterial endocarditis were the most frequent underlying systemic disease in deceased patients. Although rare death following general anaesthesia in dentistry, is a critical side effect mostly seen in patients with compromised health condition. Therefore, appropriate case selection in regard with patients’ general health status as well as standard technical and equipment conditions are mandatory to diminish the risk of death during dental anaesthesia. - NCBI Death Rate of Dental Anaesthesia
This states that up until 1955 there was about 1 death per 300,000 patients, and it dropped to half of that from 1955 - 2012 at 1 death per 600,000 patients (VERY roughly).
So for one I ask why in a more recent study they say the numbers simply aren’t available because there is no mandated reporting for deaths in dental anesthesia, then looking back a little earlier they say the numbers are about 1 in 300,000?
Well I’ll tell you why…
The HMO Act Of 1973
Since the 50’s the medical system has done away with all patient based services, as they are now running a “corporation for-profit” system thanks to some manipulation of laws and bills and such.
The HMO Act Of 1973 made HMOs exempt from state laws that kept medical decisions in the hands of doctors. As a result, the medical practice became subject to more corporate influence. Now don’t get me wrong, I’m sure most doctors weren’t in it for the money, but 4 years after Nixon signed this into effect for his buddy Edgar Kaiser, the doctors were no longer the ones calling the shots.
Back To The Numbers
Further on in the Ethics Rounds publication they leave another startling piece of information.
Procedures on adults performed in physician offices have been associated with up to a 10-fold–greater mortality compared with ambulatory surgery centers,25 a disparity that has been supported in closed-claims analysis.26
Now if there have been closed-claims analysis that state adults are dying 10x more than previously listed in their study (1 in 300,000) , this number would seem to be at least closer to the real number for children being put under in physician offices, since most DENTAL procedures are done in a physicians office rather than a surgery center.
So of course I decided it was best to stop looking only in the United States and see what other countries are saying their rates are.
Exact figures are not available, but if you are healthy and having a non-emergency surgery, the risk of dying is 1 in 100,000 general anaesthetics. - NHS (UK): RISKS ASSOCIATED WITH YOUR GENERAL ANAESTHETIC: Death or Brain damage
They go on further to state…
The anaesthetist may make a misjudgement or an error, perhaps by giving too much of a drug or giving the wrong drug. However, it israre at 1 in every 185,000 general anaesthetics administered.
There may be an unexpected allergic reaction to an anaesthetic drug. Life-threatening allergic reactions occur in less than 1 in 10,000 general anaesthetics, and many arefollowed by a full recovery.
The risk of a healthy child dying from a general anaesthetic is around 1 in 100,000
So it seems that the UK is doing a little better at throwing non-exact numbers out, although it doesn’t all add up to me.
Before the HMO Act of 1973 there were multitudes less children being put under unnecessarily since doctors KNEW that there was a very high risk that they could lose a patient and it would be completely out of their hands, because after all… It is LITERALLY just a guessing game when it comes to anesthesia, especially considering all of the different body sizes of children these people are dealing with.
Without adequate preoperative evaluation, it is a guessing game for anesthesiologists to determine which patients will be able to tolerate the stress of surgery and anesthesia, which patients will most likely be able to go home without complications, and which patients will require hospital admission. - Zhuang T. Fang, M.D., MSPH - Anesthesia Management of Ophthalmic Surgery in Geriatric Patients
let me re-emphasize part of this…
it is a guessing game for anesthesiologists to determine which patients will be able to tolerate the stress of surgery and anesthesia, which patients will most likely be able to go home without complications, and which patients will require hospital admission
Putting all of the information together i have come up with this.
If the numbers they claim from 1955 - 2012 are accurate, than this number multiplied by 10 would be the number that all of these different studies are hinting at, without actually revealing the number.
Based on these numbers alone it would equal out to be 1 death in 30,000 patients (1 in 300,000 x 10) and this is before factoring in that doctors aren’t even the ones making the decision to put someone under or not, it’s the corporation that runs whichever physicians office your dealing with. I would even go on to say that the number could be as high as 1 in 10,000 patients, since most of the time these physicians are barely getting sleep. Instead they are inducing comas in countless different patients without fully evaluating their patients.
Are you going to let them play a fucking guessing game with your child’s life?