Anesthesiologists warn against anesthesia in children’s dental treatments

In children’s dental practices, it is not uncommon for dental treatments to be carried out under general anesthesia in order to spare the children any fears. However, this practice raises questions about benefits and risks. While the need to provide children with a stress-free treatment is understandable, the “Welt“ the question of whether the risk of general anesthesia – especially in an outpatient dental practice – is in reasonable relation to it.

The “Welt” quotes a Europe-wide analysis of more than 30,000 interventions, according to which every twentieth anesthetic resulted in a “serious critical incident”, including respiratory arrest and an irregular heartbeat. One in a thousand children died.

General anesthesia at the dentist: According to the expert, the risk in the dental practice is particularly high

The anesthetist Helen Lee, who researches the risks of children’s dental treatment at the University of Illinois in Chicago, considers the risk in the dental practice to be particularly high. “Here, adults die ten times more than with interventions in the clinic,” says Lee of the “world“. She suspects that it is no different with children.

Another study presented at the NARKA congress of anesthesiologists shows that serious anesthetic incidents in dental practices between 2011 and 2021 accounted for around a third of all insurance claims. In addition, there were ten cases with compensation amounts of over 500,000 euros – so-called major losses, in which patients died or had to live with lifelong disabilities, it is said. All four deaths were in kindergarten-aged children.

Dentists lack expertise

Experts told Die Welt that they see part of the problem as many dentists’ lack of expertise in administering anesthetics, which act not only in the oral cavity but also in the lungs, heart and brain. In addition, the possible side effects of sedatives, such as nitrous oxide, which slows heartbeat and breathing, can be particularly dangerous for children.

The Berlin anesthetist Jörg Karst demands that anesthesia only be carried out in practices that meet the same minimum standards as outpatient surgery centers, writes “Welt”. He and his colleagues had handed over a corresponding set of rules to the Association of Statutory Health Insurance Physicians.

According to the report, the German Dental Association sees outpatient anesthesia only as a last resort to enable dental treatment for patients for whom all other attempts at cooperation have failed.