Among these kids was Jonathan Walski, three-year-old son of David and Lisa Walski, who live in Wilkes-Barre, Pa. In 1996, they went to the dentist to get several cavities filled. Jonathan was given general anesthesia, but somewhere along the way, something went wrong. A district attorney's investigation revealed that the dentist, Joseph Mazula, didn't have the proper equipment. The dentist pled guilty to a second-degree felony and was given five years probation, and had his anesthesia license revoked.
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Why put a child under just to fill a cavity? Many dentists say they do this to calm screaming, panicky kids. But some leading experts argue that these procedures are not serious enough to merit either general anesthesia or intense sedation. This is especially true for children, who need a deeper level of sedation than adults do.
"For a cavity versus, say, a brain tumor, you're going to accept certain risks that are different," says Dr. Myron Yaster, a pediatric anesthesiologist at Johns Hopkins Hospital. "I don't sedate patients when they go to get a hair cut. Children cry when they get a hair cut. There's a risk, and there's a benefit."
Dr. Yaster agrees that in some cases, children should be sedated to fill a cavity. But he argues that this procedure is overused, and that it should be undertaken by doctors or dentists with proper training and the right equipment.
Training is essential, Dr. Yaster says. He believes that some dentists may not have enough experience to use anesthesia safely. Medical anesthesiologists like Dr. Yaster are required to have at least four years of anesthesia training after medical school; many oral surgeons must receive a year and half of additional training. But because they are governed by a different set of regulations, dentists can perform some of the same sedation procedures, and administer the same drugs, with as little as 60 hours of training.
Most medical fields recognize anesthesia aa specialized area of care. Even veterinarians have a specialty. Dentists do not. The American Dental Association argues that there is no need for this specialty, because enough dentists know how to use anesthesia, and those who don't can work with anesthesiologists. But many observers say this approach is an invitation for disaster.
produced by David Kohn