September 18, 2018
The Honorable Edmund G. Brown, Jr.
Governor of the State of California
State Capitol, Suite 1173
Sacramento, CA 95814
RE: SB 501 (Glazer) Dentistry: Anesthesia and Sedation: Report
AAP-CA Position: Oppose
Dear Governor Brown,
The American Academy of Pediatrics, California (AAP-CA), representing over 5,000 California pediatricians, strongly opposes legislation SB 501 (Glazer), to modify requirements for dental anesthesia and sedation, with specific requirements for pediatric anesthesia and sedation, administered by the Dental Board of California (DBC). We urge your veto on SB 501.
The mission of the AAP-CA is to protect and promote the health and well-being of all children and youth in California. Pediatricians have no financial interest in who administers and monitors anesthesia in a dental office. Our interest stems solely from our mission to protect and promote children’s health and well-being.
The American Academy of Pediatrics, in conjunction with the American Academy of Pediatric Dentistry, has published national guidelines that set a minimum standard of care for children undergoing sedation and anesthesia for dental procedures. These guidelines recognize that young children “are particularly vulnerable to the sedating medication’s effects,” including its rare but dangerous side effects. Their airways are smaller, and they need more anesthesia in order to remain still during painful procedures. Due to this increased vulnerability, the guidelines call for a second qualified provider to be solely dedicated to the task of monitoring a child during deep sedation and general anesthesia, as in every other health care profession in California. The updated guidelines are due to be published this fall with a clear mandate for the necessity of a dedicated second practitioner that is qualified to perform the necessary role.
The AAP-CA has taken part in numerous discussions to try to work out a compromise within SB 501 recommending that at the very least the bill should implement a system of proper data collection in the form of a sedation registry that would help track morbidity and mortality from anesthesia within dentistry in a meaningful way. To our disappointment even this request was not included in the proposed amended version.
SB 501 (Glazer) risks making anesthesia less safe for children, because it allows unspecified “support staff” to perform the role of dedicated monitor. Dental support staff, such as dental assistants and dental sedation assistants, play valuable roles in dental offices, but are not trained or qualified to perform this highly specialized and complex task, any more than they would be qualified to perform the same task in a hospital or a surgical center.
We oppose SB 501 (Glazer), as it offers a false sense of security that “something is being done” to prevent deaths of young children in dental chairs while still permitting unspecified support staff to perform a role that requires a higher standard of expertise—thus endangering children having to undergo dental surgery.
Pediatrician members of AAP California Chapters 1, 2, 3 and 4 statewide strongly oppose legislation SB 501 (Glazer) and urge your veto. We thank you for your leadership on behalf of children, youth, and families in California.
Chief Executive Officer, American Academy of Pediatrics, California
cc: Members of the Assembly Appropriations Committee; The Honorable Senator Steve Glazer, Author; AAP-CA Leadership; Lobbyist Lydia Bourne