April 19, 2017
The Honorable Evan Low
Chair, Assembly Business and Professions Committee
State Capitol, Room 4126
Sacramento, CA 95814
Fax: (916) 319-2128
RE: AB 224 (Thurmond): Dental Anesthesia and Children
AAP-CA Position: SPONSOR
Dear Chairman Low:
The American Academy of Pediatrics, California (AAP-CA), representing over 5,000 California pediatricians, strongly supports proposed legislation AB 224 (Thurmond). This bill would increase the safety of administering anesthesia and sedation to children in outpatient settings by requiring the implementation of the California Dental Board’s recommendations regarding safe access to dental anesthesia for children, including (among others) that a general anesthesia permit holder, separate from the operating dentist, be present when a child under age 7 undergoes general anesthesia or deep sedation. The bill would also update the permit structure for dental sedation and anesthesia in California and the definitions of sedation and anesthesia contained within California statute in order to conform with modern terminology.
The mission of the AAP-CA is to protect and promote the health and well-being of all children and youth living 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 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 administering and monitoring a child during deep sedation and general anesthesia, as in every other health care profession in California. The standard of care is no longer the single operator-anesthetist model in which the operating surgeon takes on both jobs of administering and monitoring the patient while also performing the operation.
We decided to sponsor this legislation because we believe that all children, regardless of income, deserve one standard of care when they require sedation and anesthesia. The California Dental Board has recognized the need for high standards of care for our state’s youngest residents by recommending further safety measures be taken in the administration of pediatric dental anesthesia, which would help bring state law in line with the AAP-AAPD guidelines. AB 224 (Thurmond) would do right by our state’s children in codifying the Dental Board’s recommendations into California law.
Pediatricians strongly support AB 224 (Thurmond). Thank you for your public service and leadership on behalf of the health and wellbeing of children, youth, and families in California.
Chief Executive Officer
American Academy of Pediatrics, California
Cc: AAP-CA Leadership; Lydia Bourne; The Honorable Tony Thurmond; Members of the Assembly Committee on Business and Professions; Le Ondra Clark Harvey, Chief Consultant, Assembly Committee on Business and Professions