May 31, 2017
The Honorable Tony Thurmond
P.O. Box 942849
Sacramento, CA 94249-0015
Fax: (916) 319-2115
RE: AB 224 (Thurmond): Dental Anesthesia and Children
AAP-CA Position: SPONSOR
Dear Assemblymember Thurmond:
The American Academy of Pediatrics, California (AAP-CA), representing over 5,000 California pediatricians, strongly supports your 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 dedicated anesthesia monitor, 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 statue 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 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 by ending the operator-anesthetist model and guaranteeing a qualified anesthesia monitor for our state’s youngest children undergoing dental anesthesia.
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