SB-0392: Report on Access to Care Implications of Anesthesia Safety

Session: 2017-2018
Author: Bates
Status: Alive
AAP-CA Position: Oppose
To view the status of this bill on the State Website, click here.

This bill would require a study to determine how access to care might be affected by implementing the Dental Board’s recommendation that a separate anesthesia provider administer and monitor anesthesia in children under 7 undergoing general anesthesia in a dental office. This study would be completed as late as 2019.

This study is unnecessary, as there is clearly no shortage of qualified anesthesia providers, especially for the extremely small population of children under 7 undergoing deep sedation in dental settings. It stands to delay implementation of this key recommendation and put more children’s lives at risk. We urge legislators to instead support AB 224 (Thurmond), which implements this recommendation and keeps children safe.

AAP Positional Letter



April 22, 2017

The Honorable Jerry Hill
Chair, Senate Business and Professions Committee
State Capitol, Room 2053
Sacramento, CA 95814
Fax: (916) 266-9343

RE: SB 392 (Bates): Dentistry: report: access to care: pediatric dental patients: continuing education.
AAP-CA Position: OPPOSE UNLESS AMENDED

Dear Chairman Hill:

The American Academy of Pediatrics, California (AAP-CA), representing over 5,000 California pediatricians, strongly opposes SB 392 (Bates). Last year, the Dental Board of California recommended several ways to improve pediatric dental anesthesia safety, including, most importantly, banning the operator-anesthetist model for children under age seven. Leading experts have weighed in and, by consensus, agree that the Dental Board’s recommendation to require a separate, qualified anesthesia provider is critically important for the safety of young children undergoing specified anesthesia procedures in all settings.

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.

SB 392’s requirement that the Dental Board provide to the Legislature a report and analysis of the effects on access to care for pediatric dental patients of these recommendations does a disservice to children undergoing dental anesthesia, who will be unnecessarily subjected to a lower and riskier standard of care during the report’s lengthy preparation time. Further, such a report is unnecessary, as current workforce data clearly show that implementing the Dental Board of California recommendations would NOT have a negative effect on access. There are ample qualified anesthesia providers in California to meet the Dental Board’s recommended staffing for anesthesia procedures in dental offices for children under age 7.

The American Academy of Pediatrics, in conjunction with the American Academy of Pediatric Dentistry, has published national guidelines (referred to as the AAP-AAPD Guidelines) that set a standard of care for children undergoing sedation and anesthesia for dental procedures. These guidelines are thorough, definitive, proven, and evidence-based. The California Dental Board has recognized the need for higher 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. We believe that all children, regardless of income, deserve one standard of care when they require sedation and anesthesia. As such, the AAP-CA is sponsoring AB 224 (Thurmond), which would fully implement the recommendations of the Dental Board, thus protecting California children in the way that the Board intends. We oppose SB 392 (Bates), as it would unnecessarily delay implementation of the Dental Board’s recommendations to appropriately staff dental offices when children under age 7 undergo anesthesia.

Pediatricians respectfully urge your NO vote on SB 392 (Bates), unless it is amended to exclude the requirement that a report be prepared regarding the effects on access to care of the California Dental Board’s most important recommendation.

We thank you for your public service and leadership on behalf of the health and well-being of children, youth, and families.

Sincerely,

Kris Calvin
Chief Executive Officer
American Academy of Pediatrics, California

Cc: AAP-CA Leadership; Lydia Bourne; The Honorable Pat Bates; The Honorable Tony Thurmond; Members of the Senate Business and Professions Committee; Sarah Huchel, Consultant, Senate Business and Professions Committee