Oral Health Group
Feature

Got ‘Til It’s Gone

February 7, 2022
by Peter Nkansah, MSc, DDS, Dip. Anes.


Don’t it always seem to go/That you don’t know what you’ve got ‘til it’s gone.
– Joni Mitchell (“Big Yellow Taxi”)

There is an active application to recognize Dental Anesthesia as a dental specialty nationwide. Dental Anesthesia is recognized as a specialty in Ontario as well as in the United States and Japan. This assistive modality for delivering dentistry continues to grow in popularity. The need and demand for sedation dentistry remains high, its practitioners are busy (even in the context of COVID-19) and the safety numbers are very good, all of which lead to patient benefits.

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Ideally, the evaluation of specialty applications is a mostly objective exercise. The stated criteria are either met, or they are not. The Canadian National Dental Specialty Recognition Commission of the Canadian Dental Regulatory Authorities Federation (CDRAF) presides over these decisions. According to their website (cdraf.org/), the CDRAF is a forum comprised of the provincial dental regulatory authorities.

There are four criteria to be met for a specialty application to be successful. In brief, they are:

  1. There must be a sponsoring organization for the application.
  2. The discipline must be a distinct and well-defined field.
  3. There must be substantial public need and demand.
  4. There needs to be a university-based advanced education program of at least two years in length.

Happily, Dental Anesthesia meets each of these criteria.

For most Canadian dentists, a fair question is “If I’m not a dentist-anesthesiologist, why should I care?” The answer is intersectionality. The recognition of Dental Anesthesia as a specialty will help to preserve the ability for all dentists to continue to provide sedation/anaesthesia services for our patients. A recent survey suggests that over 60 percent of the 10,000 dentists in Ontario provide sedation/anaesthesia services.1 The application serves specialists and non-specialists alike. Because there is nothing that defines sedation/anesthesia for dentistry as a part of dentistry at the national level, the discipline would be put in a precarious position if dentistry was asked to defend providing sedation services. This challenge could come from numerous angles. A successful challenge could take sedation services away from us. The political pressure for change is not high now, but it will increase over time. Milton Friedman spoke of the impossible becoming inevitable with political pressure.

The application before the CDRAF acknowledges and supports sedation services provided by oral and maxillofacial surgeons, paediatric dentists, periodontists, endodontists, and prosthodontists. We know that general dentists and physicians provide sedation services for patients, and that’s a good thing that should continue.

The discovery of anesthesia is credited to Horace Wells and William T.G. Morton, both dentists who respectively introduced nitrous oxide (1844) and ether (1846) to the world. Sedation is a part of dentistry. It should be kept here. The benefits may be a little more wide-reaching than you initially thought.

References

  1. Patodia SK, LeBlanc V, and Dempster LJ. Ontario Dentists’ Practice of Sedation and General Anesthesia: Barriers to Access and Use. Journal of the Canadian Dental Association, 87: I2, 2021.

About the Author

Peter Nkansah is a Dentist Anesthesiologist with a private practice in Toronto. He is a member of the editorial board for Oral Health, an Assistant Professor at the University of Toronto’s Faculty of Dentistry and Past-President of the Canadian Academy of Dental Anaesthesia.


Oral Health is pleased to present the voices of our Editorial Advisory Board members in this forum, which allows writers to share their personal thoughts, opinions, viewpoints and experiences. We want to ensure our tradition of serving our readers the very best in clinical and editorial content continues and we thank all the members of our Editorial Advisory Board for their efforts in making this happen. We welcome your comments and feedback. Feel free to share your thoughts with us through letters to the editor (amy@newcom.ca).


RELATED ARTICLE: Barriers of Access to Deep Sedation and General Anesthesia as Identified by Ontario Dental Patients


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