The parents of a 40-year-old man who died due to complications of anesthesia administration during a dental procedure in Arizona are seeking law changes to make procedures safer, and dentists agree it’s time for a change.
Currently, no state requires a two-provider approach in which a clinician focuses on dentistry while another licensed professional oversees anesthesia, like the parents of Derek Swanson, who died after undergoing a dental implant placement at a practice in Arizona, are seeking.
“It is about time for this type of change,” Dr. Sandip Sachar of Sachar Dental in New York City, told DrBicuspid. “Human life is invaluable.”
Dr. Sharad Pandhi.
Dr. Sharad Pandhi of Smile Perfection in Tucson, AZ, agreed, telling DrBicuspid that medical doctors still report medical errors and they are not required to handle anesthesia while performing surgical procedures.
Pandhi suspected that the number of errors would climb if surgeons had to monitor patients’ vitals and the amounts of drugs used for anesthesia while still performing their duties at the highest level.
“Despite all of us claiming we can multitask, there is always a high probability that one or the other duty that we plan to perform concurrently by ourselves suffer if we are lucky, if not both,” Pandhi said.
Dr. Catrise Austin, a cosmetic dentist in New York City and host of the Let’s Talk Smiles Podcast, supports this reform, telling DrBicuspid that she works with a board-certified dental anesthesiologist for sedation cases. Austin focuses on dentistry while the anesthesiologist manages the anesthesia and monitors vitals and a chairside assistant supports airway management.
Dr. Catrise Austin.
“Sedation is not risk-free, and one person doing both jobs opens the door to mistakes that can cost lives,” Austin said. “If separate providers become the new standard, it may raise costs, but let’s be honest, we already finance big-ticket healthcare items like dental implants, orthodontics, and cosmetic procedures. Why not safety?”
Though dentists and their patients would prefer to delegate the task of anesthesia to another professional, it would not come without challenges, Pandhi said.
If a law change moves forward, anesthesiologist availability and insurance reimbursement for their services need to be addressed to prevent a financial burden for practitioners. Additionally, clinicians would need to make scheduling and administrative changes to accommodate a two-provider system, Pandhi said.
“These changes are needed and are overdue,” Pandhi said. “For these changes to be implemented, it requires a lot of planning and understanding that the cost, convenience, and short-term pain on everyone’s part is inevitable.”
Austin also recognized that cost can be a barrier and suggested that financial systems should be created to support a law change.
“Patients deserve the option to choose safe sedation, just like they choose veneers or Invisalign,” Austin said. “But they also deserve to be fully informed of the risks and alternatives, including local anesthesia or non-IV options like diazepam, when appropriate.”
Dr. Sandip Sachar.
Sachar agreed that any changes come with challenges, including putting extra financial burdens on smaller or rural communities.
“Hiring or contracting an anesthesiologist comes at a cost, and it’s understandable that providers fear these expenses might need to be passed on to patients, potentially making care less accessible for many,” Sachar said. “But when we’re talking about procedures that carry real risks, patient safety has to come first.”
Regardless of potential obstacles, Sachar said Arizona is in a unique position to lead.
“By implementing a two-provider requirement for deep sedation and general anesthesia, the state could set a powerful example -- one that brings dental care in line with best practices already used in the broader healthcare system,” Sachar said.
Austin added, “One tragedy is too many. I support the Swansons’ call for reform. We cannot undo what happened, but we can change the standard of care to ensure no other family experiences this kind of preventable loss.”
