When children need deep sedation or general anesthesia for dental or oral surgery, the clinician’s training and competency may matter more to safety than whether a separate anesthesia provider is present, according to an analysis published online in the Journal of Oral and Maxillofacial Surgery.
The authors, led by 2026 American Association of Oral and Maxillofacial Surgeons (AAOMS) President Dr. Robert Clark, reviewed FAIR Health insurance claims, California and Texas dental board reviews, and publicly reported pediatric anesthesia deaths from 2002 to 2026. They found no evidence that adding a separate anesthesia provider improved safety in office-based procedures. Instead, the depth of a clinician’s anesthesia training appeared more closely tied to outcomes.
In their analysis, published August 21, 2026, the authors also pointed to safety systems beyond individual training, including the AAOMS Office Anesthesia Evaluation peer-review program, anesthesia-assistant education, simulation training, emergency drills, and adverse event reporting. They noted that delaying treatment of dental disease can worsen pain or infection and lead to emergency department visits or hospitalization.
The authors concluded that pediatric anesthesia policies should weigh clinician competency, patient needs, and procedure complexity while preserving access to care. The findings come amid calls from some patients’ families and dentists for a two-provider anesthesia model in dental offices, an approach favored by some anesthesiology groups.
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