By Tony Edwards, editor in chief

July 17, 2017 -- A California State Assembly bill that would have required three practitioners to be present when a child younger than age 7 was undergoing anesthesia in a dental office has been put on hold, while a separate Senate bill on the same topic supported by the California Dental Association (CDA) is advancing in that state's Legislature.

The California State Senate Business, Professions and Economic Development Committee approved Senate Bill 501 (SB 501), introduced by Sen. Steven Glazer (D-Orinda). The bill would establish new requirements for dentists administering or ordering the administration of minimal sedation for pediatric patients younger than 13 years of age.

The bill would also require that a dentist possess specified licensing credentials and that any dentist who desires to administer or order the administration of minimal sedation to apply to the Dental Board of California, as specified, as well as submit an application fee. The CDA supported this bill, which passed the committee by a 16-0 vote.

“This is why CDA supports SB 501 that implements the recommendations of the Dental Board of California to increase training, monitoring, and permitting requirements for all levels of pediatric sedation.”
— Alicia Malaby, CDA spokesperson

Competency in pediatric sedation

Another bill, AB 224, introduced by Assembly Member Tony Thurmond (D-Richmond), ran into opposition from the same committee and has been put on hold by Thurmond. Besides the personnel requirement, this bill would have required dentists to establish competency in pediatric sedation by completing at least 20 training cases. The bill also would have obligated dentists to complete a physical evaluation and a medical history before administering deep sedation or general anesthesia to pediatric patients. The bill originally required 52 cases to establish competency.

In a statement on the CDA website in support of Senate bill, Government Affairs Council Chair John Blake, DDS, noted it was important to make all levels of sedation safer while ensuring children can receive care.

"There are several things that we can do that will increase safety and set new, higher standards to make all levels of sedation safer, and we should be doing those," Blake said during testimony in support of the Senate bill. "However, it is equally important to ensure that children can get care, and we cannot ignore the ramifications or pretend that changes will have no effect on the system."

Training and monitoring

In a statement to DrBicuspid.com, the CDA said that the Senate bill will increase the training and monitoring needed for pediatric sedation in the state.

"While CDA's best efforts were made to work with the author [of AB 224] in a way that best implements the Dental Board of California's recommendations on pediatric dental anesthesia, he chose to hold his legislation and work on it in 2018," CDA spokesperson Alicia Malaby wrote in an email to DrBicuspid.com. "We look forward to continuing our engagement on the issue and helping implement sound public policy that does not disrupt or interfere with medically necessary care for young children. This is why CDA supports SB 501 that implements the recommendations of the Dental Board of California to increase training, monitoring, and permitting requirements for all levels of pediatric sedation."

Assembly Bill 224 may have a further hearing at a later date. Senate Bill 501 has been referred back to the Senate Appropriations Committee, where a hearing has not been scheduled at press time. The Legislature goes on recess July 21 until August 21.


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