Sedation Safety Week 2015:
The Moral Imperative of Perpetual Education
When You Are Tested and a Life in On the Line,
Will You Know the Correct Answers?
Introducing 'The Fist of Safety'
By Dr. Michael D. Silverman - Founder, and National Chairman
Sedation Safety Week
The next 10 minutes could torpedo all you've worked for since dental school, or they could emerge among of the finest moments of your entire career.
Your patient, a 45-year-old postal worker who is under moderate sedation, has stopped breathing. It could be cardiac arrest, or it might be an unanticipated pharmacological response.
The clock isn't ticking. It's pounding.
What you and your team do during these critical few minutes will not only determine your patient's fate, but likely your professional destiny.
Are you prepared?
Don't think this scenario can or will arise in your office? Chances are excellent that if you practice long enough and treat enough people, you will face a similar emergency in which the very life of a patient rests in your hands.
Will we learn about the incident on the local news? Will the patient or the patient's family bring a lawsuit against you? Will your staff spiral into a collective state of shock and depression? Will your reputation — both professionally and personally — be permanently tainted?
The answers may very well turn on how well you planned and practiced for such an eventuality. Will this be the story of a tragedy or a triumph?
Perpetual education and emergency preparedness are not only advisable for every dentist, they are a moral imperative.
When $1,000 is Worth a $100,000, and More
For the vast majority of dentists practicing in the United States, spending an extra $1,000 to maintain or expand their professional know-how is not a major obstacle.
Yet, for those dentists who work in the nonprofit sector or in the military—where budgets are extremely tight and the deliberation is frequently between spending on equipment and supplies, or investing in tuition—an extra $1,000 can be a godsend.
That is why for the second consecutive year, as part of Sedation Safety Week, DOCS Education is offering up to five $1,000 educational scholarships for oral health professionals who work in the non-profit sector. Individuals may apply directly for these scholarships, or their for-profit colleagues can nominate them for the financial awards.
"The dedication represented by dentists who work for nonprofit organizations is superlative," explains Dr. Michael D. Silverman, founder, and national chairman of Sedation Safety Week. "Like their patients, we as their peers owe them our most sincere gratitude."
Dr. Silverman's philosophy has always been that an investment in continuing education—like our patients' investments in oral health—returns the amount spent a hundredfold, not counting the exponential increase in their level of personal fulfillment.
When $1,000 allows nonprofit oral health professionals to attend a course that they otherwise couldn't afford, the ripple effects are manifold. For starters, these dentists stay atop of the latest in safety, procedures and equipment. That means that each patient they see also receives the benefit of their additional education.
Moreover, when nonprofit dentists attend continuing education courses, it raises the professionalism of their entire organization because course graduates are able to share their many of their new insights with colleagues who could not attend. The completion of optional educational courses also motives other nonprofit dentists to go the extra mile to find similar scholarships or to generate special funding so that they, too, might enrich their careers and the lives of their patients.
"Nowhere is the concept of 'passing it forward' more evident than among those nonprofit oral health care professional who are able to utilize these scholarships," Dr. Silverman notes.
Recipients of the 2015 Sedation Safety Week scholarships will be entitled to apply their awards toward any of the many safety-related courses offered by DOCS Education.
Would you like one of these $1,000 scholarships or do you have someone deserving in mind?
Your Name Belongs Here: Sedation Safety Dentist of the Year Honorees
They are not household names. Carroccia. Phillips. Gray. Maddux. Claeys. Blann. Gesker.
Yet these seven dedicated men and women have done an enormous amount to advance our entire profession's commitment to safe, comfortable, sedation dentistry.
Our seven distinguished previous winners of the annual Sedation Safety Week Dentist of the Year Honors not only strive week in and week out to establish and maintain the oral health of their individual patients, they also serve as national role models for dental professionals who place safety and comfort ahead of all other considerations in their approach to patient care.
Now, more than ever before, we need to let our patients know that their safety, when they visit the dentist, is our overarching priority.
As Sedation Safety Week founder and national chairman Dr. Michael D. Silverman noted in his keynote essay this year, the popularity of sedation dentistry and its growing acceptance among those who previously feared visiting their dentists mean that as a profession we are seeing greater numbers of patients with less than perfect health. Their non-oral health issues make the application of safe sedation more challenging.
We are not the only ones taking note. State dental regulators — charged with the protection of the public at large - are also revisiting the way in which sedation dentistry is administered. Their scrutiny is essential.
Yet regulation alone is no substitute for the case-by-case, individual commitment that tens of thousands of sedation dentists make daily — exemplified by our annual Sedation Safety Dentist of the Year recipients — to do everything in their power to assure the well being of their patients.
That entails a career-long commitment to continuing education, training, and emergency drills. It means utilizing every available piece of equipment designed for safety and comfort. And it means offering five-star customer service that puts nervous patients at ease and makes coming to the dentist a pleasure — not a nightmare.
Safety isn't easy and, candidly, it doesn't come inexpensively.
When they could otherwise be on the golf course, cruising the Mediterranean, or at home with family and friends, Carroccia, Phillips, Gray, Maddux, Claeys, Blann and Gesker have invested the necessary time and resources to advance their education, better prepare their teams, purchase and train on state-of-the-art equipment, comfort nervous patients, and serve the indigent.
Truth be told, there are thousands of other committed oral health professionals, who like our seven prior honorees, merit the respect and recognition of their peers for a safe job, well done.
Along with our 2015 Sedation Safety Dentist of the Year honoree, Dr. Robin J. Henderson, we applaud each and every oral health professional who places safety and comfort at the top of their priorities list.
Congratulations to you all!
Cap Off Your Practice with Capnography
Why is capnography so important? Efficiency. In the highly unlikely case of an emergency, seconds count. Capnography has the ability to near-instantaneously determine a patient's expirations of carbon dioxide. On the other hand, a pulse oximeter determines the oxygenation of the patient's blood at their extremities. This means in a worst case scenario, if the patient stops breathing, it could take up to a minute before the deoxygenated blood would reach the fingertip.
As technology advances, so does the standard to which clinicians must hold themselves. DOCS Education has always been a proponent of not meeting—but exceeding the standard of care. Capnography, the measurement of a person's carbon dioxide expirations, typically while under anesthesia, is increasingly becoming one method through which to surpass safety standards.
Yet this was not always the case—mostly due to cost. Over the past 20 years, the technology used to measure capnography was very expensive: in the range of $25,000-30,000, and typically used only in very large hospitals. Yet today, both capnography's prevalence as a safety staple and its affordability are snowballing.
Technology has advanced to the point that any doctor can add capnography to their vital signs monitor for just a few thousand dollars more than the base cost of their unit.
The average patient breathes once every five seconds. Therefore a properly calibrated capnography device can determine if a patient has stopped their breathing cycles within those five seconds. In the rare case of an emergency, the difference between five seconds and sixty seconds is profound.
Knowing this, it makes perfect sense that in 2012 the American Society of Anesthesiologists updated its guidelines to include capnography for all moderate sedation outpatient sedations. In January 2014, the American Association of Oral and Maxillofacial Surgeons changed their guidelines to require their doctors to use monitors with capnography for their in-office surgeries.
Are there any guidelines that require sedation dentists to use capography? Not yet.
But that is not the point.
What matters is that clinicians take the initiative to surpass safety standards—not because they are required to—but because they should. The DOCS Education faculty has been teaching capnography for five years, and has always recommended this technology for moderate sedation, pediatric sedation and higher-risk patients. The faculty agrees that capnography should be a principal component of any sedation office: It's readily available, is inexpensive and it helps ensure a patient's wellbeing.
In fact, DOCS Education is happy to announce the American Dental Association will be discussing the topic of capnography at their next annual meeting and are likely to recommend it as an update for their guidelines—making it a true standard of care in dentistry.
As always, we recommend our doctors stay ahead of the curve.
Who Has More Fun at the Tooth Faire: You or the Kids Who Participate?
Long before you were an oral health professional, you were a dental patient.
Think back. What are your most vivid early childhood memories of visiting the dentist's office?
What did the reception area look like? What did the office smell like? Was everyone friendly? Was anyone unfriendly? Did you look forward to your next visit? Or, like so many adults today, did you dread the idea of regular dental appointments?
When it comes to patient comfort and services, today's dental profession is light years ahead of most of the oral health professionals who treated us when we were kids. Yet many parents of today's young children still recall the dental trauma of their childhood. That's one reason so many adults avoid seeing the dentist themselves, and why they pass on their dislike - whether consciously or subconsciously - to their children.
Make Going to the Dentist a Positive Thing
Sedation Safety Week's 2nd Annual Tooth Faire Open House, which we mark today, is designed to introduce parents to 21st century dentistry and make a positive first impression on their children. This is your opportunity - whether you host your Tooth Faire today or sometime later this year - to help children form early, positive memories of visiting the dentist, and begin the process of reversing their parents' own dental aversions.
The concept and execution of the Tooth Faire is simple. Basically, you and your team are throwing a party for children and their parents to visit your practice before they have no choice.
Offer a few simple activities:
- Ask someone to dress up as the Tooth Fairy; give kids a chance to have their photo taken with the Tooth Fairy, too.
- Let kids be "Junior Dental Assistants" and give them a tour of basic tools used by assistants.
- Hold a Q&A session with the doctor for kids and parents to ask any and all questions they have about your practice, oral hygiene, etc.
- Hand out door prizes and other goodies.
Plant seeds of goodwill that will sprout and serve attendees for a lifetime.