A court decision changed the rules for the use of anesthesia in dentists’ offices.
The most common anesthesia practices in dental offices are local anesthesia, an injection into the gums, and the use of nitrous oxide, a gas that the patient breathes in along with oxygen.
“Conscious sedation by inhaling oxygen and nitrous oxide is a way to alleviate patient anxiety and panic in the dentist’s office. Whether they are children or adults, and that is the purpose”, says dental surgeon Silvio Teixeira.
In procedures where anesthesia is less complex, such as a filling, nothing will change. The Federal Court’s decision refers to sedation with controlled medication, in which the patient may remain unconscious during the consultation, generally in surgeries and dental implants.
The Brazilian Society of Anesthesiology had gone to court claiming that dentists are not prepared to carry out sedation work. The medical society asked the court to prohibit procedures from being carried out on patients using controlled drugs, such as opioids and sedatives, in dentists’ offices. According to the Dentistry Council, Brazil has 409 thousand dental surgeons.
The lawyer representing the doctors states that there are no rules for dentists or supervision in offices and the risk to patients is great.
“The professional who is carrying out this procedure, which is considered a risky procedure, does not have the technical knowledge to act in the event of an incident. A doctor, not an anesthesiologist, any doctor who wants to do a sedation, an anesthetic procedure, he first needs to have an advanced life support course. This course provides the professional with knowledge of intubation, oxygen circulation, keeping the patient stable in the event of an anesthetic event”, says Celso Papaleo, lawyer at the Brazilian Society of Anesthesiologists.
The Federal Court partially accepted the anesthetists’ request. The Federal Court’s decision does not prohibit dentists from carrying out the procedure, but determines that they now have to follow the rules of the Federal Council of Medicine. Among them, a post-anesthesia recovery room is next to the office and the dentist can no longer attend to the patient and provide sedation at the same time. A professional is needed exclusively responsible for anesthesia.
Judge Rachel Soares Chiatelli states that it cannot be ignored that just as non-anesthetists can administer anesthetics, dentists must also be assured of the possibility of using them, due to the very nature of their activity.
The Federal Council of Dentistry sent a note informing that it will only comment on the case files; which will carry out a technical analysis to guarantee the rights of dental surgeons, and at the same time, comply with the Court’s decision. The council also stated that it is committed to updating and improving ethical and technical guidelines to ensure patient safety.