Restrictions could be coming to how, when you are sedated at the dentist's office

Those who get nervous in the dentist's chair might ask for sedation. But after four deaths since 2017 in oral and maxiofacial surgeon's offices, there is a proposal to dramatically change the rules about how and when dentists can use sedation in North Carolina.

The North Carolina Dental Board is holding a public hearing on Wednesday night to decide if rules about sedation should be made stricter. Sedation is used when the patient is undergoing oral surgery, or if the procedure is more minor but the patient is anxious and asks for sedation.

The proposal would require dentists and oral surgeons to have a certified registered nurse anesthetist on hand to administer sedation. Currently, dentists can administer the sedation themselves.

There is risk with sedation in a dental office, but dentists who use it say it can be done safely.

"The already established rules and protocols in place are very good. It's just adhering to them," said Dr. Matt McCullough, a dentist who works at several Riccobene Associates Family Dentistry locations.

Shital Patel lost her husband, a cardiologist and the father of two children, when he stopped breathing during a minor dental procedure involving sedation in 2020.

"We called 911 and that's kind of when I went to the floor because I was like, 'What do you mean? We're here for a dentist appointment,'" said Patel.

Three days after the appointment, Patel said her husband passed away.

"What makes me so mad is, all of it was preventable. Your dental assistants are there, but they obviously weren't any help, and they're not trained to do what [the surgeon] is trained to do," said Patel. "But how can [the surgeon] be doing both — doing a procedure and sedating your patient and monitoring everything?"

While the oral surgeon in that case was stripped of his license, Patel said more needs to be done to restrict sedation in dental offices.

"We trust our caregivers that there's safety protocols in place [and] that they know what they're doing,"

But many dental practices say using sedation is safe as long as the proper protocols are followed. McCullough said he believes the risk of problems is low, and the increased cost of the new proposal will be passed along to patients.

"It's going to highly increase the cost without necessarily increasing the safety, in my opinion, and it's going to decrease the access to care," said McCullough.

But, Patel pushes back on concerns over increased costs for care.

"Ask those of us who have lost someone — would we have minded if you charged us a few hundred dollars more?" Patel questioned.

The state Dental Board will meet in Morrisville on Wednesday night. A lot of people on both sides are expected to show up to speak, including Patel.