Alberta anesthesiologist questions safety in some dental chairs: ‘This is an outrage’
A Calgary-based anesthesiologist said he is “gobsmacked” dentists in Alberta are allowed to give a general anesthetic.
Dr. Ken Cheung works out of the Foothills Hospital and said despite his years of post-MD specialty training, he would not feel comfortable giving a general anaesthetic to a child.
Cheung was responding to the Edmonton case of four-year-old Amber Athwal, which is under review by the Alberta Dental Association and College (ADA&C).
“I think this is a big surprise to myself and my colleagues. The majority of us were not aware of that general anesthetics are being administered in dental offices without an anesthesiologist present.”
On Sept. 7, 2016, the little girl visited Dr. William Mather and was given a general anesthetic for a dental procedure. Athwal was rushed to the Stollery Children’s hospital and was in a coma. She suffered brain damage and is being treated at the Glenrose Rehabilitation hospital.
“I think this is an outrage,” Cheung said.
“Anesthesia can have impact on multiple organ systems. Anesthesiology is a medical specialty that requires five years of post-MD degree training. A dentist just does not have adequate training to do this safely.”
The ADA&C would not comment on the investigation into what happened to Athwal, but said there are 20 Alberta dentists working in 16 accredited facilities able to provide patients with a general anesthetic. There was no break-down for pediatric patients.
The ADA&C said after two to four years of undergrad and four years of dental school, training is followed by a two-year dental anesthesiology program. The ADA&C said dentists specializing in oral and maxillofacial Surgery attend a four- to six-year program.
The ADA&C accredits dental surgical facilities as well as non-hospital surgical facilities.
“Dentists work on teeth,” Cheung said. “They cannot and should never give a general anesthetic.”
“It is akin to allowing a taxi driver to pilot an airliner just because the taxi driver has taken a course and the taxi union thinks it’s OK.”
Cheung said unfortunately, anesthesiology is a low-profile medical specialty and thinks most people are not aware of who they are and their expertise.
Last week, Mather sent a letter to anesthesiologists asking if anyone would be interested in becoming the medical director of anesthesia for his office.
“I would require general anesthetic services approximately eight to 10 days per month,” Mather wrote.
Amber Athwal’s father told Global News Mather should have waited until the internal investigation was over to send out a letter asking to hire.
“He wants to continue his business,” Raman Athwal said. “He wants to earn more and more money.”
The Athwals said the ADA&C promised a deadline of Nov. 30 to provide answers to what happened to their daughter, but last week the group told Global News it depends what’s in the report.
On Monday afternoon in the legislature, Calgary-Greenway Conservative MP Prab Gill called on Alberta Health Minister Sarah Hoffman to push for public answers.
Hoffman said she is working with the college and wants to respect its process.
“I want to be clear the family deserves answers and so do all Albertans,” Hoffman responded.
On Tuesday, Hoffman said the dental college is responsible for determining best practices.
When asked if she had concerns that one group is responsible for patient safety and providing leadership to dentists, the health minister said, “I think we deserve to give them the benefit of the doubt that they’ll be able to wear both of those hats until we’re in a position where we feel that evidence has pointed us in a direction that we feel otherwise.”
“I think that they certainly have a great responsibility both to their members, but significant responsibility to the public in terms of the role of the college and providing those assurances, best practices and being guardians of the profession and I look forward to seeing how this report rolls out and giving the public the assurances that they deserve.”
Cheung thinks the province must protect patients from the use of a general anesthetic in a dentist office.
“Ask questions and be educated.”
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