PRE- EVALUATION NECESSARY: DOCTORS
In a recent incident, Mr Manikam Ramasamy, a 63year- old man suffered cardiac collapse after being administered anaesthesia for root canal surgery at a private dental clinic in the city.
After recovering from anaesthesia, Manikram complained of chest pain and after being given several medications and passed away while he was being rushed to a hospital.
In another instance, Vasudha, a three- year- old girl underwent a root canal treatment by a pediatric dentist as she complained of pain in teeth. However, her heartbeat was lost during the procedure and could not be recovered even through cardiopulmonary resuscitation ( CPR) was used immediately. Vasudha was declared dead at the hospital.
There have been cases of fatalities during dental treatments that do not seem to reflect the reasons for the death. However, dentists stress on precautionary factors and need of awareness among people on the provision of basic facilities, sedation procedure, pre- anaesthetic evaluation and protocols to be followed by a dental clinic such that medical complications and fatalities can be prevented.
Stressing on the need for p r e - a n a e s t h e t i c evaluation, oral and maxillofacial surgeon Dr George Paul said that sedation should be given only in case of painful procedures.
“Several dental clinics in the city claim to provide ‘ painless’ dental treatments under sedation which is not advisable if the patient is sensitive. Even more dangerously, pediatric dentists with little or no competence in providing life support are rampantly anaesthetizing children by themselves under the unacceptable notion that it is safe and can be given by anybody with a two- week course,” said Dr George Paul.
Lack of awareness on the part of patients also accounts for sudden deaths during medical procedures, said Dr S. Navaneethan, dental anaesthesist, Apollo White Dental.
“People should be aware of emergency equipment and emergency medical kit available at the clinic that should include oxygen cylinders, CPR, airways, suction and other monitoring
and screening he said.
While medical negligence committees and medical council investigate such cases after the loss is already caused, authoritative bodies such as Dental Council should set up a protocol for management of patient emergencies, which can help to prevent such fatalities.
“There is no mandatory protocol by Dental Council of India on infrastructure and basic facilities to be available at a dental clinic before performing any dental procedure and there are no set guidelines for training on life support,” said Dr Yashwanth Venkataraman, Medical Director, Parasu Dental Centre.
When contacted, a senior official from Dental Council of Tamil Nadu said that the various regulations laid down by the Dental Council of India under the Clinical Establishments Act are yet to be adopted in the state. While the Director of Medical Services shall look into any case of medical negligence, implementation of basic facilities protocol can be done after the approval of the government, he said.