Last month, we heard about the tragic death of Daleyza Avila Hernandez. It’s any parent’s worst nightmare—a routine dental procedure resulted in the accidental death of a three-year-old child.
All they wanted was to fix their daughter’s teeth, but now she’s gone. What happened?
Daleyza’s dentist referred her to the Children’s Dental Surgery Center to receive treatment for excessive decay in multiple teeth. The treatment included dental crowns, dental fillings, and a possible tooth extraction.
Daleyza’s parents stayed in the waiting room, as is normal for a procedure like this. While parents might have the best intentions, they can be very distracting to the doctor, who needs to be able to focus completely on the patient.
Due to the excessive amount of work needed on such a young child, Daleyza underwent general anesthesia, and she was asleep for about thirty minutes. She never woke up.
While the horrible death of Daleyza Hernandez is still being investigated (it doesn’t appear at this point to be criminal or negligence), there are things that we can learn from this tragic incident, in order to help stop it from happening again.
Operating on Children
Why are children having their baby teeth operated on in the first place?
The answer is simple: it’s to protect the development of a growing jaw and the formation of the permanent teeth that will come in later. If a child’s teeth aren’t properly treated, relatively small problems caused by decay will turn into major problems as the child grows.
The American Dental Association and the American Academy of Pediatrics recommend that all children visit a dentist by their first birthday. The sooner parents learn to care for their child’s teeth, the better the child’s chances are of keeping a healthy mouth for the rest of their lives.
The number of kids needing dental surgery has steadily been on the rise in recent years. The tragic death of Daleyza Hernandez isn’t just a question of what went wrong with dental surgery, but also how do we prevent the need for dental surgery in the first place?
Make no mistake; that level of decay in a young child is almost 100 percent preventable. It’s not just about brushing and flossing, though dental hygiene is important for everyone. In order to curtail the rising rates of toddler tooth decay (30 percent of children ages two to five have at least one untreated, decayed tooth), we must pay special attention to what children are eating and drinking.
Here are some starting points for parents of young children:
- Avoid on-demand nighttime breastfeeding after the baby’s first teeth come in.
- Do not let babies fall asleep with bottles of milk or juice! Ever!
- Give children tap water to drink regularly.
- Minimize exposure time to fermentable carbohydrates
Unfortunately, American children consume vast amounts of refined sugars on a regular basis. Children in Daleyza’s age range (one to three years old) average 12 teaspoons of added sugar per day, or approximately more than their own body weight in sugar per year!
Such massive quantities of sugar are a dental nightmare. In particular, it’s not just the amount that causes dentists concern (although the amount is concerning), but also how frequently sugar is consumed. Sugar as part of meals (and then brushing after) wouldn’t be as much of a problem. Unfortunately, children often consume a constant stream of sugar, resulting in the increasing rates of tooth decay that we are seeing.
When you protect your child’s teeth from tooth decay, you greatly reduce the odds that your child will even need to undergo such drastic oral procedures in the first place.
The Dangers of General Anesthesia
While we don’t have the full report yet, it is unlikely that Daleyza’s death was caused directly by dental care. The real threat during dental surgery isn’t the treatment, it’s the anesthesia.
Surgery has come a long way in the last 100 years. Operations that would have been excruciatingly painful just a couple of generations ago can now be performed with little to no pain, and the patient walks away with no recollection of the event.
As much as treatment has improved, general anesthesia (making a patient fall completely asleep, unable to wake up) still carries significant risks. This is why there is an entire specialized field of experts in its use, following exacting requirements and regulations. Too little medicine, and the patient may wake up during the procedure. Too much, and they might not wake up at all.
That’s why Daleyza was referred from her regular dentist to a dental surgical center. Her family dental practice lacked the needed equipment and expertise to perform such an operation, so they referred her to someone who specialized in it. Even so, sometimes things can wrong.
Dr. Randy Doesn’t Use General Anesthesia
General anesthesia isn’t the only option for getting patients through their dental treatment. Our practice uses conscious sedation.
Conscious sedation combines gentler medicines to help the patient relax and to prevent pain. It is a relatively safer alternative to general anesthesia for both children and adults. It’s perfect for most dental cases, as we can perform the treatment quickly and the medicine soon wears off, meaning the patient is back to normal quicker.
To get started, we give children fruit-flavored medicine that takes about an hour to set in. During that time, we have a comfortable spot for them to watch movies or play with toys.
This form of pain prevention doesn’t put the patient so far under that they can’t be awakened. Often, patients become so relaxed during their dental treatment that they fall asleep, but they can easily be awakened if needed.
Patients do need to have an empty stomach and clear airway for conscious sedation, so we’ll reschedule in the event of sickness or excessive congestion.
Our dental practice in Mt. Pleasant always aims to protect children. The best way that parents can protect their children’s oral health is to monitor their diet, brush their teeth, and bring them in for regular dental visits so that we can keep an eye on how they are doing. Dental issues occur much more rapidly than in adults.
If you have lingering questions about anesthesia, child sugar intake levels, or how conscious sedation with Dr. Randy, give us a call today! We’re always more than happy to help answer any questions you may have.