It’s unclear what role, if any, anesthesia played in the death of a 9-year-old San Diego girl last month. The San Diego County Medical Examiner’s preliminary summary report says the child underwent sedation for a dental procedure at Dreamtime Dentistry, in Vista, fell asleep on the way home and never woke up. Later, when family couldn’t wake her, an ambulance rushed her to the hospital, where she was declared dead. Dr. Ryan Watkins operates Dreamtime Dentistry. He sent NBC 7 a statement saying in part: “We are deeply saddened by the tragic passing of our young patient, which occurred several hours after her completed dental procedure. The patient was referred to our office for dental treatment under general anesthesia due to her young age and acute situational anxiety. Throughout the procedure, she was continuously monitored by our dentist anesthesiologist… Following the procedure, she was discharged in stable condition — awake, with stable vital signs and protective reflexes intact — into her mother’s care, following our standard post-anesthesia protocols.” Dr. Mitchell Poiset is a California board-certified pediatric dentist and the president of the California Society of Pediatric Dentistry. “I have three children,” Poiset said. “This is an unimaginable tragedy. Everyone that I’ve talked to, our hearts are just broken for this family. I mean, it’s just devastating.” Poiset said the risk of injury or death after undergoing sedation in a dental office is very low. However, he said, parents should still consider several factors before agreeing to let dentists put their children under sedation. He said there are circumstances where anesthesia is likely the safest option: Children under the age of 3 with extensive tooth decay, an infection or who are in pain When a child’s dental needs are so extensive it’s just too much to ask them to sit through that many appointments Children with special needs If your child’s dentist recommends putting your child under sedation, Poiset said you should ask a lot of hard questions. “Do we need to do this?” Poiset said. “Is this necessary?” Poiset said parents should ask if treatment can be delayed until the child is older, or if they can book several shorter appointments instead. “The next very important thing is: Who is going to be in the room?” Poiset told us. He said the correct answer should be at least three people: an anesthesiologist, the treating dentist and an assistant. And at least two people in the office should be certified in pediatric advanced life support (PALS). Poiset says parents can also ask if their dentist is certified by the American Board of Pediatric Dentistry. The Dental Board of California also has a pediatric endorsement for dental anesthesia. “If the dentist starts acting annoyed, or the anesthesiologist is acting annoyed, get a second opinion,” Poiset told us.  Last but not least, Poiset said if your child is given anesthesia,  the American Academy of Pediatric Dentistry lists criteria they should meet before they walk out of the office: Cardiovascular function and airway patency are satisfactory and stable. The patient is easily arousable, and protective airway reflexes are intact. The patient can talk (if age appropriate). The patient can sit up unaided (if age appropriate). For a very young child or a child with disability who is incapable of the usually expected responses, the presedation level of responsiveness or a level as close as possible to the normal level for that child should be achieved. The state of hydration is adequate. “Never feel like you’re being rushed out of the office and you’re being sent home when you’re not comfortable,” Poiset said. Poiset said the goal is for your child to never need extensive dental work in the first place. He said getting them in for their first dental exam at one year old can prevent cavities and surgical visits down the line.  Dreamtime Dentistry in Vista. How to look up investigations against medical professionals Californians can do their research into any health professional, including dentists. Patients can search their name on the California Department of Consumer Affairs website. While all complaints are investigated, only those that result in a legal civil filing known as an accusation are posted there. In California, dentists aren’t required to notify patients if they’re on probation, which physicians and surgeons are required to do. ...read more read less