A year and a half since a patient died after a dental procedure and several months after a second fatality tied to “conscious sedation,” the North Carolina Board of Dental Examiners is planning changes to its rules on training, emergency response and sedation.
The deaths have spurred the state board to ask members of the public and professionals in the field to speak out on possible changes to its rules and protocols for sedation and dentistry in general.
“I think that there will be changes made to the rules,” board operations officer Bobby White said, adding, “The board’s not so arrogant to think we have or know all the answers.”
Much of the discussion will focus on “conscious sedation” dentistry, a practice that is supposed to depress patients’ consciousness but keep them responsive. Both dentists involved in the suspected dentistry-related deaths had permits for conscious sedation dentistry, according to state records.
The review of standards by the body responsible for licensing and regulating state dentists and hygienists begins this month with a series of public meetings. The topics up for review might include ways to better train North Carolina’s dentists, methods for dentists to respond to emergencies and ways dentists should select patients for various treatment,White said.
In response to the fatalities, which dental board investigators linked in 2013 to sedative drugs, the board is looking for suggested improvements for the state’s system for regulating dentists, White said.
Staffers and at least one member of the dental authority will hold their first “listening conference” at Greensboro’s Grandover hotel at 9 a.m. March 28. The board has not yet announced the meeting.
The deaths at the center of the discussion happened in 2012 and 2013. In the first, the dental board eventually found that Cary dentist Toni Mascherin had ignored a patient’s medical history and an assistant’s warnings that the patient had turned blue, according to the board’s license revocation documents from September. Partly because of legal obstacles, the board allowed Mascherin to continue practicing sedation dentistry for almost eight months after the patient’s death; it’s unclear whether she did so.
In the second death investigation, the board has evidence that Williamston dentist Zachary Harrison gave sedative drugs to “a patient who was not a good candidate for outpatient deep sedation, which resulted in the death of that patient,” according to an emergency “summary suspension” issued by the board Dec. 2. Harrison has requested a public hearing on the accusations, White said.
As it reconsiders its rules, the dental board likely will hold three of the informal public input sessions, and it will accept comments by email, letter and phone. The dental board also will gather comments at a July meeting in Greenville and on an undetermined third date.
Nationally, the death of a child in Hawaii has brought calls for changes to the practice of sedation dentistry. Doctors with advanced degrees in anesthesiology often are among the advocates for more training and education.
After the first round of public comments, the two members of the board’s sedation committee will work with an outside attorney to draft any changes to policies and requirements. That official draft will go to the state’s Rules Review Commission and go up for public comment, White said.
He couldn’t say when a policy change could materialize, but he said it often takes six months to get through the state’s review.