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, moderate sedation, deep sedation (DS), or general anesthesia (GA). There is a lack of recent data regarding morbidity and mortality events related to DS/GA for dentistry in Ontario, Canada's most populous province. Specifically, data are lacking for adverse events outside of hospital settings in terms of the number of deaths (mortalities) or severe injuries (morbidities) that occur in dental offices or surgicenters in relation to the number of DS/GAs provided in these ambulatory care settings. Morbidity and mortality reports are fundamental as they provide

. SAFETY CONSIDERATIONS AND COMPLICATIONS Midazolam can evoke a paradoxical reaction in which a child becomes very agitated, hostile, angry, and even violent. 16 This is distressing to parents, and sometimes patients who frequently do not have recall of these events, and treatment is usually not possible. Serious events such as hypoxemia, airway obstruction, laryngospasm, allergy, and even permanent neurologic damage and death are all possible with moderate sedation. 17 These morbidities are more often associated with combinations of sedation medications. 8 A

for this underserved group. 2 General Practice Residency (GPR) training is an excellent venue by which general practitioners can receive education and training in many areas, including sedation. It is important to assess the safety and efficacy of sedation care in this environment as part of the continued effort of those in dentistry to evaluate its safety record. The purpose of this study was to retrospectively and randomly evaluate the morbidity outcomes of 100 sedations conducted in a GPR clinic by second year GPR residents supervised by a dentist

addressed in the survey include: practitioner's age, years in practice, type of practice (specialty), advanced cardiovascular life support (ACLS) training, participation in peer review programs, office accreditation, staffing, agents used, intubation in office, number of cases treated, morbidity, mortality, use of automated external defibrillator, and office stocking of dantrolene. Why was an updated survey done at this time? In addition to being the 10-year anniversary of the original survey, a number of changes have occurred during this period that have

(d) duration of anesthesia (e) any intraoperative or postoperative morbidity, its nature and the intervention needed. Data were tabulated and analyzed. Any records that had any aspect of the information not clearly legible were eliminated from the data analysis; however, all retrieved records were looked at for morbidity events. Results Four hundred twenty-five medical records were retrieved and reviewed. Data from 363 records were analyzed and tabulated. Data from 62 records were

nitrous oxide. 12 Currently, 31 of 50 states have legislation that lists criteria for dentistry for children under GA, and in many instances, there are age-based criteria. 9 , 10 The primary aim of this study was to evaluate the likelihood for post–GA respiratory morbidity in a pediatric dental population with parent-reported ETS. METHODS This institutional review board–approved, double-blinded, randomized case cohort study was conducted at the Nationwide Children's Hospital Dental Surgery Center. Caregivers gave written consent for

proper placement in the nasally intubated patient, and discusses improvements in NG feeding tube placement techniques that would eliminate the morbidity associated with malpositioning in the tracheopulmonary system. CASE DESCRIPTION An 83-year-old woman with a diagnosis of primary squamous cell carcinoma of the left lateral tongue (T2N2bM0) presented for left partial glossectomy, left modified radical neck dissection including levels I–V, and local rotational flap reconstruction. She was 172 cm tall, weighed 91 kg, and had a calculated body

retromolar intubation, 17 , 18 use of an indexed splint allowing for IMF around an orotracheal tube, 19 placing the tube through an edentulous area, 20 or, lastly, performing the surgical treatment in 2 or more stages. 3 All of these alternatives present limitations and drawbacks such as technical difficulties, greater morbidity, or higher costs. Given this scenario, Hernandez Altemir 21 proposed in 1986 a new technique called submental endotracheal intubation (SEI), which consisted of passing the tube through a submental skin incision into the anterior floor

condition can tolerate. Along with other co-morbidities, such as advanced age and potential significant cardiovascular compromise, the dental practitioner providing sedation or general anesthesia must tailor any treatment plan to address multiple organ systems and mitigate risks of precipitating acute respiratory failure from inadequate pain and/or anxiety control. Part I of this article covered the epidemiology, etiology, and pathophysiology of COPD as well as patient considerations in the preoperative period. Once all of this information is synthesized, whether to