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, “Little if any research has focused on errors or adverse events occurring outside of hospital settings.” 10 Likewise, a 2014 review of the safety and outcomes of OBA noted a relative paucity of outcomes research in dental OBA, and most of the literature that currently exists on complications following anesthesia for dental procedures has focused on adults. 11 , 12 Lee et al 13 studied the morbidity and mortality for children in the United States subsequent to receiving sedation or general anesthesia for dental treatment based on available media reports, but noted

With the recent increase in national attention directed at patient safety involving sedation and anesthesia for dentistry within the office-based environment, organizations inside and outside of dentistry are attempting to collect and evaluate data to improve outcomes and reduce or eliminate untoward events. However, given the general isolated nature of most dental practices, this has proved challenging. Unlike the hospital setting, which can provide abundant opportunity for licensed health care providers to practice in an environment prime

safety systemically innate to medical practices in hospitals and surgery centers. Finally, state dental boards and liability insurance companies are frequently reluctant to release information that could be potentially quite useful for shedding light on and improving these areas. Despite these obstacles, efforts are underway to improve this scarcity of data within dentistry. The Dental Patient Safety Foundation was founded in 2017 as an independent, nonprofit organization whose mission is to improve the safety and quality of dental care by the collecting

-trained dentists who will be at the forefront of bringing sensible policies and procedures to the dental office. In this way, the readers of Anesthesia Progress will hopefully make a profession-wide contribution to enhancing safety in dental practice more generally. REFERENCES 1 World Health Organization . Safe surgery saves lives . Available at: http://www.who.int/patientsafety/safesurgery/tools_resources/SSSL_Checklist_finalJun08.pdf . Accessed November 1 , 2015 . 2

that it has an extraoral approach. The general safety concern with any extraoral injection is infection. Thus, is vital to employ a strict antiseptic protocol to cleanse and disinfect the overlying skin prior to insertion of the needle. If a second injection is planned, a new needle should always be used to avoid cross-contamination. Two additional risk factors pertaining to the administration of a nerve block include hematoma and possible damage to critical structures such as nerves and blood vessels. The temporalis muscle is the main anatomic structure

have not been shown to be statistically significant. 10 , 12 , 13 To the best of our knowledge, no well-designed clinical trials have been conducted to assess the cardiovascular effects of topical epinephrine on gingival tissue in a pediatric population. The purpose of this pilot study was to determine the cardiovascular safety and hemostatic efficacy of topical racemic epinephrine compared to placebo. The primary objective was to determine if topical racemic epinephrine had any effect on heart rate (HR) or blood pressure in children receiving dental care

socioeconomic forces. By virtue of our professional oaths, as well as statements of practice ethics, we can see that the changes of improved patient care are not all scientific, but are also directed toward improved patient safety. I will concentrate, therefore, on some areas of change in our practice over the past few decades that have enabled us to significantly improve patient safety. A major impetus for changes in patient safety is a result of change in our society and its propensity for computers and the Internet. The Internet and the media are making the public

access, it is virtually impossible for providers to perform root cause analysis effectively in order to identify and address any recurrent underlying issues. If we don't know what's broken, how can we fix it? Throughout the years, the general field of anesthesiology has successfully borrowed many safety optimizing approaches from the aviation industry, which has been a leader in safety analysis. Commonplace anesthesiology protocols such as preoperative checklists, emergency response flowcharts, and simulation all have roots stemming from within aviation. Even the

achieve the desired degree of sedation, resulting in the patient still not being able to cooperate. Safety is another important consideration, because sedation is a continuum and a practitioner must be prepared to rescue a patient who falls into a level of sedation deeper than intended and experiences complications. Sedation is replacing more advanced procedures but may be decreasing in use overall. 3 ORAL SEDATIVE AGENTS IN PEDIATRIC DENTISTRY The ideal sedative agent or combination of agents reduces anxiety and mitigates uncooperative