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March 28, 1986

General Anesthesia in Dental Offices-Reply

Author Affiliations

Chairman, National Institute of Dental Research Consensus Panel Bethesda, Md

JAMA. 1986;255(12):1567. doi:10.1001/jama.1986.03370120041007

In Reply.—  Dr Goldbeck is correct when he notes that the number of deaths in the United States related to the administration of deep sedation or general anesthesia in the dental office is very difficult to determine accurately because of problems with reporting mechanisms. However, the study from Great Britain (where there is more controlled reporting of fatalities), done by Coplans and Curson,1 does provide some statistically valid data that can be used for comparison. These data, presented by Dr Coplans at the Consensus Development Conference, involved both general dentists and oral surgeons and disclosed an overall office and community dental service mortality rate of 1:248,000. Even if there was a 50% error, the estimate of mortality risk would still be more than ten times less with general anesthesia administered in the dental office than in the hospital. This is not a condemnation of anesthesia services provided in the hospital