Dental tragedy prompts concerns over sedating kids

Published: Jan. 6, 2014 at 10:25 PM HST|Updated: Jan. 6, 2014 at 11:23 PM HST
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Finley Boyle
Finley Boyle

HONOLULU (HawaiiNewsNow) - The tragic case of 3-year old Finley Boyle has raised concerns about some dental procedures for kids after she died Friday night due to complications from a dental visit. There are various philosophies on sedation for young children and experts say responsibility falls on the dentist's shoulders.

A trip to Island Dentistry in Kailua proved fatal for three year old Finley Boyle when her family claims she was sedated with a host of drugs and went into cardiac arrest. She had ten cavities and needed four procedures called a pulpotomy to remove infected tissue near the root canal. Experts say that's not uncommon for kids.

"Just because of the fact we don't have a fluoridated water system," said Dr. Allen Hirai, Pediatric Dentistry Kahala. "The extensiveness of the decay is quite large."

Dr. Allen Hirai has been a pediatric dentist the past 29 years. He does not use any sedation on children because of the risks.

"Number 1 it's all about the child's safety," said Dr. Hirai. "You can definitely create changes within the system of that child."

He also believes in teaching proper behavior.

"My philosophy may not be in agreement with some other colleagues of mine. Each colleague has their own philosophy in terms of how they handle behavior," said Dr. Hirai.

"My first response is oh no this happened again," said Dr. Anthony Caputo, Southwest Dental Anesthesia Services President. "We're trying to sedate them beyond a level we should be sedating them and that ends up in tragedy all too often."

Southwest Dental Anesthesia Services in Arizona cautions medicating kids is unpredictable drugs are different for everybody.

"Unfortunately what happens is that mentality of if all I have is a hammer everything looks like a nail. It's that one size fits all approach where we want to get the treatment done and we're not thinking about the well being of the child," said Dr. Caputo. "I can tell you from experience that's been the most common thing I have seen is that dentists have not recognized the limits of what sedation can do and should do for a patient."

In Finley Boyle's case the family says a technician administered the medications. Dr. Caputo says that's okay as long as the dentist measures the amount and the patient is monitored properly.

"It really doesn't matter who administers the drug, it matters more who draws up the drug and determines the amount of drug to be administered," said Dr. Caputo.

If parents are uncomfortable get a second or even third opinion.

"It's appropriate to ask all the questions pertaining to your concerns, or your anxieties," said Dr. Hirai.

So why don't dentists use anesthesiologists? It's just too expensive and would make the cost of certain procedures out of reach for many families.

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