JOMS Study: Clinician Training, Not Number Of Providers, Key To Pediatric Anesthesia Safety

New analysis finds available evidence does not show that requiring a separate anesthesia provider makes office-based pediatric dental anesthesia safer

ROSEMONT, Ill., Oct. 8, 2026 /PRNewswire/ -- When a child needs deep sedation or general anesthesia for dental or oral surgery, the clinician's training and competency may matter more to safety than whether a separate anesthesia provider is in the room, according to a new analysis published in the Journal of Oral and Maxillofacial Surgery (JOMS), the peer-reviewed official journal of the American Association of Oral and Maxillofacial Surgeons (AAOMS).

The authors reviewed years of national data, including FAIR Health insurance claims, California Dental Board and Texas State Board of Dental Examiners reviews as well as publicly reported pediatric anesthesia deaths recorded between 2002 and 2026. The analysis found no evidence that adding a separate anesthesia provider makes a child's procedure safer. Instead, available evidence suggests the clinician's depth of anesthesia training may be more closely tied to safety.

For parents, the findings reframe an important question. Rather than asking only how many providers will be present, families may be better served by asking about their surgeon's specific training and experience with anesthesia. Oral and maxillofacial surgeons complete four to six years of hospital-based surgical training after dental school, including extensive anesthesia education and experience working alongside physician anesthesiologists – training that, according to the analysis, may be more closely tied to safe outcomes than the number of people in the room.

The analysis highlights the safety systems that support care beyond an individual clinician's training. AAOMS's Office Anesthesia Evaluation program uses peer review to assess areas such as equipment, patient monitoring, emergency preparedness and documentation. AAOMS also supports anesthesia-assistant education, simulation-based training, emergency drills and adverse-event reporting to help office teams prepare for emergencies and continually improve care.

Timely access to appropriate treatment is integral to patient safety, the authors noted. Delayed treatment of dental disease can allow pain or infection to worsen and may lead to emergency department visits, repeated antibiotic use or hospitalization. The authors conclude that pediatric anesthesia policies should account for clinician training and competency, patient needs and procedure complexity while preserving access to care.

"Parents want to know their child is in good hands, and that confidence comes from understanding their clinician's training, the team's preparedness and the safeguards in place," said Robert S. Clark, DMD, 2026 AAOMS President and lead author of the analysis. "This research gives families and policymakers a clearer, more accurate picture of the factors that contribute to safe pediatric anesthesia care."

Visit MyOMS.org to find a qualified oral and maxillofacial surgeon and learn more about office-based anesthesia safety.

The authors of "Training Matters: Why Competency Should Guide Office-Based Pediatric Anesthesia Policy" are Robert S. Clark, DMD; Charles A. Crago, DMD, MD; Debra M. Sacco, DMD, MD; J. David Morrison, DMD; Jeffrey H. Wallen, DDS; Steven R. Nelson, DDS, MS; Pushkar Mehra, DMD, MS, BDS; Martin E. Eichner, DDS; Daniel J. Gesek Jr., DMD; Gregory M. Ness, DDS; Julia R. Plevnia, DDS; W. Frederick Stephens, DDS; J. David Johnson Jr., DDS; and Paul J. Schwartz, DMD. The article was published online Aug. 22, 2026, and can be accessed at https://doi.org/10.1016/j.joms.2026.08.012.

About the Journal of Oral and Maxillofacial Surgery (JOMS)
The Journal of Oral and Maxillofacial Surgery is published by the American Association of Oral and Maxillofacial Surgeons to present to the dental and medical communities comprehensive coverage of new techniques, important developments and innovative ideas in oral and maxillofacial surgery. Practice-applicable articles help develop the methods used to handle dentoalveolar surgery, facial injuries and deformities, TMJ disorders, oral and head and neck cancer, jaw reconstruction, anesthesia and analgesia. The journal also includes specifics on new instruments and diagnostic equipment, and modern therapeutic drugs and devices.

About AAOMS
The American Association of Oral and Maxillofacial Surgeons (AAOMS) represents more than 9,000 oral and maxillofacial surgeons in the U.S. AAOMS surgeons specialize in treating diseases, injuries, and defects of the mouth, jaw and face. Learn more at AAOMS.org.

Contact:
Jolene Kremer
Associate Executive Director, Communications and Publications
American Association of Oral and Maxillofacial Surgeons
847-233-4336
[email protected]
AAOMS.org

SOURCE American Association of Oral and Maxillofacial Surgeons