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Training Matters: Why Competency Should Guide Office-Based Pediatric Anesthesia Policy.

Created on 26 Aug 2026

Authors

Robert S Clark, Charles A Crago, Debra M Sacco, J David Morrison, Jeffrey H Wallen, Steven R Nelson, Pushkar Mehra, Martin E Eichner, Daniel J Gesek, Gregory M Ness, Julia R Plevnia, W Frederick Stephens, J David Johnson, Paul J Schwartz

Published in

Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. Aug 22, 2026. Epub Aug 22, 2026.

Abstract

Pediatric office-based deep sedation and general anesthesia policy should prioritize patient safety and preserve access to care. Debate has focused on whether universal staffing requirements-imposing a separate anesthesia provider-should supersede differences in practitioner education, training, and demonstrated competency.
Oral and maxillofacial surgery residency provides extensive hospital-based anesthesia education, longitudinal experience with deep sedation and general anesthesia in a surgeon-directed anesthesia team model, airway management, and emergency care. Oral and maxillofacial surgery practice is reinforced by a specialty-wide safety infrastructure incorporating office evaluation, anesthesia-assistant education, simulation, emergency preparedness, adverse-event reporting, and continuing education. Available utilization and adverse-event data demonstrate that including a separate anesthesia provider does not improve pediatric anesthesia safety.
Pediatric dental anesthesia policy should recognize differences in specialty-specific training and professional competency rather than impose uniform staffing models. A competency-based approach supports patient safety and preserves access to care, while appropriately accommodating the demonstrated safety of the surgeon-directed anesthesia team model practiced by oral and maxillofacial surgeons.

PMID:
42642021
Bibliographic data and abstract were imported from PubMed on 26 Aug 2026.

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