By James Stockman, MSNA, CRNA, NSPM-C
Attitudes and habits established at an early age are critical in maintaining good oral health throughout life. During February, National Children’s Dental Health Month, it is important to know how to keep your child’s teeth healthy and that they have access to safe dental care in Texas.
As a Certified Registered Nurse Anesthetist (CRNA), President-Elect of the Texas Association of Nurse Anesthetists (TxANA), and a father of three, I have been in both roles of a parent of a child receiving sedation for dentistry and that of a professional providing anesthesia care to a child for dentistry. I understand the importance of teaching your children good dental habits and providing safe, quality anesthesia with their dental team to help ensure the delivery of sedation or anesthesia care is provided by a qualified, licensed anesthesia professional.
According to the Centers for Disease Control and Prevention (CDC), tooth decay is one of the most common chronic diseases in childhood. Children who have poor oral health miss more school and receive lower grades than children who do not. Untreated cavities can cause pain, infections and can lead to problems eating, speaking, and learning. Moreover, although generally thought of for adult dental procedures, many children receive sedation and anesthesia, even for what would be considered routine dental care, due to special needs, fear, anxiety, or procedural pain.
This increases the complexity of care and emphasizes the importance that sedation and anesthesia are provided by an anesthesia professional, such as a CRNA, who is focused only on patient safety, monitoring, and vigilance. Unfortunately, in Texas, state law limits access to CRNA services in the dental setting. For a CRNA to provide an anesthesia service, the dentist must have an anesthesia permit up to the level that would be required if the dentist was performing it themselves. Obtaining these permits can be difficult and time-consuming and is needless when the CRNA already has the training. This is not the case when an anesthesiologist provides the service, and it is a redundancy that severely limits access to safe anesthesia care. Sadly, this limitation disproportionately affects the poorest and most vulnerable Texas children because many of them live in rural, underserved areas where physician anesthesiologists do not live.
CRNAs are highly educated, trained, and qualified anesthesia experts. They provide 50 million anesthetics per year in the United States, working in every setting in which anesthesia is delivered. Most often you will find CRNAs delivering quality care to rural and other medically underserved areas, where they ensure access to anesthesia care to populations that would otherwise have to travel significant distances from their homes for treatment.
Patients who require sedation or anesthesia for dental procedures can count on a CRNA to stay with them throughout their procedure, advocate on their behalf, and provide high-quality, patient-centered care. CRNAs are proud to serve patients in communities throughout our state, working with dentists to provide important access to safe, cost-effective dental services.
Establishing healthy habits early, like regular brushing and flossing, is essential to maintaining good oral health. But when the need arises, you also want your child to have a dental team, including a CRNA, that is working together to deliver safe, quality dental care.
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The Texas Association of Nurse Anesthetists (TxANA) was founded on August 9, 1974. Its goals include facilitating cooperation between nurse anesthetists and the medical profession, hospitals, healthcare providers, and other agencies interested in anesthesia. The membership is limited to Certified Registered Nurse Anesthetists (CRNAs) and Nurse Anesthesia Students who are members of the American Association of Nurse Anesthetists (AANA).
Nurses were the first professional group to specialize in and provide anesthesia services in the United States in the 1880s. Today there are over 59,000 CRNAs practicing throughout the United States, of which more than 5,400 are located in Texas. CRNAs are advanced practice nurses registered by the Texas Board of Nursing (BON). CRNAs must hold a current state license as a registered nurse, graduate from an approved educational program, successfully complete the certification examination and comply with continuing education requirements for recertification (see here for CRNA regulation of practice in Texas). Learn more at www.txana.org.