This retrospective study searched the College of Dental Surgeons of British Columbia (CDSBC) and the Chief Coroner of British Columbia (CCBC) databases, as well as gray literature in digital and newsprint media. Azzopardi et al. set inclusion criteria as follows: (1) procedure occurred in British Columbia; (2) dental treatment included DS/GA and was done by a qualified provider in an out-of-hospital setting; and (3) that anesthesia or factors under the control of the anesthesiologist caused mortality or serious morbidity within 30 days of the procedure. The researchers defined severe morbidity as “either major temporary injuries (SIS 4) or permanent injuries classified as minor/significant/major (SIS 5, 6, or 7) or grave (SIS 8).” Mortality inclusion criteria were based on the Australian and New Zealand College of Anaesthetists report on the safety of anesthesia.
The search results from the CDSBC and CCBD databases and the gray literature revealed three mortality events that met the inclusion criteria, one occurring in 1986 and two in 1987. There were no severe morbidity events that met the inclusion criteria. Research revealed that all three events involved the same oral surgeon but three different physician anesthesiologists. The cause of death was determined to be venous air embolism that caused cardiovascular collapse in all three cases because the dental drill being used was not rated for implant surgery by the manufacturer.
This retrospective study identified only three anesthesia-related mortality events among 1,019,853 DS/GA dental treatment procedures performed out of hospital in British Columbia between 1984 and 2019. There were no severe morbidity-related events. Given these findings, Azzopardi and colleagues conclude, “This study suggests that the provision of out-of-hospital DS/GA for dental treatment in British Columbia has a low risk of mortality or serious morbidity.”
Full text of the article, “Mortality and Morbidity Associated With Out-of-Hospital Deep Sedation and General Anesthesia for Dental Treatment: A 36-Year Retrospective Study in
British Columbia, Canada (1984-2019),” Anesthesia Progress, Vol. 72, No. 4, 2025, is now available at anesthesiaprogress.org.
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