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A dentist’s office generally has fewer hands on deck than a hospital if trouble strikes.“If you are working in a hospital, you press a button, an alarm goes off and everyone comes to help with that kid,” Dr. But in an office, “you end up having to call 911 for help” and the dentist must begin resuscitation during the wait.

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In recent years, a few reports of sedated children dying at dental offices have come to light, alarming lawmakers, parents and the dental profession.The Pediatric Sedation Research Consortium — which collects data mostly from hospitals, not dental offices — has found a low but persistent rate of life-threatening events associated with sedation, such as airway blockage, a drop in blood oxygen levels or a spasm of the vocal cords that makes breathing hard.Unfortunately, it’s not known how many children are sedated in dental offices nor the actual frequency of problems.(The substance may darken decayed areas, but baby teeth fall out.)Dr.Studen-Pavlovich, who directs the pediatric residency program at the University of Pittsburgh School of Dental Medicine, emphasizes the importance of hands-on sedation training for dentists: “Classroom training is not enough,” she said.“It’s not appropriate for sedation to be a first-line treatment” for all cavities, Dr. Less risky and less invasive options, such as placing a temporary filling to buy time until a child will sit for a proper one, should be discussed.

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