Monday, May 14, 2012

How prepared is your dentist?

How prepared is your dentist?

One local family's mission to keep children safe

How prepared is your dentist?:


Updated: Monday, 14 May 2012, 6:30 PM EDT
Published : Monday, 14 May 2012, 4:49 PM EDT

CHESAPEAKE, Va. (WAVY) - A trip to the dentist can evoke pain, anxiety or fear. Those feelings generally subside once your appointment is over. But for one Chesapeake family the pain will never end. It's been five years since their traumatic visit.

Today, they want to challenge parents; they want them to question their child's dentist.

On March 9, 2007, the Blanco family took their 8-year-old daughter Raven in for a simple procedure. She would be sedated, worked on, then awakened from her sleep.

But Raven never woke up.

Raven's father, Mario Blanco, often visits Norfolk's Forest Lawn Cemetery ; that's where Raven is buried. He brings a chair and sits a few steps from her headstone. It's time alone with his eldest daughter. He opens up to her.

"I don't hear her talk back, but I feel her presence," Mario said.

There is a picture of her at the burial site and Mario meditates on her sweet smile. The same smile still fills the Blanco's Chesapeake home. There are family pictures in every room.

Raven's mother, Robin Blanco, still finds her young daughter's death hard to accept.

"For me, the longer the time goes by, you learn to cope with it. But the longer the time goes by, I miss her more," Robin said, her voice cracking.

Raven was sedated for a routine dental procedure. While getting the work done, complications arose and her heart stopped. Robin watched as staff members performed CPR on her little girl. Crews rushed the child from the dental office to the hospital emergency room.

"I remember a doctor coming out and telling... you know, that they've done all that they can do," Robin continued tearfully. "And did I want to see her - you know I just couldn't believe it. And I said, 'Yes I want to see her. I want to see her.' I just couldn't believe it. And she was gone."

In Raven’s memory, the family started The Raven Maria Blanco Foundation, Inc. They follow and share the stories of other children who’ve died following complications at the dentist.

By their count, 11 have lost their lives in the past year.

Today they're on a mission to educate parents and they want dentists to be prepared. Raven's cousin, Nicole Cunha, is spearheading those efforts.

"People have to go to the dentist, people have to have these things done, there are children with anxiety that have to be sedated, they have to have the work done on them, so no you can't take that away, you have to know what to do if something goes wrong," Cunha said.

Virginia Beach Oral Surgeon Dr. Scott Goodove puts into practice what Raven’s foundation wants in every dental office. He told us, "If we have an emergency, our assistants are prepared. They have stations to take if we have an emergency from the back to the front."

Each morning he holds a staff meeting and goes through the patient list. They discuss any medical complications that could arise.

Dr. Goodove sedates hundreds of patients each year. That's far more than a general dentist. But he points out that oral surgeons also undergo years of specialty training. His advice for any dental office, whether they sedate or not, be ready for a worst-case scenario.

"What we have here is sort of a more organized central emergency station.... (Our) patients walk in, they feel comfortable, 'Hey ... these guys are prepared.'"

In a corner of his office he has an automated external defibrillator (AED), a tank of oxygen, a range of medications and drugs. There's also an emergency response guide.


"It's as simple as picking the emergency - someone passes out - and it will give you the step-by-step guide. But you don't want someone reading this for the first time during the emergency itself, so you run through these drills."

And Dr. Goodove holds mock drills every month. For general dentists, not doing deep sedation procedures Virginia dental regulations don’t go nearly that far. That’s where the Blanco’s want the public to help.

"If we get a group of the whole country coming together, and demanding these things, you'll see a big change," Mario said. Mario eventually wants to see these preparedness practices become law - Raven’s law - as he sees it.

Meantime, much of his time is spent sitting across from Raven burial site, as they keep each other company. Her epitaph reads: "'The most beautiful girl in the world a beloved daughter and sister who is missed and loved so much. One day we will all be together again....' And we will."

Raven's parents want you to ask certain questions before you make a dentist appointment for your child. Click here for a list of those six questions.

Click here to watch the portion of our interview in which the Blanco's discuss taking their other children to the dentist for the first time, following Raven's death.

After this story aired, I received the following:


Kimberly Asercion

After going to the link that showed all the children that had lost their lives due to "complications" at the dental office, I felt like I just needed to tell someone briefly what I have experienced as someone "in the field". I live in Va. Beach and was a dental assistant for almost thirteen years. (I left the field in 2004 after working in an adult practice, and since that time I actually work in the cemetery industry as a General Manager at a cemetery in Va. Beach) I worked five of my thirteen years in a pediatric office. (Drs Sundin and Bullock) and about two months after that at Drs Hechtkopf and Cox. (1998) I did not work long at the last office because the unsafe practices that they undertook actually scared me.

When a child had to have a lengthy procedure they were given Chloral Hydrate for the procedure as well as Nitrous Oxide. (and Lidocaine of course) The dental assistant would come out to the waiting room and get their patient and bring them back. Then the assistant would mix the Chloral Hydrate based on the dose prescribed by the Dr. and give it to the child. Within about ten minutes the children would literally just start getting drowsy and then basically pass out. We would then have to hold them until it was time for them to have their work done...if the office was busy that day then sometimes that could be up to 45 minutes. During that time (and this happened A LOT) the children would begin vomiting...while unconscious and we would have to try to hold them upright while this was happening.

When the procedure would start, the child (who was already completely unconscious) was given Nitrous. It was jacked up way over the necessary level (about 70%) and to the point that it would induce nausea and vomiting even in an adult...but especially on a child that was already sedated. While the child was being worked on (with the papoose board) they had a heart monitor on...when their heartbeat would start to increase the Dr. would say, "Okay...get we go!" (Because the heart rate would increase when they were getting ready to vomit.) They would not reduce the Nitrous strength and we would just have to keep suctioning as they were getting sick.

After the procedure was finished, they would turn on the straight oxygen and start to try to wake the child up. They would still be very groggy when we would carry them back out to their parents, however we were not allowed to tell them that their little child had just spent the last two hours vomiting while unconscious. We did give them precautions for them to eat lightly and to watch them while their mouth was still numb so that they wouldn't bite the inside of their mouth, etc. They never had any idea what had happened back in the office though. That is the part that was so upsetting to me.

I happened to be CPR certified, however this was not a requirement for the job. I was never asked before I was hired if I was. That I know of, none of the assistants were ever shown emergency procedures. I know I was not. This happened on an almost every day basis. Now, when I started the job, I did have eight years of experience and five of those had been in a pediatric office...however the requirements to get a job in Dr. Hechtkopf and Cox's office were very minimal.

I am saddened to hear these stories...I can very easily see how these tragedies could take place. The dentist most of the time very heavily relied on their assistant to have already checked the child's health history without every looking at it themselves. (This was the story in every office I worked at unfortunately.)
I'm truly sorry that this happened and I hope that you sharing these stories will help to regulate the requirements of dentists and their assistants in the future. I just felt like I needed to tell what it was like behind the scenes because I can easily see how this could have happened.