DID YOU KNOW: Cambridge child died after dental appointment

"Police and the coroner are investigating the circumstances surrounding the death of a Cambridge child," said Olaf Heinzel, Waterloo Regional Police spokesperson. "No details are available for release at this time."


The child was pronounced dead at hospital, Heinzel said. He said police can't release any more information — including the name of the dental office, when it happened or the age and sex of the child — because it could interfere with the investigation.

"We will look at doing a (news) release in consultation with the coroner's office once we have the information we need to provide a comprehensive account of what occurred." This isn't the first local death connected to dental work. In 2007, Leejay Levene, an 18-year-old Waterloo man, died when he went to a local dental surgeon's office to have three wisdom teeth pulled.

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After being given a general anesthetic by a medical doctor, something went wrong and he started struggling for breath. There was a kink in the tube supplying him oxygen. He was later pulled off life support at Grand River Hospital.

"This is such an anomaly," Irwin Fefergrad, registrar for the Royal College of Dental Surgeons of Ontario, said at the time. "It's so unusual and rare. We are all in a state of shock and sadness. This is a safe procedure."

He was unavailable for comment Thursday. Peggi Mace, spokesperson for the college, which serves as the regulatory body for dentists, was unaware of the Cambridge child's death.

"Ordinarily, unless someone filed a complaint or shared information with us that would require the college to intervene, we wouldn't be involved," she said.

Anesthesia and sedation are generally extremely safe, Mace said. "We have incredibly stringent guidelines about how sedation and anesthesia are used. We've probably got the gold standard. … In fact, other provinces have adopted our standard."

Death from anesthetic in the dentist chair is "rare," said Dr. Daniel Haas, an international expert on sedation and anesthesia.

"It has happened from time to time. You can't say it's perfect — nothing's perfect. The role of the practitioner is to keep the incidence as close to zero as possible, but once in a while it unfortunately does happen."

Haas, dean of the University of Toronto faculty of dentistry, said anesthetic could prove troublesome for someone with an undiagnosed heart condition.

"A patient may have a medical condition that wasn't known at the time and under the stress of the anesthetic it becomes too much and has a terrible outcome."

The dental college's professional responsibilities for dentists include: "An adequate, clearly recorded current medical history, including present and past illnesses, hospital admissions, current medications and/or non-prescription drugs and/or herbal supplements, as well as dose, allergies (in particular to drugs), and a functional inquiry, along with an appropriate physical examination, must be completed for each patient prior to the administration of any form of sedation or general anesthesia."

The Ontario Dental Association referred calls to the dental college. Jennifer Sherry, writing in RDH Magazine, a U.S. publication for dental hygienists, says few people have "true allergies" to anesthetic.

"But if a child is not monitored and the dental office is not trained in advanced life-support techniques, this could turn into a life-and-death situation very quickly," she wrote. "Toxicity of local anesthetics can occur quickly. Overdose of local anesthetic can occur if blood pressure elevates and this, in turn, affects the central nervous system. The patient can even slip into unconsciousness or go into complete respiratory failure.

"Local anesthesia toxicity is extremely rare in infants and children; however, seizures, dysrhythmias (irregular heartbeat), cardiovascular collapse … have been reported."

Sherry referred to eight cases — none of them in Canada — where anesthesia caused the deaths of children aged two to 10.