It is stated on this website that roughly 1 death occurs in every 400,000 cases where anesthesia is used in dental offices. The description below is an explanation of how this number was arrived at.

Numerous studies have been done over the years to determine outpatient anesthesia mortality rates in dentistry. [1-27, 32]. The accumulation of these reports generally shows a death rate of 1 in 327,684 to 1 in 1,733,055 cases depending on which study is looked at [27, 28]. Compilation and analysis of data by various authors in primarily the United Kingdom, Canada, and the United States of America have shown different death rates occurs in dental offices where anesthesia is used [1-27, 32].

A review of 23 surveys from 1955 to 2019 found a total of 326 deaths for an estimated 109,311,951 patients given anesthesia for dental procedures performed in dental offices. This indicates a mortality rate of 1:335,313 which has been adjusted slightly higher to take into account improvements over time. [1-27, 32] Various differences in studies occurs depending on if general anesthesia, sedation, and local anesthesia was given and in what setting the procedure occured, such as a hospital or dental office. Further note this data incorporates all possible types of dental procedures.

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Note the study included by Lytle is a comparitive mortality rate which included previous studies over a 20 year period from 1968 to 1987 [9]. Therefore, the prior two studies by Lytle [6] and [7] are believed to be included in this.

Of course this does not include all people who were treated with anesthesia in a dental office over this time. Nor does it include all people who died in a dental office during this time or all deaths related to dentistry. Coplans and Curson 1982 determined that a total of 120 total deaths associated with dentistry occured in the study period of 1970-1979 and in 1993 in a 10 year follow up study determined a total of 71 deaths occured associated with dentistry with both studies occuring exclusively in England and Wales. The 1993 study was unable to determine approximately how many total patients were given anesthesia over the 10 year period from 1979-1989 so that figure was not included above. However, they did determine in the 1982 study 56 deaths and in the 1993 study 29 deaths all occured in general dental practices, community dental services, or from hospital outpatients. The other deaths not included out of the total reported were either hospital inpatients or unknown. [8, 25]

The insurance company OMSNIC insures roughly 80% of all oral and maxillofacial surgeons in the U.S. [24, 29] OMSNIC estimated that from 2000 to 2013 among its insured oral and maxillofacial surgeons administered 39,392,008 in-office anesthetics (conscious sedation, deep sedation and general anesthesia) and found the ratio of office fatalities/brain damage per anesthetics administered to be 1 out of every 348,602. [24] This data was previously closed [30].

The two studies by Coplans and Curson showed a decrease in dental deaths after the 1970s so one could argue that the data prior to to the 1990s should be removed. Instead of throwing out earlier studies, a better treatment would be to simply deweight the data prior to the 1990s (as in have that data factor in less to the end result).  If one does not do any deweighting using older data and takes 109,311,951 and divides it by 326, this means roughly 1 death occurs in every 335,313 cases where anesthesia is used in dental offices. For convenience, and taking into account that the earlier studies may have had a higher death rate than present today, this number has been rounded to 1 death in every 400,000 cases where anesthesia is used in dental offices.

Further note the actual numbers classified as a dental death in some of these studies is somewhat debatable and some practitioners massage and tweak the data by altering these numbers slightly. [1-27, 32] Also note that [27] uses a study from Pakistan [31] and may have included a typo in their analysis (see https://blog.teethremoval.com/continuing-to-assess-the-death-rate-of-dental-treatment/ for more details). If one removes this study from their analysis they have a death rate of 1 out of every 330,560.

Refer back to the to the death from wisdom teeth removal page and dental deaths page for individual case reports and descriptions.

Updated October 14, 2019

References
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