Mortality Rate for Ambulatory Dental Surgery Under General Anesthesia
The mortality rate for ambulatory dental surgery under general anesthesia is extremely low, approximately 1 death per 1 million procedures, based on the most recent high-quality evidence from North America.
Current Evidence on Mortality Rates
The most recent and rigorous study from British Columbia, Canada (2025) examining 36 years of data (1984-2019) found a mortality rate of 2.94 deaths per 1 million out-of-hospital deep sedation/general anesthesia procedures for dental treatment 1. This represents approximately 3 deaths in over 1 million procedures when anesthesia could not be ruled out as a contributing factor.
Supporting data from Ontario, Canada (2019) covering 1996-2015 found an even lower adjusted mortality rate of 0.8 deaths per 1 million cases (3 deaths in 3,742,068 cases) 2.
Massachusetts data from oral and maxillofacial surgeons showed zero deaths in 431,680 patient visits during 2015-2016 3, and only 1 death in 1,733,055 procedures in 2004 4.
Context from General Ambulatory Surgery
For broader context, older guideline data from 2004 reported anesthesia mortality for general ambulatory surgery at approximately 1 death per 50,000 procedures 5, though current rates may be lower. The 2019 tonsillectomy guidelines cite US mortality rates of 1 per 18,000 for ambulatory tonsillectomy specifically 6, 7, 6.
Key Points About Risk
- Dental ambulatory anesthesia appears safer than general ambulatory surgery: The dental-specific mortality rate (approximately 1 per 1 million) is substantially lower than general ambulatory surgery rates
- Causes of death: When deaths occur, approximately one-third are attributable to bleeding, while the remainder relate to aspiration, cardiopulmonary failure, electrolyte imbalance, or anesthetic complications 6, 7
- Serious morbidity is also rare: The Ontario study found serious morbidity at only 0.25 per 1 million cases 2
Important Caveats
These excellent safety outcomes apply specifically to:
- Procedures performed by qualified, credentialed providers in properly equipped facilities
- Patients who are generally healthy (ASA physical status 1-2)
- Appropriate patient selection and risk stratification
Risk increases significantly with:
- Greater patient comorbidities (ASA physical status ≥3) 8
- Airway manipulation and intubation procedures 8
- Emergency procedures (though less relevant for elective dental surgery)
The data consistently demonstrates that when performed by appropriately trained providers with proper patient selection, ambulatory dental anesthesia carries an exceptionally low mortality risk—approximately 1 per 1 million procedures or lower.