But for now, Cathy Garger hopes to shed light on dangers surrounding routine dental visits that she believes led to the death of her daughter, 17-year-old Jennifer Michelle "Jenny" Olenick, and other pediatric patients. Olenick, a junior at Marriotts Ridge High School, died in April 2011, 10 days after losing oxygen during a wisdom tooth extraction procedure at an oral surgeon's Columbia office.
"I had never heard of anything going wrong in a dentist's office before, so at first when Jenny died, I thought, 'this is a freak accident. This doesn't happen to other people,' " said Garger, who had been a stay-at-home mom to her only child.
In the two years since Jenny died, Garger has discovered more similar cases than she'd ever imagined. She began building a network of family members who've also lost children to dental-related deaths. Now, the Woodstock resident is launching a grassroots group devoted to improving dental safety — Families Eliminating Dental Deaths Urging Precautions, or FEDD UP.
The group, being formed as a corporation that eventually will seek nonprofit status, hopes to work state by state to increase awareness and press for uniform standards and regulations governing emergency medical procedures in dental offices. In Maryland and other states, dentists are regulated by state dental boards.
Longer term, FEDD UP aims to require procedures under general anesthesia to be performed in hospitals, where advanced life rescue measures would be available. But the first course of action will be calling for a national Dental Safety Day.
"I feel like my conscience is leading me to this, specifically making people aware that children do die in dental offices," Garger said. "I do believe these deaths are unnecessary, and I believe we can prevent them."
In March 2011, Jenny Olenick was a high school junior and honor roll student who sang and played piano and guitar and planned to study music at college in Boston. During an appointment to have four wisdom teeth extracted, her heart rate decreased and she lost oxygen, according to an autopsy report. Paramedics who responded were able to resuscitate her, but not before she had suffered severe brain injury. She went into a coma and died 10 days later of lack of oxygen to her brain during surgery, the report said.
"It was like a bad dream," her mother said. "No one ever expects their child to have an emergency when they're simply getting their wisdom teeth pulled."
Garger and Jenny's father, John Olenick, filed a medical malpractice case against their daughter's surgeon, Dr. Domenick Coletti, and anesthesiologist, Dr. Krista Michelle Isaacs, and medical practices involved. In March the case was settled out of court. Terms of the settlement have not been disclosed.
In the months after her daughter's death, Garger said, she was contacted by Ramona Zavada, of Columbus, Ohio, whose 13-year-old granddaughter, Marissa Kingery, had died four months earlier after having two baby teeth extracted. Zavada said after the procedure in an oral surgeon's office in Lorain, Ohio, Marissa was unresponsive and was rushed to a hospital. She never regained consciousness, slipped into a coma and died two weeks later.
Zavada put Garger in touch with the Raven Maria Blanco Foundation Inc., a Virginia-Beach nonprofit that advocates for better preparedness among dental practitioners. Since 2009, the group called on dentists to voluntarily adopt what it calls the "the six links of survival," into their practices, a mix of doctor and staff training, drills, proper equipment and emergency drugs.
The group points to statistics from the University of Texas Health Science Center that say every U.S. dentist will come across eight potential life threatening medical emergencies every 10 years.
Still, relatively few dental offices are adequately prepared to handle medical emergencies, said Nicole Cunha, executive director of the Blanco Foundation. It is named for Cunha's cousin, Raven Maria Blanco. Raven, who lived in Chesapeake, Va., died in 2007 at age 8 after being given what a medical examiner said was an improper dose of chloral hydrate during a routine dental check up and cleaning.
The foundation's leaders travel to dental conventions and make presentations to inform dentists and parents alike. The reaction from dentists is typically mixed, Cunha said.
"Some are more open to hearing what we have to say than others," she said. "Most of the time they are immediately turned off regardless of our approach because, and this is just my opinion, they feel we are pointing the finger at them… Most doctors don't think its going to happen to them. That's the mentality."
Though no national registry of dental deaths exists, the group has built its own database, mainly culled from media reports. The group lists 45 children who have died in medical-related dental emergencies since 1974, including Deamonte Driver, a Prince George's County 12-year-old who died in 2007 of a brain infection caused by an untreated infected tooth. Cunha said they believe "there are a lot more cases out there we don't know about."
A spokesman for the American Dental Association said the group does not track instances of patient deaths related to procedures.
Cunha said the Blanco Foundation supports FEDD UP and has similar goals, though the foundation believes it's unrealistic to assign all procedures with general anesthesia to hospitals.
"It's hard because insurance is not there to do that," Cunha said. "If it could be done, we'd be happy to hear that. But it's not as realistic as making sure every office that is doing these procedures is safe."
Zavada, Marissa Kingery's grandmother, said she believes FEDD UP can help educate parents and prompt more people to research their children's' dentists and oral surgeons and the sedation drugs they intend to use.
Garger said she's often asked whether the work she's devoted to now is helping her cope with Jenny's death. It is not, she says.
"This is very sad work," she said. "I'd rather go smell the flowers. I just feel like I have to do it. If your child dies of something that can help another child, how can you stay quiet?"