Dreamtime Dentistry has said that a pre-operative form completed by the parent stated the child was not sick at the time of the appointment. The clinic also said that if it had been told about an active illness or recent fever, the procedure would have been delayed until the patient was stable.
Pre-operative screening is an important part of sedation dentistry, especially for children. These checks are meant to help identify medical concerns that could affect anesthesia, breathing, or recovery after treatment.
On the day of the procedure, Silvanna was treated by Dr. Ryan Watkins, who served as both the dentist and anesthesiologist at the clinic. The clinic has stated that sedation was administered before the dental work began and that the treatment was completed without reported complications at the time.
Dreamtime Dentistry also said Silvanna was monitored throughout the procedure and during recovery from anesthesia. According to statements shared with media outlets, she was discharged awake, stable, and with vital signs in the normal range.
Her Condition Changed After She Returned Home
After leaving the dental office, Silvanna went home with her family. Reports say she appeared very drowsy and continued sleeping for an extended period, which can happen after anesthesia or sedation.
Family members later became concerned when they noticed changes in her breathing. Her grandmother reportedly checked on her more than once as her breathing appeared slower and less regular.
When Silvanna became unresponsive, her family called emergency services. Paramedics transported her to Rady Children’s Hospital in San Diego, where medical staff found she was in cardiac arrest. The condition was described as asystole, meaning the heart had stopped its electrical activity and was no longer pumping blood effectively.
Doctors attempted life-saving treatment, but Silvanna could not be revived. She was later pronounced dead at the hospital.
What Investigators Are Reviewing
The medical examiner later listed the cause of death as methemoglobinemia in the context of recent nitrous oxide administration. Methemoglobinemia is a rare condition in which changes in the blood reduce its ability to carry oxygen properly. In medical settings, it is recognized as uncommon but potentially serious.
Reports have also pointed to the possible role of multiple anesthetic medications used during the procedure. Sedation plans can vary depending on the patient and the type of treatment, but they require careful monitoring because of possible risks.
Dreamtime Dentistry has said Silvanna showed no immediate signs of distress during treatment or recovery. The clinic stated that her oxygen levels remained within normal range while she was under its care.
Dr. Watkins also said that no warning signs of methemoglobinemia were observed during or after the appointment. According to his statement, if signs had appeared, emergency protocols would have been started immediately, including transfer to a hospital.
The clinic has said it is conducting an internal review to evaluate the case and confirm whether procedures followed medical and dental guidelines.
Reports have also noted that Dr. Watkins had previously been reviewed by the California Dental Board in connection with a separate 2016 case involving a serious medical emergency during treatment. That matter involved anesthesia administration and led to a lawsuit that was later settled. Disciplinary measures reportedly included a period of professional probation from 2020 to 2023.
Silvanna’s death has left her community grieving and has raised difficult questions about pediatric sedation, dental safety protocols, and what families should be told to watch for after a child comes home from a procedure.
As the review continues, the case remains a painful reminder of how quickly a routine medical or dental appointment can become a matter of urgent concern.