In the June issue of Pediatrics, 1 the American Academy of Pediatrics (AAP) published a joint statement with the American Academy of Pediatric Dentistry updating the 2016 AAP sedation guideline. 2 This statement contains strong wording concerning the need for an independent, skilled professional to manage children during deep sedation in the dental setting. It is essential for pediatricians and family practitioners to understand why this document was revised. The guideline reiterates the need for an appropriate history and physical examination, including a focused airway examination. For highrisk patients (eg, syndromic children or serious health issues), consultation with an anesthesiologist or other specialist is suggested. It provides a list of ageappropriate and size-appropriate equipment; resuscitation drugs and other sedation basics, including opioid and benzodiazepine antagonists; and decision algorithms for the management of airway obstruction, laryngospasm, and apnea. Oxygen saturation, expired carbon dioxide, heart rate, and other parameters are documented on a time-based record. Both the independent observer and the dental clinician must be up to date with Pediatric Advanced Life Support (PALS) or Advanced Pediatric Life Support certification.In March 2015, a healthy 6-year-old boy received deep sedation for removal of a supernumerary tooth; after multiple sedating medications, he developed apnea and airway obstruction. The oral surgeon was unable to clear the airway, and there was no other skilled help in the office. Caleb was in full cardiac arrest when the emergency medical technicians arrived, and he died from his hypoxic event.Caleb's aunt, Anna Kaplan, now a pediatric resident, worked diligently to introduce legislation that required an anesthesia-trained professional for deep sedation/anesthesia for children, but Assembly Bill 2235, known as Caleb's Law, 3 was withdrawn owing to the wellfunded oral surgery lobby. 4 Instead, the California legislature codified the single-clinician-operator/ anesthetist model for oral surgeons, whereby the operating dentist/oral surgeon can simultaneously provide deep sedation/anesthesia and perform the dental procedure (2 tasks concurrently) and bill the patient or family for both.This law is of national importance because their success in California has encouraged oral surgeons in other states to propose similar legislation. The single-clinicianoperator/anesthetist model supported in these laws is in contradistinction to all known anesthesia standards of the modern medical community, including the World Health Organization, the American Society of Anesthesiologists, the Society for Pediatric Sedation, the