9-year-old dies after dental procedure
Nine-year-old Silvanna Moreno’s routine dental visit turned into an unimaginable tragedy on March 18, 2025. She had gone to Dreamtime Dentistry in Vista, California, for what was expected to be a standard procedure—but by the end of the day, she was gone.
More than two months later, the San Diego County Medical Examiner’s Office ruled her death accidental. The official cause was “methemoglobinemia in the setting of recent nitrous oxide administration”—a rare and serious condition where hemoglobin fails to deliver enough oxygen to the body’s tissues, resulting in hypoxia. According to medical experts, the disorder can cause symptoms ranging from skin discoloration to unconsciousness, and in some cases, may be fatal.
The day before her dental appointment, Silvanna had been given children’s Tylenol due to a low-grade fever. She was a new patient referred for a root canal on a molar, and during the three-hour procedure, several baby teeth and a decayed permanent tooth were removed. The office’s anesthesiologist, Dr. Ryan Watkins, confirmed she passed all preoperative evaluations and was considered fit for outpatient general anesthesia.
Following the procedure, Silvanna was placed in a recovery room. Her mother later described her as groggy, intermittently opening her eyes and mumbling incoherently. On the drive home, she remained drowsy and appeared to be asleep once they arrived. But within thirty minutes, her breathing began to slow, and when attempts to wake her failed, her family called 911.
Silvanna was rushed to the hospital, but doctors were unable to revive her. She was pronounced dead that same evening.
In a public statement, Dr. Watkins said, “Our hearts continue to go out to Silvanna’s family. We are deeply saddened by her loss.”
However, this wasn’t the first time Watkins had come under scrutiny. In 2016, he was investigated for the near-death of a 54-year-old patient under his care. That incident led to a ruling from the Dental Board of California, which concluded that a medication he had administered should never have been used due to its risk of cardiac arrest. As a result, Watkins was placed on probation from 2020 to 2023.
Silvanna’s death has reignited concerns over pediatric dental anesthesia practices, especially in outpatient clinics. Though classified as accidental, her story has left many parents questioning the risks behind procedures often labeled as routine.
What should have been just another appointment became a family’s worst nightmare. And while no punishment can undo what happened, Silvanna’s story may become a call to action—one that sparks deeper scrutiny, stricter safety standards, and better accountability in pediatric care.
She was a bright, lively child with her future ahead of her. Now, her name stands as a painful reminder that even the most ordinary moments can carry extraordinary consequences.