A dentist anesthesiologist (DA) provides advanced anesthesia and pain management services for dental and oral surgical procedures. Some dentist anesthesiologists also attend medical surgeries. Post-doctoral specialty programs that train dentist anesthesiologists are rooted in medical anesthesia residencies, with DA residents closely and in some instances identically following the medical anesthesia residency training as their physician cohorts.
Similar to other dental specialties trained in advanced anesthesia, a dental anesthesiology 2- or 3-year residency consists of Commission on Dental Accreditation (CODA) standards that outline an advanced anesthesia education program to ensure proficiency in anesthesia delivery, including intravenous deep sedation and general anesthesia. Unlike other dental specialties, dental anesthesiology focuses exclusively on anesthesia delivery.
The dental anesthesia residency curriculum consists of emergency rescue, advanced airway management, internal medicine, emergency medicine, cardiology, and intensive care rotations. DA residents participate alongside their physician colleagues in general, ENT, complex oral, cosmetic and body contouring, orthopedic, and organ transplant surgeries, as well as satellite anesthesia delivery in nuclear medicine, radiology, cardiac catheterization, and other hospital areas where pediatric or adult sedation is needed.
Some DA residency programs offer rotations in obstetric anesthesia, including spinal and epidural anesthesia, regional anesthesia, 3 to 4 months of dedicated pediatric anesthesia, and office-based anesthesia in the dental setting. DA residencies devote time to anesthesia research projects, medical academic conferences, medical grand rounds, problem-based case learning, and journal club anesthesia-based presentations.
The practice of dental anesthesiology is recognized by the ADA and has recently gained specialty status in select states, with other states sure to follow. After residency, dentist anesthesiologists work within the profession as mobile anesthesia providers in dental and medical settings, hospital anesthesiologists for medical and dental cases, anesthesiologists in ambulatory surgical centers, and anesthesia faculty in medical and dental academic institutions.
Dentist anesthesiologists collaborate with other dentists and dental specialists to expand the field of dental medicine and help maintain a high level of behavior management and anesthetic safety during dental procedures. Many DAs hold faculty positions in academic learning centers. And in carrying on with the tradition that Horace Wells, a dentist and acknowledged “Father of Modern Anesthesia,” started nearly 200 years ago, these specialists enjoy passing on their anesthesia knowledge and experience to future generations of dental, medical, and nursing professional colleagues. Most patients served by dentist anesthesiologists are patients with special needs, fearful children, patients with complex treatments, patients with post-traumatic stress disorder, or dental-phobics.
A dentist anesthesiologist typically is asked to assist the general dental or dental specialist surgeon with cases that need higher levels of anesthetic administration or increased airway management skills for improved patient cooperation. Reasons for lack of patient cooperation in the dental setting may be age, previous dental trauma, a history of post-traumatic stress disorder, inadequate comprehension of procedure, the patient’s inability to control movements, or a lengthy involved surgical procedure.
Personally, I have assisted surgeons with fearful pediatric patients, patients with special needs, patients who have suffered traumatic accidents, laborious procedures, and patients with co-morbidities or physiological airway compromise. Bringing a dentist anesthesiologist into the dental team aids the operating dentist or specialist in maximizing patient safety, comfort, and procedure timeliness, while minimizing negative, disruptive behaviors.
There are societies within dental medicine that offer resources to learn more about dentist anesthesiologists and associated specialty residencies, such as the American Society of Dentist Anesthesiologists, American Dental Society of Anesthesiology, National Dental Board of Anesthesiology, and American Board of Dental Specialties.
Jason R. Flores, RN, DDS, attended dental school at the University of Texas Dental Branch in Houston. After graduation, he attended the University of Pittsburgh School of Dental Medicine, where he completed his specialty training in dental anesthesiology. Dr. Flores has received a dual-board certification in dental anesthesiology and was awarded Diplomate status with the American Dental Board of Anesthesiology and Fellow status with the American Dental Society of Anesthesiology. He currently serves as the clinic director and director of dental anesthesiology for the University of New Mexico Medical Group’s Ambulatory Surgical Center and as assistant professor for the Advanced Education in General Dentistry residency. He can be reached at email@example.com.