Yes there are advantages in using a dentist anesthesiologist over a physician anesthesiologist. Your question asks about anesthesia in a dental office, so I'll try to focus on that. I would like to say, these are general comments and in no way shape or form downplaying the extensive training physician anesthesiologists undergo.
When you compare the residency training of a dentist vs physician anesthesiologist, dental anesthesia residencies are more geared towards delivering anesthesia services for BOTH pediatric and adult patients in an ambulatory setting, doing predominantly nasal intubations or open airway anesthetics with the operator working in you airway. That was a long sentence, but those nuances are integral to being a dentist anesthesiologist (i.e. pediatrics, nasal intubations, open airway, operator working in your airway...)
One example: the number of pediatric deep sedation and general anesthesia cases a dentist does in residency is usually greater than their physician counterparts (except for, of course, fellowship trained pediatric anesthesiologists, but I've never heard of one going into a dental office).
Just look at the minimum requirements. Physicians must do 100 cases involving patients 12 years or younger. Dentists must do 125 cases involving patients 7 years or younger, and 75 of those must be patients with special needs (btw, DA residents end up doing wayyy more than 125 by the end of their three years). There is a huge difference between a 7 year old and a 12 year old, especially when you factor in special needs patients, and then factor in doing an anesthetic in a dental office/surgicenter setting. It's just more specific training to suit dental cases, and all the nuances that go with it. Physicians are more comfortable doing full GA in a hospital OR on orally intubated adults, and most "regular" physician anesthesiologists don't do much or any pediatrics, those cases are usually handled by pediatric anesthesiologists (especially when the patient is 2-8 years old).
Another example: when I was externing at various DA programs, I remember one case quite well. We were in the OR, and the dental anesthesia team was doing the anesthetic for the OMFS team (ORIF of mandible). The DA resident and attending did a fiber optic nasal intubation. Once the intubation was complete, the OMFS attending voluntarily announced to the whole OR, "I hope everyone watched that intubation, because that's how it's supposed to be done." The OMFS attending went on to say he thinks all the anesthesia residents (meaning both medical and dental) should rotate with the DA team so they can learn how he does it. Now I'm not saying DAs are better at fiber optic nasal intubations than physicians, but that type of training is a big focus in a DA residency.
Those are some broad general statements, and I realize it doesn't hold true for all anesthesiologists across the country, but I'm just trying to point out differences in training as it pertains to dental cases.
Most DAs do a ton of pediatrics when they are out in practice (i.e. 3, 4, 5 year olds). Some do a lot of open airway, and some do a lot of nasal intubations. Some do a bunch of pediatric dental cases, and others work a lot with oral surgeons and periodontists on adult patients. DA residencies are more geared towards this type of care. So it's just different. The best way to think of it is that dental anesthesia is a "subspecialty" of anesthesiology, not a hierarchy between dentists and physicians.
Additionally, a dentist will understand the dental procedures being performed to a significantly greater extent, which can help with treatment planning/sequencing of appointments, especially if the operator is someone who has little or no experience working on a sedated patient.
I'd love for others to comment, because I think this is a really good topic for increasing awareness. At this point and time, I would argue most dentists don't know what a DA actually does, and most dentists definitely don't know about the training a DA receives.
If you are interested in applying to a dental anesthesia residency, one of the best and first things you should do is an externship or two (or five lol); they are invaluable.
