Not general dentistry... pediatric dentistry. Very few general dentists doing any form of sedation. Also realize there is a difference between “sedations” and general anesthesia. No one is doing IV sedations on kids, just oral. Parents will agree with whatever the dentists talks them into. If the dentist doesn’t have access to GA and thus doesn’t want to do it, they’ll talk up the risks of GA and push them towards papoose.
Yep higher risk so more money
I do IV sedation on kids every single week in my peds dental residency
I stand corrected. I’ve have multiple anesthesia providers tell me kids crash too fast, etc to be doing moderate sedation without an airway secured. Guess there’s more variation in those opinions than I realized.
I don't understand, if you would, can you please elaborate? You're a pediatric dental resident and you yourself are doing operator-anesthetist "IV sedation" and dentistry at the same time on kids? Or you are just doing the anesthesia? Or you are just doing the dentistry while someone else provides the anesthesia? Also, is this moderate sedation or deep/GA open airway? Just curious, thank you!
I'm sorry, this is 100% false. Modern dental anesthesia residents complete a 3-year hospital-based anesthesia residency. This means they are fully integrated into the medical anesthesia team. DA residents do all the cases in the hospital just like the physician anesthesia residents (except for OB, but that isn't an issue because dental anesthesiologists don't need to know how to do spinals/epidurals...some MDs don't even do OB after they finish residency). DA residents treat ALL patients coming through the hospital OR, ASA 1-6, both outpatients and very sick inpatients; routine lap appys to emergent level 1 traumas in the middle of the night. Everything. If you weren't looking at the resident's ID badge, you wouldn't know if they had a DDS or a MD. Clearly, DA residents are trained "to handle complications."
Zero
Traveling is the job for most DAs. It is how we are able to perform GA in a significantly more efficient and cost effective manner than a hospital. Hospitals are, unfortunately, usually very expensive and full of red tape and wait lists. (I would just like to say, some patients are not good candidates for in-office deep sedation/GA and should only be seen in a hospital. A well-trained anesthesiologist can make that determination.)
In my opinion, very good. Lots of good markets out there. DAs can make as much as anyone.
Difficult question to answer. I think they are both very good. But keep in mind those are two radically different businesses/practices. A traveling DA doesn’t have a brick-and-mortar office, usually minimal to no staff. They just have a vehicle and their equipment and travel from office to office. An operator-anesthetist has a full dental practice. So, very different start-up costs, different overhead, different business models, etc.
Most DA residencies give you tons of experience with peds anesthesia, but not the actual dentistry. As in, you do zero actual dentistry in a DA residency. So if you also want to be a pediatric dentist, yes you want to do both residencies. I guess you could do them in either order, but if I were doing it, I would do anes first, then peds. I think it makes more sense. But others may have different opinions.
In short, yes I agree. I think a dentist who received really good moderate IV sedation training can do it safely, as long as they stay within their limits. I.e. strictly only ASA 1-2 adults, no kids, don’t push patients into deep sedation...because that’s actually illegal and extremely unsafe.
Moderate sedation, the kids are expected to maintain their own airway, and respond purposefully to tactile or verbal stimuli. Obviously it's a spectrum with blurry lines, but we stay within moderate sedation 99% of the time. We use weight based doses of midazolam and fentanyl, titrated up to effect. Occasionally we also use precedex when the former two meds are ineffective. Very rarely do kids need any kind of airway manipulation, and when they do it's almost always just a chin lift. We currently either do the anesthesia or the dentistry, though a moderate parenteral sedation license allows you to do both as long as you have someone else dedicated strictly to monitoring.
People do both. But if it were me I'd apply while in dental school to start residency right after graduating.
I am in medicine but I have a friend who is in her last year of training to become a dental anesthesiologist and she told me it's as lucrative as being as MD/DO anesthesiologist.
She does have job offers and said these offers are about what MD/DO make in term of salary.. My guess is that they are in the 300k-400k/yr.
Yes. Because, truthfully, DA groups don't need to post job offers online. The DA community is so small, and there are so few residents that graduate each year, that everyone knows everyone. When you are a resident and go to the annual ASDA conferences (not ADSA), you will meet most of the DAs in the country. If you want to join a DA group, you will be offered a job / talk to groups about jobs before you graduate. It's a tight knit community.
