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Dental Anesthesiology

Discussion in 'Dental Residents and Practicing Dentists' started by Denticized, Apr 20, 2007.

  1. Denticized

    7+ Year Member

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    Ok, what is this specialty? Don't be smart. I know what it's supposed to be. But is there any dentist out there that works specifically as an anesthesiologist and nothing else? If not it's just a made up specialty for which there is no use since most dentists are competent at anesthesiology. Unless some OMSs would hire them I don't see any point. Anyone?
     
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  3. 2th_DK

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    you probably won't get too many replies, but i'll try...my school has an anesthesia residency...i think they take 4 or 6 each year...they basically after residency go on and just drive from one pvt. pract. to another or be in a group and do the sedation cases for the team or individual...for the most part, there are exceptions..i know of some omfs in pvt. pract. that do employ the services of a dental anesthesiologist, not because the oms doc can't do it, but he/she can see more patients...some of our anesthesia attending sonly do the anesthesia part and not do any dental proc.

    now, i don't know what you mean that most dentists are competent at anesthesiology...local anes. yes, but i don't know about concious sedation and general anesthesia...are all the students in your school required to learn concious sedation and general anesthesia...if so, you have a pretty damn good school to be teaching all the undergrads that...nitrous sedation i could understand...our undergrads are required to do nitrous here, and we have two "special" students that does iv sedation under oms supervision...good luck...hope i answered some of it...
     
  4. ItsGavinC

    Dentist Moderator Emeritus 15+ Year Member

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    Dental anesth. isn't an ADA recognized specialty, but it certainly is a dental sub-specialty.

    The above poster hit the description right on the head.
     
  5. brycethefatty

    brycethefatty thefatone
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    I was interested in this for a while, but I am not interested at all anymore. I talked to about 8 DA's, most from Arizona, two from California, one from Ohio. I emailed 3 Program Directors several times each. I was interested in it for a while, but after being in dental school a while, I realized I enjoyed doing the dental procedures too, rather than just standing there and monitoring the pulse oximeter after being able to find a vein. But to each his/her own. Dental anesthsiology (DA) is NOT a specialty as recognized by the ADA and it probably won't be for a while (although, some are optimistic). But that probably doesn't matter because it sounds like they do just fine.
    There are 6 programs -- 4 are 2 years long, the program in Pittsburg is 3 years long and the program in Toronto is also 3 years long. The Ohio State residency is the only one (to my knowledge) that offers a Masters degree in Pharm to its graduates.
    They don't have too many applicants to their programs every year (the program director at Ohio State's program compared it's competitiveness to that of Oral Pathology -- about 6 to 10 applicants for each spot or less some years -- with the applicant pool being pretty small). He said most programs aren't too concerned about an applicant's grades in clinic, but A's in physiology, pharm, anatomy, pain managment, ect. are a must. Also, a student who has shown interest, e.g. shadowing several DA's, completing a ACLS and PALS course, and volunteering at the hospital/clinic to help OMFS with sedation cases.
    The programs pretty much go through the same training an medical anesthesiologist goes through, with an emphasis, of course, on dentistry. Although, for medical anesthesiology, the residency is 3 to 4 years long (plus a year of internship), so DA's obviously don't get EXACTLY the same training. But its very similar. DA residents rotate through Pediatric Anesth., Cardio. and Neuro. Anesthesiology, as well as a few other rotations that differ according to the program (see links at bottom of this message). Also, they rotate through general anesthesia cases for medical cases and also work in the dental clinic doing some conscious sedation, but mostly general anesth. in pedo. They are pretty much the experts in the dental field about anesthesiology, along with oral surgeons, who recieve comparable clinical experience.
    From the DA's I've talked to, there are 3 different career routes: 1) some own their own dental clinic and employ associates to do the dentistry part, and then the DA does sedation cases -- some of these folks still practice as general dentists (which is apparently frowned upon by some in the dental anesthesiology community); 2) some DA's are employees of surgicenters or big dental clinics to only perform anesthesia for mostly pediatric dentists who need to sedate those little bastards that won't sit still; 3) some own their own practice, and all I talked to that go this route travel 4 or 5 days a week to the offices of dentists, pedodontists, periodontists (NOT oral surgeons -- many oral surgeons don't support the DA "specialty") to perform sedation cases in these offices.
    Of the DA's that travel from office to office like this, typically, they travel to one office a day, to a dentist who has scheduled anywhere from 2 to 6 patients for sedation. Most of the time, it's kids and its for a pedodontist, but adults also use the service of course. One DA who emailed me said he works strange hours sometimes. Sometimes, he'll have to leave at 3, 4, 5 in the morning to get to the office to prepare, then he'll do cases all morning, until 12, and then have the rest of the day off. Other days, he'll have 1 or 2 big cases and then be done. Other days, he'll work from 7 in the morning until 7 at night. He said he has enough work to work all day everyday, and also fill up his Saturday, if he wanted to. But he chooses his schedule, for the most part.
    As far as fees, if you sign a contract with a state welfare program, you typically make $75 every 15 minutes. If you run a fee-for-service practice, you can make $400 (about the average) to $600 and I've heard of a guy in Conneticut who charges $1000/hr (very rarely do they make this much). The good thing is the average overhead is about 20%, but 15% is very attainable after several years of practice. Startup costs right out of school are relatively low (about $20,000 all equipment and first few months of medications, but could be as high as 50,000 or more), and malpractice insurance is low, about 800-1500 per month (depending on the state, insurance carrier, level of coverage, ect.), so not too bad (compared to medical anesth.). They don't take hospital call, so that's good. Most I talked to spend about 30 to 35 hours a week treating patients and collecting cash. The rest of the time is reviewing charts, doing paper work, running the business from home, ect.
    It's a good job, turns a good profit, and there's PLENTY of work out there for DA's right now, from what I'm told. Some Oral surgeons have opposed the dental anesthesiologist "movement". The reason is probably because if DA's get a lot of power, they could end up taking away the right for OMFS to preform outpatient sedations (this has happened to some medical specialties due to med. anesthsiologists getting all hot and bothered). I think the chance of it of happening is about zero, because OMFS have such a good track record and a lot of power in dentistry right now. That's my opinion.

    God speed, bitches. Hope you all enjoyed this lengthy read. I'm going to go ice my fingers and realize I just wasted a LOT of time writing this.





    Here are some very good reference websites:
    http://www.adsahome.org/
    http://www.adba.org/
     
  6. rahmed

    rahmed SDN Angel
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    Excellent info on DA. You haven't wasted time. Thanks,
     
  7. 2th_DK

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    i hear ohio state is a good residency for DA...i have a classmate who externed there for a week...he is one of the entering DA residents in my school...is dr. weaver still the man in ohio?
     
  8. brycethefatty

    brycethefatty thefatone
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    I thought I heard weaver was going to step down as program director soon and just stay on as faculty and continue as the editor of anesthesia progress. As if he did, I'm not sure. Last time we emailed was about 8 months ago.
     
  9. Dr.Millisevert

    Dr.Millisevert Senior Member
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  10. toofache32

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  11. BuckeyeDDS

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    I think that Dr. Kristen Zitterell, Dr. Weaver's protege, is now the program director. I could be wrong, though.
     
  12. DocPainless

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    Does DA residency pay you while you are in school or do you have to pay for the residency and how much?

    Thanks. Just curious
     
  13. IcedOMFS

    IcedOMFS realultimatepower.net
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  14. Denticized

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    Thanks everyone for your amazing info about this. However, I am still confused that financially it could be justified for a D.A. to go around from office to office in order to perform anesthesiology. Think of all the time wasted being on the road and after all how much would they charge?
     
  15. shabu2

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    With all that time wasted on the road from office to office, it might be better staying put and cutting a few crowns financially. I guess you have to love anesthesia, or really hate dentistry to do it.
     
  16. dentalman

    dentalman Senior Member
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    They usually spend one full day at each office (not several offices during one day.) And they get paid very well, but they have a much larger responsibility.
     
  17. muberrymolar

    muberrymolar Member
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    i copied this response by an anesthesiologist straight from dentaltown.


    "####, I have a certifcate in anesthesiology, but have never pursued this field. ###### and I have gone round and round on this issue, and I once thought that he was going to fall off his chair at #### restaurant when I told him I didn't do any sedation in my office, with the training that I had. I am sure there is a need for these services, but the malpractice and liablilty insurance and issues will eat you alive, in costs. The monitors and meds are not that costly. A well stocked "crash box" will be a few bucks, but the insurance will kill you. Do yourself a favor before you jump into it, figure out what it will cost to set it all up, and figure out how much it will cost you on a daily basis. You will most likely only get one or maybe two cases in per day, as you will be responsible for the pre,intra and post operative anesthesia care of the patient. You will then have to be compensated accordingly. Then once you have these numbers, contact a number of doctors, Personally, and ask them if they think they could use your services and if their patients would pay for them. this would give you an idea if there is a market for you services."
     
  18. wizziefiend

    wizziefiend Guest

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  19. rocknightmare

    rocknightmare Senior Member
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  20. aphistis

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  21. rocknightmare

    rocknightmare Senior Member
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  22. IcedOMFS

    IcedOMFS realultimatepower.net
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  23. wizziefiend

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  24. Dr.Millisevert

    Dr.Millisevert Senior Member
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  25. Stroszeck

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    So in the end, just to reiterate for those of us interested, is it worth going into a DA residency? I really am interested in the job, but not if there is no demand for it and if the insurance etc is extremely expensive.

    Who would be a decent person to contact regarding this? I've tried various admissions representatives at the few schools which provide this training, but they are fairly cryptic when it comes to giving answers!
     
  26. Dr.Millisevert

    Dr.Millisevert Senior Member
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    Yeah.. there really isn't that much information out there about it because to be honest.. most people go to dental school to be dentists not anesthesiologists. (your day to day practice is very diff (Dentist vs. Anesth) and you can make just as much cash and better lifestyle usually as a general dentist hence the lack of interest).

    If that's what you're interested.. then prob better to go to med school. However.. that being said, you can also do it through the dental route if you want.

    As far as the demand and how much money you can make. It really depends on where you're living and your market. I have heard of some who after completing the dental anesth residency training just purchased an suv and drove around from office to office with a bunch of equipment doing sedations for gp, pedo, and oms cases... and I have also met a guy who is a general anesth at a large hospital doing GA for everything under the sun... So again it just comes down to what you want to do.
     
  27. brycethefatty

    brycethefatty thefatone
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    Of the 8 or so DA's I talked to, all said they were very busy -- some said they were too busy and wanted to drop a few doctors. The MP insurance isn't that expensive, essentially no overhead. But do you really want to do that job? My advice:shadow several DA's and figure it out for yourself. This is the only way to know. The money is good, plenty of work (at least in Arizona and California -- the practices of the DA's I talked to). One DA told me there are pros and cons to it, mainly, that it is "98% boredom and 2% sheer terror".
     
  28. niles19

    niles19 New Member
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    Is it feasible for a DA to get a job in a Hospital setting just like a MD?
     
  29. smsc2009

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    Hi,
    I am just curious if one were interested in going into Dental Anesthesia would they go to medical school and recieve an MD, or DO or Dental School and recieve a DDS, or DMD? Does a dental anesthesiologist only work with Anesthesia? What is the path to becoming one? What are hours and pay like? Do you work at a hospital? Also, what are the procedures like?
    Thanks
     
  30. brycethefatty

    brycethefatty thefatone
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  31. smsc2009

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    I thought all my questions were pretty reasonable for what I know about the sub-speicality. The first question was simply about the schooling, which I think can be questioned. I was thinking maybe there was a fellowship as an MD that you had to complete to speicalize in Dental Anesthesiology. My second question do they only do Anesthesia is also legitimite. Since it is not considered a dental speciality, maybe they can still practice as a general dentist. Your right, I did not read this thread. I was referred here by the pre-dental forum, it was late and I was tired so I just posted a topic hoping to get some answers.

    Some of my other questions have not yet been answered, hopefully someone can help me out there. (ie: do they work in a hospital setting?)

    Thanks
     
  32. toofache32

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    Can someone explain to me what a dental anesthesiologist does?
     
  33. gryffindor

    Dentist 10+ Year Member

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    Yes to both. You can still do GP procedures and dental anesthesia. You can also work 100% in a hospital. At my GPR hospital, Mt. Sinai in NY, they had a 2-year dental anesthesia training program and there were graduates of the program in both of the scenarios you described. I have also seen people go into dental anesthesia because they despised general dentistry, but then again, probably half the people in ortho hated general dentistry as well, haha. :laugh:
     
  34. smsc2009

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    So the process to becoming a Dental Anesthesiologist is four years undergraduate, (B.S.) four years dental school, (D.D.S. or D.M.D.) and then a two year residency is Dental Anesthesia? Are DDS or DMD anesthesiologists compensated as well as MD or DO?
    Thanks
     
  35. GatorDMD

    GatorDMD Suck ChocoSaltyBalls
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    There is a Anesthesiology attending at OHSU who is a dentist (endodontist) who did no med school, only has a DMD and did a true AMA anesthesiology residency. Believe it or not. He gets respect among MD attendings and residents.

    http://www.ohsu.edu/anesth/about/faculty/anderson.htm
     
  36. brycethefatty

    brycethefatty thefatone
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    I'm sorry, I wasn't being mean, really, I just have a really really dry sense of humor and you were an easy target, so please don't be offended. I was more trying to be funny than anything -- plus I didn't realize that you were just out of high school trying to apply for college -- so I'm sorry, but I got a kick out of it so I guess that's all that matters. Anyway, good luck to you.
     
  37. LeFort

    LeFort Junior Member
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    Back in the days, dentist could enroll in MEDICAL anesthesiology residencies for about 2 years and graduate as a dental anesthesiologist...

    for example Johns Hopkins and Robert Wood Johnson (which have no dental school) had a medical anesthesiology residency open to dentists

    However somewhere in the 90's probably because of the ACGME or reduced funding they stopped accepting dentists.

    Here is the evidence for what I am saying: "In 1977 Klein, Wollman, and Cohen 1 published an article in Anesthesiology in
    which they reviewed the practice of anesthesia by dentists. They proposed that
    anesthesiology training programs should help to improve the quality of dental
    anesthesia practice by providing anesthesia training to dentists. They said: “It is
    the opinion of the authors that it would benefit the profession of dentistry and
    the quality of outpatient dental anesthesia in this country in a positive manner if
    there were formally set aside a small number of anesthesia residencies for dental
    applicants who have good academic qualifications and show a desire for teaching
    and research on a dental school faculty.”" "International Anesthesiology Clinics, Volume 41(3) Summer 2003 pp 103-113"
     
  38. GatorDMD

    GatorDMD Suck ChocoSaltyBalls
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    but this kat at OHSU does Anesthesiology...not dental stuff. He teaches Anesthesiology residents and runs case just like any other attending.
     
  39. scalpel2008

    scalpel2008 beep beep beep...smash
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    i would like to make a few points:
    1. The American Board of Anesthesiology doesn't have him listed (unlike what his biography says which is probably a mistake)
    2. His "clinical interests" all sound like dental stuff
    3. His anesthesia training was only for 1 year which makes this all the more ridiculous
    4. He got into that department because he has a DMD. He'd have no chance with a DDS
    5. The state of Oregon is known for being weird
     
  40. aphistis

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    I'm glad somebody else was thinking some of these things too.
     
  41. armorshell

    armorshell One Man Freak Show
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    Epic win.
     
  42. GatorDMD

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    :laugh:

    they are weird.... but we got the top pick baby! Oden?
     
  43. LeFort

    LeFort Junior Member
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    brycethefatty : you seem to know a lot, I msgd you
     
  44. brycethefatty

    brycethefatty thefatone
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  45. skatertudoroga

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    would you be able to do dental anesthesia if you are an anesthesia m.d. who is not interested in hospital medicine? would an m.d. be able to get the low dental malpractice?

    why isn't dental anesthesia an attractive field for dentists if they can make a lot of money without worrying about overhead and cosmetic problems for their patients? and why is there any need for general anesthesia? I mean when I was a kid and had cavities they did not even give me lidocaine.. And I know that when people go to oral surgeons for implants(which i think is pretty traumatic) they still tend to get concious sedation done by omfs...
     
  46. skatertudoroga

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    Btw, what do you think would make one competitive for a toronto dental anesthesia residency if he went to dental school in australia? Would you need to write some kind of standardized exams or arrange an externship?
     
  47. armorshell

    armorshell One Man Freak Show
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    Implants really aren't that traumatic, much less in general than say, impacted wisdom teeth. Lots of patients say getting the implant is way easier than getting the tooth taken out in the first place.

    The drive for sedation dentistry is mostly from dental phobia, which is pretty commonplace, not from a discomfort/pain standpoint.
     
  48. skatertudoroga

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    Thank you.
     
  49. setdoc7

    Dentist 10+ Year Member

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    A lot of DA residencies opened in NY last year. Due to the accreditation standard set up by the ADA. I went to the national meeting of ASDA and they seem to have a pretty good group. Went to the DA program directors meeting and the 2011 class will be in the MATCH. This branch of dentistry is picking up.
     

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