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/
