The bottom line is this:
Implants do not belong to a single specialty. Implants are a multi-specialty discipline from General Practice, Prosthodontics, Perio and Maxillofacial Surgery. There are varying degrees of difficulty and procedures that can be provided by doctors in each specialty. There is plenty of work to go around for everyone. This turf-war really shouldn't exist. People need to know their limitations and know when to swallow their pride and make the right referral. Our job is not to place implants just because we know how, its to do what is BEST FOR THE PATIENT.
Anesthesia is a different area of contention... Any doctor who performs oral sedations or IV sedations without having ever intubated patients, seen the vocal cords, used LMA's, masked patients down, or manually supported their ventillation is simply a danger to patients. 20 IV sedation cases are a far cry from "SAFE". This takes extensive practice! This will never compare to the average of 250-400+ General Anesthesia Cases and 1000 plus IV sedations the average oral surgery resident experiences in their residency.
I will say however that I was pleased to read that some perio programs are starting to offer more "substantial anesthesia rotations." I can only hope that during those rotationst he perio residents are getting to run the general anesthetic cases from start to finish just as Oral and Maxillofacial Surgery residents do.
And as far as ACLS goes... its one thing to have the take the course, read the book and pass the class. Its another thing to have these principles drilled into your head on a daily/weekly/monthly basis, when you are an oral surgery resident dealing with life and death constantly. This becomes second nature.
Outside of the actual specialty of Anesthesiology (including CRNA's), Oral and Maxillofacial surgery has THE MOST ANESTHESIA training of ANY medical/surgical/dental specialty. Their safety record in the literature rivals and exceeds that of hospitals and surgical centers. I'm too lazy to look up the links for these studies, but maybe Dr. Ruska has it if the periodontists in the group need to see it for themselves...
If someone is so nuts about providing general anesthesia or IV sedations and they don't want to go through the intense training of maxillofacial surgery, then they should look into doing a Dental Anesthesiology Residency of 2-3 years length.
I do agree with an earlier post that more people in dentistry should get on the anesthesia band-wagon to help protect our rights from ridiculous legislation (like what happened with plastics/cosmetic surgery/OMFS in cali). To do so, we need to support organizations such as the American Association of Oral & Maxillofacial Surgery and the American Dental Society of Anesthesiology. These 2 organizations are our greatest advocates for our rights to practice.
ok, enough said... more later. Gonna go kick my periodontist friend's !$$ in a game of basketball. maybe i'll make out with his girlfriend too...
