General Dentist knowledge of OMFS specialty

[Don'tSleep]

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Hi everyone. recent OMFS graduate here. I've been doing a lot of referrals marketing recently. I've noticed something that I think is the fault of both dental school education and the OMFS professional organization (AAOMS/ACOMS). Dentists seem to have a surprisingly limited understanding of what oral surgeons can actually do and their training.

Since starting in practice, one of the most common questions I get from general dentists is, “Can you sedate patients?” It has made me realize that many referring dentists may not have a clear sense of the full scope of OMFS training and practice. Literally every OMFS is trained/licensed to provide general anesthesia; it is a requirement for accreditation/graduation. Only dental anesthesiologists and OMFS can do provide this level of sedation/anesthesia. I'm struggling to explain to them that this is not just mild or moderate sedation. I also get the feeling some actually don't know the difference between the levels of sedation/anesthesia.

For the oral surgeons here: what aspects of our scope have you found general dentists are most commonly unaware of and how did you go about informing them of your skills? I’m especially interested in how people have successfully educated referral offices without coming across as overly promotional or coming off as "giving a lecture to them".

And for GPs: what services did you not realize an oral surgeon could provide until you started working closely with one? How could your oral surgeon have better informed you of what they can do?

 

[Pralk Nekorf]

Resident here. If I understand correctly, some states are beginning require that the OMFS who does the procedure is not the one doing the anesthesia. So yes, while every OMFS can sedate patients, it's possible that some can't due to state requirements. I remember hearing about this during interviews as this extends into residency, as in some programs one resident does the procedure while also pushing drugs and in others the chief does the procedure while the senior pushes drugs or vice verse. Also the statement that "Only DA and OMFS can provide this level of anesthesia" is technically true, but GPs can get moderate/deep sedation licenses as long as they limit the number of drugs to 2 or 3 and get away with it that way. You really only need GA for stuff youd be doing in a hospital anyway.

 

[Don'tSleep]

I was not aware that GP's can do deep sedation. Moderate yes, but not deep. First I'm hearing about certain states not allowing simultaneous operator/anesthesia provider. Any sources for this, because this is a huge deal for OMFS.

 

[axiumgod]

Resident here. If I understand correctly, some states are beginning require that the OMFS who does the procedure is not the one doing the anesthesia. So yes, while every OMFS can sedate patients, it's possible that some can't due to state requirements. I remember hearing about this during interviews as this extends into residency, as in some programs one resident does the procedure while also pushing drugs and in others the chief does the procedure while the senior pushes drugs or vice verse. Also the statement that "Only DA and OMFS can provide this level of anesthesia" is technically true, but GPs can get moderate/deep sedation licenses as long as they limit the number of drugs to 2 or 3 and get away with it that way. You really only need GA for stuff youd be doing in a hospital anyway.

No states have banned single provider sedation. Have you done your anesthesia rotation yet? The line between deep and GA is often slim, which is why we are credentialed and need to be proficient in both.

 

[Rush_motion]

a dentist that is not a DA or omfs can provide intravenous conscious sedation. One cannot provide deep sedation/GA unless there is a completion of a residency in DA or omfs.

 

[SuxDrugs&Rocuronium]

Resident here. If I understand correctly, some states are beginning require that the OMFS who does the procedure is not the one doing the anesthesia. So yes, while every OMFS can sedate patients, it's possible that some can't due to state requirements. I remember hearing about this during interviews as this extends into residency, as in some programs one resident does the procedure while also pushing drugs and in others the chief does the procedure while the senior pushes drugs or vice verse. Also the statement that "Only DA and OMFS can provide this level of anesthesia" is technically true, but GPs can get moderate/deep sedation licenses as long as they limit the number of drugs to 2 or 3 and get away with it that way. You really only need GA for stuff youd be doing in a hospital anyway.

GA is absolutely indicated for many out of hospital procedures and patients. Pediatrics? Good luck with moderate. Patients with high tolerances due to hx of drug use/other medical history? Have fun wrestling them during a moderate sedation. 5 hour procedure? Moderate isn’t gonna be fun for anyone during that long of a case

 

[LegendaryPanda]

Also a resident, but have my fair share of phone calls from GPs.
Most GPs have a good idea to send their most complex patients but sometimes they have this weird understanding that we're miracle workers.
One patient came when the GP couldn't get their maxillary teeth numb and so the GP called and asked if we can make an injection at foramen rotundum to numb them.
Had a GP friend who asked, verbatim, if we "do pituitary adenoma resections via the transsphenoidal approach" and I just answered, dude that's the brain... through the nose... What part of that is oral?