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During my training, I had the privilege of also going through a one year anesthesia residency which was on top of the typical intensive anesthesia training that goes along with becoming an oral and maxillofacial surgeon. With this residency, I was able to work for the Department of Anesthesiology at Metro Health Center in Cleveland for most of my three years as a surgery resident. This was moonlighting as an anesthetist, most typically doing nighttime cases such as burns, heart procedures, and trauma. This was an unbelievably great opportunity in that these are highly challenging cases in terms of management which helped to greatly sharpen my skills and knowledge of anesthesia and medicine. I came into practice with a very healthy respect for anesthesia and in particular the importance of patient assessment and management of medical concerns.
Experience and Care With Dental Anesthesia
Over the years, we have seen a continued erosion in training standards and care standards for anesthesia with many practitioners entering into this treatment realm with little training and experience. Dental anesthesia is a good example of this, but marginal anesthesia training has been around in multiple medical specialties for some time. The idea has been to bring the cost of care down, but they have seen more cases of complications and problems. My observation is that drug selection and inadequate emergency preparedness are the main shortcomings leading to complications.
Attention to Detail
I am proud to say that in over 30 years of practice we have never had any serious anesthesia complications. I believe this is mainly due to our attention to detail (with monitoring and dealing with concerns before they become problems) along with a very conservative technique (titrated dose anesthesia). We have performed thousands of anesthesia procedures on patients of all ages.
Having said that, I am well aware that a serious problem could happen tomorrow. Maybe the important point is that we are prepared, trained, and follow safety protocols in this care.
Ask Questions About Your Doctor’s Background
Be aware that there are many doctors out there who may perform office based anesthesia, many with a minimum of training. Check you doctor’s background and training. Residency based training is most ideal. A board certified oral and maxillofacial surgeon should have excellent training. A specific anesthesia residency is even better. Then look at their office, staff, and equipment. Does it look up-to-date? Are they ACLS certified? Is their facility set up as a surgical care center with easy access for emergency medical service? Ask questions.
