During my first residency in General Dentistry, I was trained by five oral surgeons who used general anesthesia, and I became fascinated by envisioning the benefits that anesthesia could have in all of dentistry, not just surgery. I understood that anesthesia would allow me to treat patients who were avoiding going to the dentist for whatever reason: too afraid, physical or mental disabilities, very young or very old, and so on. That was my vision – to be able to help as many people as possible keep their teeth and maintain good oral health. That was when I decided to do a second residency and become one of the few dentists to be certified as a Dentist Anesthesiologist.
In all 50 states, since just prior to 1976, in order to put someone to sleep in a dental office, the dentist has to be trained in anesthesia and receive a general anesthesia permit. Anesthesia training is not part of dental school training. There are important, rigid guidelines about who is allowed and qualified to put people all the way to sleep in a dental office, and that training has to be done in a hospital residency program like the one I completed at Long Island Jewish Medical Center. In New Jersey, in order to do what I do, a dentist must be certified by a General Anesthesia Permit from the NJ State Board of Dentistry under the state Attorney General’s office. Oral surgeons get some of that training, but those who get the most training are the dentists who, like me, are also board certified as anesthesiologists from national organizations.
Sedation is a lot different from general anesthesia, but it’s all part of the same spectrum. The lowest form of sedation would be something like talking to you, making jokes to make you laugh to calm you down. Special drugs to make you feel less anxious, like laughing gas (nitrous oxide). Orally administered pills such as Valium and Xanax-like drugs, are one level up from that. Next, there are IV-administered drugs to make you more comfortable and relaxed, which is known as moderate conscious sedation.
For some people, none of these levels work or are appropriate, so they are often best served with the next level up, general anesthesia, where the patient is not awake and so not aware of anything. If you’ve ever been in a hospital for surgery and the anesthesiologist puts you to sleep, there is a whole host of monitoring equipment for every aspect possible of your body’s physiology while you’re asleep. My dental office is fully equipped with the most advanced monitoring equipment to comply with state guidelines for standards of care.
As to the question of why I wanted to specialize in anesthesiology and dentistry, the answer is that it allows me to provide the full range of dental care, not only for people who have no problem going to the dentist and just want to keep their teeth healthy, but also to the many, many people who for a variety of reasons have not been able to access dental care.
Some people have so much anxiety about dental work, they won’t even walk into the office or reception room. If they know they will get anesthesia, they will agree to have the dental work done. People of all ages with autism spectrum disorder, ADD, ADHD, Alzheimer’s dementia, epilepsy and other neurological conditions, psychiatric disorders, musculoskeletal conditions may not be willing or able to cooperate or sit still long enough to have dental work done safely. There are those with an extreme hyperactive gag reflex that makes it impossible to put anything inside their mouths. Anesthesiology and dentistry allows me to help these patients get the dental care they need but, often, have been unable to receive. My mission is to make every dental patient’s experience as comfortable and pain-free as possible.
In addition to my practice, I do a lot of training and teaching. I lecture in hospital programs, county dental associations, the Greater New York dental meeting and others. Anesthesia residents from New York City come to visit my practice. Teaching other people to do what I do is my way of giving back to a profession that I love.
In my career, few recognitions have touched me quite so much as my recent designation as the 2018 recipient of the Leonard Monheim Distinguished Service Award from The American Society of Dentist Anesthesiologists (ASDA). I am humbled, but also excited that ASDA chose me from all my peers nationwide as deserving of recognition for excellence and service in our field. It affirms that my choice to help people through sedation dentistry and anesthesia was the right choice for my career and profession.
Specialty: Advanced restorative dentistry, Sedation Dentistry, Anesthesiology
Graduate: Fairleigh Dickinson University School of Dentistry
Rensselaer Polytechnic Institute, BS Chemistry
State University New York, Empire State College, MBA
Residencies: Middlesex General Hospital (Robert Wood Johnson Medical Center);
Long Island Jewish Medical Center (Northwell Health)
Fellowships: the American College of Dentists; American Dental Society of Anesthesiology; Fellow and Master, Academy of General Dentistry
Board Certification: American Dental Board of Anesthesiology, National Dental Board of
Affiliations: American Dental Association; NJ Dental Association; Monmouth & Ocean Counties Dental Association; American Society of Dentist Anesthesiologists; Academy of General Dentistry, American Dental Society of Anesthesiology
Awards: 2018 Monheim Award, ASDA
Special Clinical Interests: Instructor, Advanced Cardiac Life Support