May 07, 2012
I read with both approval and dismay the letter from Dr. Michael Mashni (Feb. 20 ADA News). Dr. Mashni is certainly correct that all dentists who offer the range from mild sedation to general anesthesia must be adequately trained and conversant with advances in these practices. The safety and welfare of the patient is unquestionably the primary concern for all of us who administer these wonderful services.
However, I was stunned by the assertion from Dr. Mashni that "dentist anesthesiologists … have continually led the profession in authoring texts; conducting dental anesthesia research; and instructing students in various local anesthesia, moderate sedation and general anesthesia programs."
While I, as an oral and maxillofacial surgeon, am confident that dentist anesthesiologists have made contributions to the art and science of sedation and general anesthesia, I find Dr. Mashni’s position of superiority demeaning to both MD anesthesiologists and oral and maxillofacial surgeons.
Most oral and maxillofacial surgeons in this country are trained by a combination of MD anesthesiologists and oral and maxillofacial surgeons. Indeed, I believe we have been major pioneers for the last 50 years in advancing safe and painless office-based intravenous anesthesia.
This practice today, commonly midazolam, fentanyl and propofol, is widely utilized by not only my peers but gastroenterologists; ear, nose and throat physicians; and plastic surgeons. For Dr. Mashni to mislead the readers to assert "leadership" by dentist anesthesiologists is simply incorrect.
The American Society of Dentist Anesthesiologists should concentrate on improving relations with the American Association of Oral and Maxillofacial Surgeons in a shared effort to protect the anxious dental patient. Perhaps then the dentist anesthesiologist will gain support from oral and maxillofacial surgeons.
Impugning and ignoring our contributions to the literature and record of developing and refining safe techniques from sedation to general anesthesia only serves to impair the recognition of dental anesthesiology as an ADA-recognized specialty.
Gary D. Burnidge, D.D.S.