Dr. Hillel Feldman founded the American Society for the Advancement of Anesthesia in Dentistry (ASAAD) in 1929. Dr. Feldman had a pioneering spirit and sought ways to deliver painfree dental care. Dr. Feldman brought modern methods of delivering anesthesia into the dental operatories of his time. While our name is an old and cherished main purpose of our society, our mission in dentistry has changed with the times. Pain control in dentistry is the main purpose of our society. Today, this goal is achieved by the use of sedation, intramuscular sedation, and nitrous oxide inhalation sedation. Among the various forms of sedation, the intravenous route is the safest, most effective, and most predictable form of sedation.
ASAAD historically has been the only society in dentistry to tell and encourage the general practitioner that he can use and should use sedation in the office. ASAAD has and will continue to disseminate knowledge and training in sedation for those who desire to attain these goals. There has always been a prevailing belief that dentists do not possess the skill or ability to use sedation. These beliefs have been fostered in ignorance and in order to benefit certain dental self-interests. Most so called difficult or impossible patients are in reality terrified of receiving routine dental care. For these patients, the best chair-side manner and local anesthesia are not sufficient. The vast majority of these patients can be treated properly and in a calm, pain-free atmosphere with the use of sedation. The use of sedation is also especially effective for long, difficult procedures such as surgical placement of implants and periodontal surgery.
For the past 20 years, ASAAD has continually met the needs of general dentistry by offering courses that would qualify them for licensure in conscious sedation. This is recognized in 47 states. We will continue to give courses which meet these requirements.
The American Society for Anesthesia and Sedation in Dentistry (ASAASD) proudly sponsors an 80 hour, comprehensive, hands-on program in parenteral moderate sedation for dentists. The program provides training that is consistent with the ADA’s 2007 guidelines for the use and teaching of anesthesia and sedation by dentists. Program graduates have earned certification and practice parenteral sedation in many of the United States.
In considering whether to offer an enteral sedation course, the ASAASD carefully evaluated the ADA guidelines and educational requirements. Concerns regarding enteral sedation training include the following:
- titration is the technique that is most likely to produce satisfactory outcomes while offering patients maximal protection against oversedation;
- the oral route does not permit titration and does not eliminate the possibility of serious oversedation, the management of which may require a high level of preparedness and skill;
- emergency protocols including ACLS-level pharmacologic interventions rely to a significant degree on the ability of the clinician to obtain intravenous access;
- the skill required to obtain intravenous access is far more predictably maintained when this technique is used on a regular basis, and the clinician with limited training and little ongoing experience is less likely to apply such techniques successfully, particularly under duress.
As such, it is the position of the ASAASD that dentists who wish to practice any form of moderate sedation are best served by comprehensive parenteral training. The ASAASD recognizes that existing programs in enteral sedation do comply with regulations and do follow published guidelines. Nonetheless, it is the belief of the ASAASD that the knowledge and skills of more rigorously trained clinicians along with their ongoing and routine utilization of intravenous techniques, increases the likelihood that they will respond rapidly and appropriately to urgencies and emergencies that may arise whenever sedation in any form is administered.
The ASAASD will continue to focus its effort on educating clinicians who choose to commit to a comprehensive parenteral sedation course. The Society will also sponsor continuing education programs designed for the professional development of all dentists interested anesthesia and sedation.
If you are interested in bringing your practice to a higher level, please contact the society and inquire about the courses and training we offer. Instead of turning away frightened patients, you can now welcome them into your practice. The successful use of sedation in your office can become a source of many referrals. This society can give you the training, knowledge, and encouragement to successfully use this modality in your office. For additional information, please contact Dr. David Crystal at (732) 469-9050.