The procedural differences between dentist and physician anaesthesiologists have recently been examined by US researchers.
Their findings are published in the current issue of Anesthesia Progress.
Dentist anaesthesiologists are a unique medical provider. Their training is related more closely to medical anaesthesiologists than to dentists in that they do not receive clinical training in dental or oral surgery.
During their three-year residency program, dentist anaesthesiologists receive most of their training in a hospital-based setting, performing a minimum of 800 cases of general anaesthesia, of which at least 125 must be performed on children younger than age seven. However, very little is known about the post-residency practice characteristics of dentist anaesthesiologists.
Using two main dental databases, the National Anesthesia Clinical Outcomes Registry (NACOR) and the Society for Ambulatory Anesthesia Clinical Outcomes Registry (SCOR), for dental and oral surgery procedures, the researchers from the Indiana University School of Dentistry in Indianapolis, Brigham and Women’s Hospital in Boston, and the University of California at San Diego, compared 7,133 office-based procedures performed by dentist anaesthesiologists with 106,420 in-hospital procedures provided by physician anaesthesiologists.
The information from the SCOR database focused on office-based settings, while NACOR included hospital-based. The data showed that in both groups children six years and younger were the predominant recipients receiving anaesthetic dental treatment (two-thirds of NACOR patients; three-fourths of SCOR patients); however, the average age for SCOR was approximately nine years and for NACOR approximately 12 years.
The researchers also found a 46 per cent longer surgical time for the cases from the NACOR database versus those from the SCOR.
Both databases noted that early childhood caries (tooth decay) was the main diagnosis for the dental procedures needing anaesthesia.
In reviewing the data, the researchers found a clear correlation between early childhood caries and the need for anaesthesia during dental procedures. Given that this is the most common disease among children six years and younger, paediatric dentists need dentist anaesthesiologists.
Overall, there is a consistent trend with more dental anaesthetic procedures being performed in an office-based setting, particularly for paediatric dentistry.