The art and science of office-based anesthesia in dentistry: a 150-year history.

Abstract

Office-based anesthesia in dentistry dates back over 150 years to the discovery of general anesthesia itself, and the fields of dentistry and anesthesiology have maintained close ties ever since. Many of the world's firstanesthetics were administered in dental offices, and for years, more anesthetics have been administered for dentistry than for any other procedure. Today, dentist anesthesiologists continue to practice state-of-the-art anesthesia, upholding the proud tradition of dentists in the delivery of quality office-based services. Over the years, numerous improvements in the art and science of office anesthesia have helped the specialty of oral and maxillofacial surgery to achieve the distinguished status that it now enjoys as a respected member of the health care community. Historically, the willingness of a general dentist to refer patients to an oral surgeon for dental extractions had more to do with the surgeon's skills in providing general anesthesia than his or her ability to remove teeth. With major contributions coming from the dental profession, anesthesia delivery in the hospital environment has evolved into a scientific practice based on sound principles. Ironically, at present there is increasing pressure on physicians to move out of the hospital or surgery center operating room and, like their dental colleagues, perform more diagnostic and surgical procedures in the office setting. Dentists have demonstrated an enviable safety record in the practice of outpatient anesthesia, leading the way in developing techniques that permit rapid induction and recovery in the office for procedures that encroach on the airway. While the modern practice of office-based anesthesia for oral surgery has certainly benefited from the wonderful scientific progress seen in medicine, it remains an art with a proud legacy in the field of dentistry.