Physician-administered anesthesia care can be particularly beneficial for patients undergoing oral or dental surgery who have medical conditions, require deeper sedation, or may need advanced airway or physiologic management.

Patients who commonly benefit include:

Dental and Oral Surgery Procedures
Common procedures where anesthesia services are often requested include:

• Impacted wisdom tooth removal (one of the most common oral surgeries performed)
• Surgical tooth extractions due to severe decay or infection
• Dental implant placement
• Bone grafting or sinus lift procedures
• Exposure of impacted teeth for orthodontic treatment
• Treatment of odontogenic cysts or oral pathology
• Full-mouth extractions prior to dentures or prosthetics
• Complex restorative or full-arch implant procedures
• Alveoloplasty or pre-prosthetic surgery
• Facial trauma or maxillofacial reconstruction

Patient Comfort and Anxiety
• Severe dental anxiety or dental phobia
• Patients unable to tolerate procedures under local anesthesia alone
• Individuals requiring multiple procedures in a single visit
• Patients with strong gag reflex or difficulty remaining still during procedures

Special Patient Populations
• Children requiring dental surgery
• Elderly patients with multiple medical conditions
• Patients with developmental disabilities or special healthcare needs

Patients Seeking Physician-Level Medical Oversight
• Individuals who prefer anesthesia care delivered by a physician anesthesiologist
• Patients undergoing longer or more complex dental or oral surgical procedures
• Patients desiring hospital-level anesthesia monitoring in an office-based setting

Medical Conditions
• Heart disease (coronary artery disease, arrhythmias, heart failure)
• Lung disease (asthma, COPD, reactive airway disease)
• Obstructive sleep apnea or airway abnormalities
• Diabetes or metabolic disorders
• Hypertension or vascular disease
• Kidney or liver disease
• Patients taking complex medication regimens (anticoagulants, psychiatric medications, etc.)

Airway and Physiologic Risk Factors
• Obesity or difficult airway anatomy
• Severe obstructive sleep apnea requiring airway vigilance
• Patients with prior anesthesia or sedation complications
• Patients requiring advanced airway management or enhanced physiologic monitoring

As your anesthesiologist, my top priority is your safety and comfort throughout your dental or oral surgery.

🛡️ Safety

• Your airway will always be secured (other dental anesthesia providers may not secure your airway) and your vital signs continuously monitored.

• Any changes or concerns during your procedure will be addressed immediately with the appropriate interventions (versus if the dental provider was also operating there would inevitably be a longer delay to intervention).

💊 Comfort

• You will receive medications to manage pain, prevent nausea, and reduce inflammation.

• Your anesthetic care will be tailored specifically to what is best for you.

😴  Options for going to sleep:

1. Inhalational induction (default, most popular option) – gently fall asleep using a mask (1-2 breaths of an anesthetic gas)

2. Intravenous induction – medications given through an IV for a smooth, quick onset (tiny poke for IV placement)

🦷 During the procedure:

• Your airway will remain secured.

• If you requested an inhalational induction you may still get an IV depending on the situation.

• Vital signs will be monitored continuously no matter what.

• Once the procedure is complete, you will be gently awakened and monitored as you recover.

🏠 Postoperative Instructions

• Arrange transport home — do not drive, operate machinery, or make important decisions for the rest of the day. Your ride must be a family member or close friend, no taxi/rideshare.

• Feeling sleepy, fatigued, or mildly groggy is normal and usually improves within 24 hours, though some individuals may notice these effects a bit longer.

• Follow all postoperative instructions given by myself and the dental/oral surgery team.

Preoperative Care

Dr. Hine will call you to confirm your medical history and discuss the anesthetic plan.

If you develop a worsening sore throat, cough, fever, any new acute illness, or a flare of an existing medical condition, your procedure should be postponed. If you have any concerns about your health or safety, please seek immediate medical care by calling 911 or going to the nearest emergency department.

Please do not eat anything for at least 8 hours before the surgery. Non-human milk/formula 6 hours, breast milk 4 hours, clear liquid (water, sports drinks, black coffee, tea without milk) 2 hours.

Please wear short sleeves on your base layer to allow access to arms for physiologic monitoring purposes.

Instructions on which medications to continue before your procedure will be given by Dr. Hine. Please resume all medications as scheduled after your procedure unless otherwise instructed.

Please communicate everything you can regarding your medical history. Withholding information from your anesthesiologist may potentially compromise the quality of care given. Below are questions which may be asked:

• Medical history: neurological, pulmonary, cardiac, gastrointestinal, hematological, oncological, infectious disease, musculoskeletal

• Anesthetic history

• Medications and Allergies

• Supplements/vitamins/herbs, recreational drugs/substances

• Relevant laboratory and imaging studies depending on your medical conditions

Postoperative care:
Please arrange for a responsible adult to accompany you home after the procedure and remain with you for observation for at least 4–6 hours. You should not drive, operate machinery, or travel unaccompanied during this period. Your escort should be capable of assisting you as needed and monitoring for any unexpected symptoms during recovery.

You will also be provided with Dr. Hine’s personal mobile number for direct contact should any questions or concerns arise at any time following the procedure.

Payment is due on the day of your procedure (unless otherwise previously agreed upon with your dental provider). We accept mobile payments (Apple Pay, Google Pay, Samsung Pay, Venmo, Zelle), credit cards (Visa, MasterCard, American Express), check, or cash. FSA and HSA cards are also accepted.

Anesthesia services are separate from your dental treatment charges. Payments or deposits made for dental procedures do not apply to anesthesia fees.

Most dental insurance plans do not cover services provided by a physician anesthesiologist in an office setting, and medical insurance coverage is also uncommon. Insurance policies can be confusing — coverage is usually intended for anesthesia delivered by a physician anesthesiologist in a hospital or surgical center. Even with coverage, co-pays and deductibles often result in a patient balance that is higher than the anesthesia fees themselves.

Depending on the complexity of the case, dental offices may provide sedation administered by the dentist or oral surgeon while performing the procedure. In these cases you may not have to pay a separate anesthesia fee. This is different from anesthesia delivered by a physician anesthesiologist, which provides the highest level of patient comfort and safety and allows your dentist or oral surgeon to focus entirely on operating.

On rare occasions, insurance companies may approve anesthesia coverage after an appeal by you and your healthcare team. Please note that Dr. Hine does not bill insurance, and patients or guardians are responsible for anesthesia fees on the day of the procedure.

If you plan to submit an insurance claim yourself, we can provide a digital receipt and the necessary billing codes.

Preoperative/Postoperative Instructions

Anesthesia Consent