On February 17, 2023, the Canadian Dental Regulatory Authorities Federation approved the national recognition of Dental Anesthesia as a Specialty in Dentistry. Shall I be so bold to say “A New Era Has Begun”? As current President of the Canadian Academy of Dental Anaesthesia (CADA), I think I will be so bold as to name our dentist predecessors Dr. Horace Wells and Dr. William T.G. Morton, posthumously, as the first dentist-anesthesiologists, demonstrating nitrous oxide and ether to the world in 1844 and 1846, respectively.
“It became at once apparent to all the world that surgical anaesthesia had become a reality and that pain was no longer the master but the servant of the body.”
– J Collins Warren III MD, 1921
Since the time of Drs. Wells and Morton, the profession of dentistry has sought relief for our dental patients’ pain, suffering, and anxiety. There are few, if any, discoveries that have changed the world in such a dramatic and important fashion than the discovery of anesthesia. Canada is special in that it is only the third country in the world, joining Japan and the United States to recognize Anesthesiology as a specialty in dentistry.
Yellow Pages and VHS tapes
In this new era, Canadian dentists recognize that oral health is not achieved in isolation. Attached to biologic hard tissues is the inseparable psychological, and emotional well-being of our children, our adults, and their families. It is no longer acceptable to believe in the legacy notion that it is not in our professional scope of practice to address fear, anxiety, or physical limitations of involuntary movement, and/or behaviour. I would put forth that it is the penultimate reason that we exist and practise, and if not for a patient’s emotional and psychological well-being, there would be no point in practising at all. The tides of change are at our shores, and we may embrace them, or fight them, clinging desperately to outdated practice philosophies that have gone the way of the Yellow Pages and VHS videotapes.
A Gift to the Entire Profession
In this new era, Canadian dentists recognize anesthesiology as a gift to the entire profession. The CADA is an embodiment of this principle by its active leadership in supporting and sharing knowledge by way of education, research, and clinical training. Inclusivity of all disciplines of dentistry and the recognition of natural synergism between them is acknowledged by the CADA. Segregation and isolation of society and professional specialties serves no one positively in the long term and my hopes are that a holistic, cooperative, and multidimensional approach to anesthesia and dentistry will continue to develop.
A Growing Need for Dentist ANESTHESIOLOGISTS and Anesthesia In Dentistry
In this new era, Canadian dentists recognize that government officials, policy makers, as well as other healthcare professionals, need to be educated on the advances in the practice of anaesthesiology within dentistry. Many physicians are still innocently unaware of the wonderful resource represented by the unique and advanced training and practice of Canadian dentist-anesthesiologists. In this day and age of burgeoning operating room waitlists and massive shortages of skilled physician-anesthesiologists, it would relieve the economic and figurative pain of waiting to leverage expert practices of anesthesia for dentistry by dentists.
Pre-school children with early childhood caries have eclipsed all other reasons for requiring general anesthesia for over a decade. The aging demographics of Canada has seen the number of seniors afflicted with dementia now requiring sedation and general anesthesia for basic dental care in a parabolic rise. Special-needs patients, patients who have a sensitive gag reflex, and those with local anesthetic intolerance or allergy round out the populations in need.
The Future is Bright
Until now, organized dentistry in Canada has been without an official specialty in anesthesia but that has changed. Like the mobile phone and the internet, change is sometimes difficult to embrace but it comes with the procurement of benefits that are nothing short of life-changing. In 1956, Dr. Robert Locke, a University of Toronto dental graduate, completed the Dental Anesthesia program at the University of Pittsburgh. That program was lead by the dentist-anesthesiologist Dr. Leonard Monheim who believed, as did W.T.G. Morton, that anesthesiology belonged in dentistry. He returned to Canada, and in 1960 founded the first and only program of its kind in Canada at the University of Toronto. Dentist-anesthesiologists are now practicing in at least four provinces with other provinces now recognizing the specialty of dental anesthesia. Change is sometimes challenging but not always a bad thing and that means the future is bright for all dentistry and dental patients in Canada.
I leave you with my personal “why” as coined and popularized by author and personality Simon Sinek:
“In the service of humanity, we seek to abolish, the burdens of suffering from pain, fear, and anxiety through the gifts and science of anesthesiology in dentistry.”
About the Author:
Dr. Jason K. Wong, President, Canadian Academy of Dental Anaesthesia. Dr. Wong is past-president of the Ontario Dental Society of Anesthesia, and also past-president of the Waterloo-Wellington Dental Society. He has been engaged in full-time private practice in Kitchener, Ontario, for over 20 years at Dental Care Asleep, providing general anesthesia and sedation for dentistry for pediatric and adult patients.
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