Getting Anesthetized To Fear Of The Dentist

Posted: December 27, 1990

Root canal. Fillings. Crown reconstruction.

For many people, even routine dental operations provoke responses of fear. For dental phobics, the fear is multiplied a thousand times.

Brian Moscow, a dental anesthesiologist, believes that dental phobics need not go through life shielding their teeth from the world. He believes the solution, in a word, is anesthesia.

"Ninety percent of my patients are people who want to go to the dentist, but don't want to hear a drill and can't handle a needle. We offer them the ability to wake up after an operation without any recall."

Combining his degrees in anesthesiology and dentistry, Moscow offers what he believes is a unique service: sedation for even the simplest procedures, including a simple buff of the teeth.

Patients who may not have seen a dentist for years, however, will probably require some more high-maintenance attention than routine cleaning, said Moscow.

"It's usually a case of four or five years of neglect, and reversing it in one day," he said.

Moscow, a 1981 graduate of the University of Pennsylvania Dental School, got his certificate of anesthesiology from the Medical College of Pennsylvania in 1985. He still practices anethesia there two days a week, in addition to his practice in Wynnewood.

But the versatility of his service allows him to take his skills to other dentists' offices; he makes about one "office call" every two months.

"I'm here to augment the businesses of other dentists," he said. "I'm affording them with an opportunity to expand their services to patients who they would otherwise struggle with."

Moscow has hired another anesthesiologist to assist him while he operates in his own office. When he makes his office calls, he administers the anesthesia while the other dentist works on the teeth.

Until last year, Moscow said, any dentist in Pennsylvania could take a weekend course and use simple anesthesia during dental surgery. Now, state law requires one year of an anesthesia residency program that is approved by the American Dental Association.

"I'm not knocking oral surgeons, but if someone is looking in the back of your mouth, they're not looking at your EKG or your anesthesia level," he said. "I don't believe that one person should do dentistry and anesthesia together," he said.

Since Moscow began his practice a year ago, he has developed a clientele of about 25 to 30 patients.

"We can do a three-hour root canal operation in one visit," Moscow said. ''Usually, an operation like this requires at least three visits."

That capability, Moscow said, attracts professionals with heavy schedules. ''They can come in for one long visit and we get the whole procedure over with.

"Not everybody is a candidate," Moscow said. "If I decide that someone is not medically fit, then I send them to the hospital. . . . I do not want to come across as a guy who says, 'Go to sleep and get your teeth pulled.' "

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