For Dentists

asked questions.

Simply contact Nebraska Dental Anesthesia to either schedule a meeting in your office, or to further discuss your facility’s particular sedation and anesthesia needs. During this meeting we will discuss the steps required to obtain a state issued facility permit from the State Dental Board. Please be aware that most State Dental Boards take 2-4 weeks to issue this permit. Though this process can be cumbersome, we have completed it numerous times with other offices, and will help facilitate this process.  We’ve even established some professional connections which will help to speed up this process.

During the permitting process, your office will work with NEDA to schedule specific dates for these office-based services.  Once these days have been solidified, your office staff can begin to schedule patients for these days. 

When a patient is identified that meets the criteria for office-based sedation or general anesthesia and agrees to this care, your staff will start by creating a patient account within the Patient Portal System.  This Patient Portal will serve as the basecamp for completing all the steps necessary to prepare the child for our services, and is accessible by the patient, your office, and the anesthesia team.   In the Dentist Portal view, your office will be able to schedule the patient for future services on a specific date and the patient can begin to complete the required steps.  Should your staff identify a questionable candidate, they can let us know and we can review the patient’s medical history within the Portal.  If needed, we will consult with the patient’s physician(s) to obtain additional information to help us make a decision.  If we deem that the patient is indeed an ideal candidate, we’ll then verify the date for this treatment with your office and solidify the appointment.  For most healthy patients, this process can be completed without us physically seeing the patient prior to the day of service, however in some cases it may be necessary for us to examine the patient in person.  If this is the case, we will have you schedule us a brief consultation with the patient in your office when we are providing care for other patients.  This, in turn, will allow us to better assess the physical status, body habitus, and airway for certain patients.  During this brief consultation, the anesthetic procedure will be explained to the parents and all questions can be answered.  If accepted as a patient, they will be directed back to the Patient Portal to proceed with completion of the parental check-list. 

For those patients that are healthy, the Patient Portal will provide all the needed documents, consents, and information, as we won’t need to see the patient prior to the procedure.  In all instances however, a recent H&P must be completed by the patient’s pediatrician prior to the date of care (preferably conducted within the previous 30-days).  

In order to schedule sedation and anesthesia services with Nebraska Dental Anesthesia, your dental office will need to provide a full day’s worth of cases.  This may be 6-8 short cases, or possibly 3-4 longer cases.  When you secure our services for the day, you may schedule as many cases as you can complete between 05:30 and 14:30.  We’ll have your office schedule cases with 15-20 minutes between each to facilitate operatory turnover, recover the patient, and pre-op the next case.  The more efficient your staff becomes with this process, the more cases you’ll be able to complete during a typical day.

We will treat healthy infants, toddlers, children, and teenagers without hesitation.  Patients with more complex medical conditions will be evaluated on a case-by-case basis.  We will, however, routinely provide care for special needs patients who have no, or limited, system deficiencies.  We are happy to evaluate any patients you feel might be a questionable candidate for care in an office-based setting, but will never put you or your reputation at risk by taking on complex patients that are meant for care in a formal hospital setting.  Examples of good special needs candidates include otherwise healthy individuals with autism, cerebral palsy, muscular dystrophy, or syndromes which do not affect the airway.  Examples of poor candidates include morbidly obese patients, syndromes which cause facial deformities, and those with advanced respiratory or cardiac conditions.

In most cases it will not affect your premium, however, we recommend that you contact your liability insurance carrier to inform them that you plan to make office-based anesthetic services available using a third-party certified mobile dentist anesthesiologist.  Usually they will request a copy of the anesthesiologist’s liability insurance declaration or alternatively, request to be certificate holders on the policy (e.g. they would be notified if the policy is ever modified or cancelled.)

When you identify a candidate for sedation or anesthesia care, your office will first create a patient account within the Patient Portal System.  Once the parents activate their personal account, they will then be able to apply payments to their ledger using a link on the Patient Portal home page. 

Once scheduled, an initial deposit will be applied to reserve this appointment, while the remaining balance will be due no less than 24-hours prior to the onset of care.  Due to a delay in merchant service processing, only cash payments will be accepted if less than 24-hours prior to the procedure.

We recommend that your dental office charge a reasonable facility fee to cover the cost of any supplies that we may use while providing care in your facility.  This might include oxygen, cotton rolls, gauze, printer paper, toner, and fractional use of your staff.  Most offices charge an additional $100 to $250 facility fee to cover such expenses.  This charge should be documented within your dental office software as D9420…..Facility Fee.

The dental office will be responsible for maintaining oxygen and nitrous oxide tanks for use during the anesthesia care.  Without the presence of an adequate amount of oxygen, we will not be able to complete cases.  Oxygen may be stored in the form of several small E-cylinders (1 tank for every 2-hours of anticipated anesthesia care) or as an H-cylinder, as used in a centralized medical gas system. 

Otherwise, all medications, fluids, circuits, IV lines, and anesthesia and emergency equipment will be supplied by the anesthesiologist.  

You and your staff are required to maintain Basic Life Support Provider (BLS) certification and one individual (usually the dentist) is required to have either Advanced Cardiac Life Support (ACLS) or Pediatric Advanced Life Support (PALS) certification.  Because most dentists maintain these credentials as a requirement for their dental license or oral conscious sedation permit, these individuals will have no additional requirements.

We will provide the entire office with a sedation and anesthesia orientation prior to initiating patient care. 

This will include a front office seminar to help train your staff on presenting sedation and anesthesia treatment options, managing the Dentist & Patient Portals, and guiding them through the administrative process. While on the clinical side, we will help prepare your staff for supporting the anesthesiologist, patient management, and managing medical emergencies.  

Reoccurring training will also be provided to educate the entire staff on how to provide support to the anesthesiologist in the event of an emergency.  Individual staff members will be assigned basic responsibilities aimed at managing an emergency event.

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