Dental care for patients who thought it wasn’t possible.

Sleep dentistry is a term we use for dental care performed while a patient is deeply relaxed or fully asleep using sedation or general anesthesia. “Sedation dentistry” is the broader umbrella — it includes everything from mild nitrous oxide to deep IV sedation. Sleep dentistry usually refers to the deeper end of that range, where the patient is unconscious and has no memory of the procedure. Our office offers every level, and we tailor the choice to each patient’s health, anxiety, and treatment needs.

Dental anesthesia is for patients who can’t comfortably or safely receive dental treatment while fully awake. That includes adults with severe dental anxiety or phobia, patients with a strong gag reflex, children who can’t yet cooperate for long procedures, and patients with autism, cerebral palsy, Down syndrome, dementia, Parkinson’s, or other conditions that make traditional dental visits difficult. It’s also used for patients who simply need extensive work completed in fewer visits.

We’re not a general dental office that also offers light sedation — sedation and anesthesia are our specialty. We were the first board-certified dental anesthesiologists in Missouri, and we’ve been doing this in St. Louis since 1991. We’re a privately owned practice that proudly remains doctor-owned, not a corporate dental chain, which lets us keep our focus on patient-centered care. We’re also a certified clinical training site for the St. Louis University Graduate Program in Periodontics and the University of Pittsburgh Dental Anesthesiology Residency Program — other doctors come here to learn how to do what we do.

Sedation is one of the most carefully studied and monitored procedures in dentistry. In our office, deeper sedation and general anesthesia are administered by board-certified dentist anesthesiologists, with continuous monitoring of heart rate, oxygen, blood pressure, and breathing throughout the procedure. We review every patient’s medical history in detail and individualize the plan — what’s safe for one patient isn’t always right for another, and we say so when it isn’t.

That depends on the level of sedation. With nitrous oxide you’re awake but relaxed, and you’ll feel the work being done — just without the anxiety. With oral or IV sedation, most patients are deeply relaxed and either remember very little or nothing at all. With general anesthesia, you’re fully asleep and have no awareness of the procedure. We’ll walk you through your options before treatment so you know exactly what to expect.

Nitrous oxide wears off within minutes — you can drive yourself home. Oral and IV sedation can leave you feeling groggy for the rest of the day, so you’ll need someone to drive you home and stay with you for a few hours. After general anesthesia, most patients feel back to normal within 24 hours but should plan for a full day of rest. We’ll give you and your caregiver detailed recovery instructions before you leave, and we follow up the next day.

The first visit is a conversation. We review your medical history, talk through what’s brought you in, and answer your questions. If you’re comfortable, we’ll do an exam and discuss treatment options — including which level of sedation would be appropriate. You don’t have to commit to anything at the first visit. Many of our patients have avoided dental offices for years; we go at your pace.

Often, yes. One of the real advantages of working with us is that we can complete extensive treatment — fillings, extractions, crowns, even surgical work — in a single visit under sedation or general anesthesia. For patients who’ve put off care for years, this can be a meaningful relief. The specifics depend on your treatment needs and overall health, which we’ll review during your consultation.

No. Most of our patients haven’t been able to comfortably see a dentist for years, sometimes decades — that’s why they come to us. We don’t shame anyone for the state of their teeth, and we don’t lecture about what should have been done sooner. Our team is here to help you move forward, not look backward.

Special needs dentistry has been part of our practice from the start — Dr. Hoffmann and our team have worked with patients across the autism spectrum, with cerebral palsy, Down syndrome, intellectual disabilities, and sensory sensitivities for over 30 years. Before the appointment, we talk with you about your child’s specific needs and triggers, what’s worked and what hasn’t at other offices, and what sedation approach makes sense. You’re welcome to stay with your child throughout. Many caregivers tell us this is the first dental office where their child has been able to receive complete care.

Yes. Dental care for patients with dementia, Alzheimer’s, Parkinson’s, or other conditions affecting cognition and coordination is one of our core areas. We work closely with family caregivers to plan care, choose the right level of sedation, and minimize confusion or stress on appointment day. Patients can be brought in from home care, assisted living, or long-term care settings — we’ll help coordinate as much as we can on our end.

We file with most major dental insurance plans as a courtesy and help you understand your benefits. Sedation and anesthesia coverage varies significantly by plan — some cover it for medical necessity, some don’t cover it at all. We’re upfront about costs before treatment, give you a written estimate, and offer financing options for patients who need them. Call our office and we’ll talk specifics for your situation.