Wondering why your dentist referred you out for sedation instead of doing it in-office? Here is what actually decides who can sedate you. Call (314) 862-7844.
The short answer is that sedation is not one service. It is a range of very different levels of care, and the training, licensing, staffing, and equipment required at each level are different. Most general dentists are licensed for the lighter end of that range and refer out for the rest.
I have been going here for 30 years and the extra care they take is outstanding.
Response from the owner:Thank you for your kind words and longtime support! We truly appreciate you taking the time to share your feedback and are grateful for the trust placed in our team over the years.
It was thorough professional and informative. I was satisfied with consultation and look forward to having my dental needs addressed
Response from the owner:Thank you for your 5-star review! We appreciate your kind words and are grateful you took the time to share your feedback. Thank you for your support!
Everything went great today for her surgery but I do have some feedback about other things. My daughter was scheduled to be put to sleep to undergo a root canal. They ended up needing more anthesia which I was willing to pay for. Surgery was supposed to be an hour (I was told this before they started), and it ended up being 2 hours because of some minor complications. Noone came to the lobby to inform us. When it was over, I asked to see her. They said I had to pay first. I just paid almost 5k and they were more worried about an additional $300 before allowing me to see my daughter? This didn't sit right. I didn't say anything. I paid the bill and went to see my daughter. Dr. Hoffman is the nicest man I have ever met! He was outstanding.
Also, in the weeks before her surgery, the office appeared to not communicate. I would receive a call saying one thing then someone else would say another. They were never on the same page.
Last week, they needed to speak with me to confirm a few things. They called me at 8:16am then again at 1:06pm. Leaving me a voicemail that if they do not hear from me they were going to cancel her surgery. Wow! I work. I work 8am-5pm. I do not have access to my phone during those hours. They did leave a voicemail and I would have called the next day but they did not give me a chance before sending me an email threatening to cancel.
Also, they had called me several weeks before to inform me I had no insurance. I called my insurance company and they said I did. Not sure what happened but it resulted in unnecessary phone calls during my only free 20 minutes at work.
If your appointment is at 10am, do not plan on seeing anyone for awhile. All our appointments ran an hour behind.
I think Dr. Hoffman is wonderful but the office staff needs some help.
Not friendly at all. Noone even smiled!
The nurses in the room with my daughter were great too.
Response from the owner:Thank you for your feedback and kind words about Dr. Hoffmann and our clinical team. We appreciate you taking the time to share your experience. Your feedback is valuable to us as we continually strive to provide the best possible care and experience for every family.
Response from the owner:Thank you for the 5-star Google review! We truly appreciate your support and are grateful you chose The Dental Anesthesia Center!
Everyone took time to address our daughter directly. They explained each step to her, even though she is nonverbal and most likely would not respond. No one acted afraid of her. This means a lot to us. Thank you for seeing her.
Response from the owner:Thank you for the 4-star review! We believe everyone deserves to feel seen, respected, and valued, and we’re grateful your experience reflected that. ❤️
I went to nervous and 3 to 4 hours later, I essentially woke up in the car on my way home without realizing anything had happened. If you have trauma with previous dental issues, this is the place. I have a had severe dental trauma my entire life. Until now, they are all fantastic.
Response from the owner:Thank you for your kind words and for sharing your experience. We’re grateful our team could help provide a comfortable experience and appreciate your trust in us.
Our experience was wonderful. Our Down’s Syndrome son is very apprehensive about his appointments, but Dr. Thoms and all of his staff made our son more compliant. Each member seems vested in their job and are so kind and caring. Thank you for a positive experience.
Response from the owner:Thank you for your kind words! We’re so glad your family had a positive experience. Our team takes great pride in providing compassionate, individualized care, and your feedback means so much to us!
I had a dental problem that needed attention quickly. They got me in the next day and we identified the problem and came up with a great solution. I have been going there for over 10 years and they always come through.
Response from the owner:Thank you for your continued trust in our team over the years! We’re always happy to help and truly appreciate your kind words and recommendation!
Always a great experience. Carrie does a wonderful job keeping my smile healthy and bright. Dr. Thoms is always very nice and professional. They make going to the dentist much less stressful!
Response from the owner:Thank you for the great feedback! We're so glad Carrie and Dr. Thoms have made your visits comfortable and enjoyable.
I’ve had wonderful experiences at this dental office. The team is professional, the care is top-notch, and appointments run smoothly. I’ve never had to wait long in the waiting room. I highly recommend them!
Response from the owner:Thank you for your kind words and recommendation! We’re so glad to hear you’ve had such positive experiences with our team. We truly appreciate your support!
I love coming to the Dental CENTER , all the ladies are so nice and they keep you up to date. Dr. Belah is great and Carrie are so good. They do a great job.
Response from the owner:Thank you so much for your kind words! We’re thrilled to hear you’ve had such a positive experience with our team. We’ll be sure to share your appreciation with Dr. Behl, Carrie, and the rest of the team!
Dr. Hoffman is a friendly individual and readily answers can't questions you may have. His office staff are all friendly. One in particular,Meaghan, has learned to put up with the grumpy old guy from Illinois. I would recommend you give these people a try for your special needs relative.
Response from the owner:Thank you for the kind words and recommendation! We’re so glad to hear you’ve felt welcomed and well cared for by Dr. Hoffman and our team. And we’ll be sure to let Meaghan know she’s doing a great job putting up with our “grumpy old guy from Illinois!”
The Best Dental Office In St Louis! Thanks for keeping my pearly whites shining! … back again and they always do a great job and make me feel comfortable! They have an exceptional staff who are friendly and also very good at their jobs!!
Response from the owner:Thank you so much for the wonderful review! We’re thrilled to hear that you always feel comfortable and well cared for. Our team truly appreciates your kind words!
The practice is top notch. Could not ask for better care. Wish dental care was more affordable.
Response from the owner:Thank you for your kind words! We’re grateful for your feedback and are proud to provide high-quality care in a supportive environment.
The best staff for dealing with my level 3 non verbal autistic son. Very understanding and supportive.
Response from the owner:Thank you for your kind words! We’re so glad our team could provide a supportive and understanding experience. Your feedback means so much to us!
Dr Thoms is the best. He and his team are very attentive and extremely dedicated to the dental care for our special needs son
Response from the owner:Thank you so much for your kind words! We truly appreciate your recognition of Dr. Thoms and our team. Providing compassionate, attentive care is at the heart of what we do!
We brought our 1.5 and 3.5 year old daughters here for cleaning / check ups. Our dental hygienist Laina was amazing...made them feel so comfortable. They had a great time and keep asking when they can go to the dentist again. Dr. Hoffman was great too and made everything super quick and not stressful. Great place for kids in addition to adults!
Response from the owner:Thank you for your kind words! We’re so glad to hear your little ones had such a positive experience. We’ll be sure to share your compliments with Laina and Dr. Hoffman! 💙
Every person in the office is so personable. That first off makes you comfortable. But then the methods used to clean my teeth, particularly. I don't feel a thing, and it's the first time in my life that I haven't. And I have a lot of anxiety about dental work, and I really do not feel a thing when my teeth are being cleaned
Response from the owner:Thank you for your kind words! We’re so glad our team could help make your experience comfortable and relaxing. It means so much to know you felt at ease with your care!
I came here with my 18 year old daughter who has an immense fear of Doctors and Dentist , The kindness and understanding without any judgement we received from Dr.Thom was just unbelievable. The work he did on my daughter was life changing for her . I would recommend him to anyone . Just amazing, kind talented Doctor.
Response from the owner:Thank you so much for your heartfelt words! It means a great deal to our team to know that you felt welcomed, understood, and cared for. We’re especially grateful you shared how meaningful your experience was.
Sedation Is a Range, Not a Switch
Patients often use “sedation” and “being put to sleep” to mean the same thing. Clinically, they are far apart.
Moderate sedation leaves you drowsy and relaxed, able to respond to voice or touch, and often with little memory of the appointment afterward.
Deep sedation means you are not easily roused and may need help maintaining your breathing.
General anesthesia means you are fully unconscious for the procedure, with your airway and vital signs managed continuously.
The important part is that these levels are not separate boxes. Sedation is a continuum, and people do not all respond the same way to the same dose. Age, weight, medications, sleep apnea, and heart or lung conditions can all shift where someone lands. A patient given a moderate dose may drift deeper than intended. That possibility is the reason the rules exist.
Why Training and Permits Decide Who Can Do What
Because a patient can move deeper than planned, the standard across dentistry is that a provider must be trained and equipped to manage a patient one level beyond the one they intended to deliver. Someone offering moderate sedation has to be prepared to manage deep sedation if it happens.
That readiness is not something a dentist can add to an existing practice in a weekend. Deeper levels typically require formal residency training in anesthesiology, a separate state permit for each level, specific monitoring equipment, emergency medications and airway tools on site, a trained team, and periodic facility inspection. Missouri, like most states, issues those permits level by level.
So when your dentist says no, they are usually telling you something accurate and responsible: this level of care sits outside what their license and setup allow. A dentist who agreed anyway would be the one to worry about.
Someone Whose Only Job Is You
There is a second reason, and it may matter more than the paperwork. During deep sedation or general anesthesia, someone needs to watch your breathing, oxygen levels, heart rhythm, and blood pressure continuously and respond the moment anything changes. That is difficult to do well while also performing dental work that demands full attention.
In a practice built around anesthesia, those are two separate roles filled by two separate people, and the room, the monitors, and the recovery process are all set up for it in advance rather than borrowed for the day.
A Referral Is a Good Sign
It is easy to read a referral as rejection. It usually means your dentist recognized that your needs called for a different setting and sent you to one. Many patients we see arrive exactly this way, and their dentist often stays involved in the plan afterward. You also do not need a referral to reach us. If you have simply decided that traditional appointments are not working for you, you are welcome to contact us directly.
Frequently Asked Questions
In many cases, yes. Some patients receive routine care with their dentist and come to us for treatment requiring sedation or anesthesia. Others prefer to have everything done in one setting. Your consultation will cover what makes sense for you.
Every level carries its own considerations, which is why the health history review and monitoring matter so much. The right question is not which level is safest in the abstract, but which level suits your health and the treatment you need.
That is what a consultation is for. Nothing gets scheduled before you understand the plan.
Consider Contacting Us Today
If you have been told “no” once, you may assume the answer is “no” everywhere. It is not. This is the care we are built around, and your first conversation with us is just a conversation.
Call The Dental Anesthesia Center at (314) 862-7844, Monday through Thursday, 7 a.m. to 4 p.m., or Friday, 7 a.m. to 2pm, or request a consultation through our contact form. We are at 950 Francis Place, Suite 305, in Clayton, serving patients throughout the St. Louis area.
