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.
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!
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
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.
We met Dr. Shawn in Sept 2023 and in December, he removed our adult nonverbal son's wisdom teeth. Not gonna hold you, general anesthesia is billed incrementally (by the minute/quarter-hour) and is a heavy financial investment. I love this clinic because it really is a safe space for special needs families. There's a huge calm that accompanies knowing your dependent person is getting healthy. Dr. Shawn is exceptional. We drove 6 hours to get here so we'll choose a local practice for routine sedation cleanings down the road. I hope to see more neurodivergent acceptance built locally in our state's dentistry like this team has here. Meanwhile we are so grateful for this practice and grateful our son was in Dr. Shawn's care.
Response from the owner:Thank you so much for sharing your heartfelt words. We’re honored to be a place where families feel safe, supported, and understood. Your trust in Dr. Thoms and our team truly means so much to us.
Dr. Thoms and Robin are excellent in their care, concern, and support. Dr. Thoms explains everything and takes his time. If I have questions or concerns, he is easy to talk to and listens well.Robin is right there by my side throughout procedures. Her technical skills and professionalism are impressive. She is terrific!
Response from the owner:Thank you for your kind words! We’re so glad Dr. Thoms and Robin made you feel heard, supported, and cared for. We’ll be sure to share your wonderful compliments with them—they’ll mean so much!
Individualized care, expertise in general anesthesia, and attention to detail are why we keep returning for our son.
Response from the owner:Thank you for your kind words and continued trust in our team! We’re grateful to be part of your family’s care and truly appreciate your confidence in us.
The dental anesthesia center is hands down the best dental office I have ever been to. I neglected my teeth for years due to severe dental anxiety. I had work done under anesthesia with doctor hoffman who did an amazing job. Doctor Behl is not only a fantastic dentist but one of the nicest people I have ever met. The dental hygienists are both thorough and gentle. Stop your search and just go here
Response from the owner:Thank you for your incredibly kind words! We’re so glad our team could help make your experience comfortable and positive. We truly appreciate your trust and recommendation!
I had a great experience at the Dental Anesthesia Center. The reception area Personnel the Doctor-Dentist and one of his assistants all helped to make sure I was comfortable, informed and ready to get it done! Thank you Dental Anesthesia Center team!! CB
Response from the owner:Thank you for your kind words! We’re so glad our team could help make your experience comfortable and reassuring. We truly appreciate your 5-star review!
Their staff was truly caring and respectful in everything they did. The dentist explained what they found in the initial tests, asked us questions about our 82 year old sister, then explained the options that would give the best results.
Response from the owner:Thank you for your thoughtful feedback. We’re grateful for the opportunity to provide compassionate care and appreciate you taking the time to share your experience.
My hygienist, DeLaina Joost, takes excellent care of my teeth with her advanced skills, gentle touch and great “chair side” manner. She is a consummate professional, and such a compassionate person. I look forward to my visits at DAC!
Response from the owner:Thank you for your kind words! We’re so glad to hear you had a positive experience with our team and appreciate you taking the time to share your feedback.
Devon’s has received his dental services here for several years. The staff are always pleasant. Dr. Hoffman unmatched. His bedside manner is always welcoming. Devon receives amazing care and support based on his assessed needs. Feedback and instruction is clear and detailed. Follow-up is greatly appreciated. I appreciate their acceptance of differences and assurance that Devon will be taken care of.
Response from the owner:Thank you for your kind words and continued trust in our team! We’re grateful to be part of Devon’s care and truly appreciate your thoughtful feedback.
Best Dentists in St. Louis. Really a great dental experience. I have used this office for regular dental care, cavities, crowns, and cosmetic dentistry. Teeth look great.
Response from the owner:Christopher we apologize for the belated response. We are very pleased to hear you have a great dental experience with our office! Thank you for your kind words. We look forward to seeing you at your next dental appointment!
Dr. Behl!
I cannot recommend Dr. Maris Behl enough. If you have dental anxiety, she is truly the kind of dentist you hope to find. If teeth could be wrapped in pillows and protected by flying unicorns, Dr. Behl would somehow make it happen.
I have significant anxiety around dental procedures and have needed deeper sedation for dental work in the past. From the beginning, Dr. Behl took the time to listen to my concerns and made me feel genuinely heard rather than dismissed or rushed. She created such a sense of trust and safety that I was eventually able to have my dental work done with only nitrous instead of full sedation, which is something I honestly didn’t think I would be comfortable doing.
During my crown placement, she explained what she was doing throughout the procedure, which made an enormous difference in keeping me calm. She also took the time to address a filling that had been bothering me for what felt like forever — and she actually fixed the problem.
What stands out most about Dr. Behl is how safe I feel in her care. She is compassionate, patient, communicative, and incredibly attentive to how her patients are feeling. For someone with dental anxiety, that combination is invaluable.
Finding a dentist I trust this much has completely changed my experience with dental care. I am incredibly grateful to Dr. Behl and would recommend her without hesitation, especially to anyone who has dental anxiety or has struggled to feel comfortable receiving dental treatment.
Response from the owner:Thank you for such incredibly kind words! We’ll be sure to pass this along to Dr. Behl. We’re pretty sure the flying unicorns are going to be the part she remembers most! 🦄💙 We’re so glad our team could help make your experience a more comfortable one.
Dr Thoms and his team are phenomenal. No question, the absolute best possible option for my child when he needed work done while sleeping (age based). While this option is not inexpensive, this set up of have anesthesiology in-house allowed us to get his mouth healthy when a traditional pediatric dentist could/would not. I am a parent that asks a lot of questions on behalf of my toddler’s care and at no point did I feel judged for this, nor was I rushed during my evaluation process during the consultation. Although the procedure is not one I would like to repeat for my child, my husband and I were both so pleased with how well Dr. Thoms communicated and how he clearly cared for our son’s wellbeing (both physical and emotional during a less than comfortable visit). Cannot recommend the back of house team more highly.
My one detraction is the FOH staff (not everyone) were not nearly as pleasant. I would like to communicate that while their day-to-day is very routine for them, being in that office as a parent is very scary for some people in their office and a little bit of kindness goes along way. I do recall, having a very pleasant conversation with Rebecca, but otherwise everyone else was on the apathetic side, in my personal opinion. That said you’ll notice that I still am leaving a five star review because the dental staff really just knocked out of the park, but as a parent I want to encourage you to look past any rudeness you may experience over email or on the phone because Dr. Thom’s is really that excellent.
Response from the owner:Thank you for taking the time to share such thoughtful feedback. We’re grateful to hear that our team provided compassionate, attentive care and took the time to answer your questions throughout the process. We also appreciate your comments regarding your experience with our front office team and will certainly share your feedback. Your kind words mean so much to us!
I have Autism. I had my caregiver call ahead to give them a heads up. It was ignored. The building sits on the highway with major traffic next to building. The building is under construction and the inside of building was a mess with workers, trash and construction equipment everywhere. I tried to use restroom but it was filled with loud workers from building hanging out. I sat in waiting room for 45 minutes while another mentally challenged individual was very loud next to me the entire time I waited. The waiting room had debris all over the floor as if somebody spent hours moving ceiling tiles. When I was finally taken back it was by a person in training. They led me to a back area of office and asked me to sit in a seat. The building is completely open. They have nothing deviding you from seeing, hearing and being in the way of other patients. Just walking through the office I almost bumped into patients having work done. They have absolutely no privacy in this building. The floor of this dental practice was littered with trash. I took photos.Clients be warned! This is not set up for patients with anxiety. This is not set up for people with autism . This dentist is not set up for any sort of privacy at all. This is not a dentist for you if you like things clean. When I explained to staff I needed to leave, I explained to them why. Yet, they made me sit and wait for an office manager. After waiting 30 minutes I got up and left on my own. On my way out I could not find the exit. I walked around office while patients were getting work done. I almost bumped into numerous objects, dentist helpers and patients. This place is UNSAFE! Never have I seen somewhere that advertises for autistic patients and they have the office SET UP Like this. BEWARE! STAY AWAY IF YOU WANT PRIVACY! STAY AWAY IF YOU HAVE ANXIETY! STAY AWAY IF YOU ATE AUTISTIC! YOU HAVE BEEN WARNED!!!
Response from the owner:Thank you for taking the time to share this feedback. Privacy laws prevent us from discussing any individual's experience, but we want to speak to the concerns raised. Our office is set up as a surgery center, and our open layout is intentional. It allows our clinical team to maintain clear visibility and respond quickly, which is essential for patient safety. Our building is currently undergoing renovation, and we know the construction has created noise and conditions that do not reflect the environment we work hard to provide. That work is expected to be complete by the end of the year. We proudly care for patients with special healthcare needs and high anxiety, and every patient is welcome in our office. Anyone with concerns is welcome to contact our office manager, Marie, at 314-862-7844.
Very nice very convenient for me great people working
Response from the owner:Thank you for your kind words! We’re so glad you had a positive experience with our team. We truly appreciate your 5-star review!
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 3pm, 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.
