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.
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.
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.
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.
