Specialized sedation options for patients with cognitive disabilities at DAC, where we make dental care comfortable and accessible.
For individuals with cognitive disabilities, a visit to the dentist can present unique challenges that extend far beyond typical dental anxiety. Sensory sensitivities, communication difficulties, and challenges with following instructions can transform routine dental care into a deeply stressful experience for patients, caregivers, and dental professionals alike.
Seeing Dr Hoffman at the Dental Anesthesia Center has been one of the best decisions I have made in my life. Dr Hoffman and all of his staff, the other dentists, the dental assistants and the front desk personnel are the absolute best. Everyone I’ve encountered in the office have been so kind, patient, professional and compassionate. I will always have a degree of dental anxiety, but everyone shows such compassion and understanding, that it really helps make you feel less anxious.
Our son, Jimmy Henderson , has been having all of his dental care done by Dr. Michael Hoffmann and his team at the Dental Anesthesia Center for the past 10 years. He goes there once a year and they put him to sleep, clean his teeth, take x-rays and fix anything that needs to be repaired. They are such a blessing for us and our son. He couldn’t tolerate a regular dentist. We heartily recommend them for your dental care. Terry & Debbie Henderson
Dr. Hoffmann and his awesome staff are always on time and do a great job. A very professional group of people providing excellent dental care.
Response from the owner:Thank you for your kind feedback! We’re grateful for your support and proud to provide timely, professional care to our patients.
I am happy to see dentists finding ways to make things easier for those who don't like to go to the dentist. I have even seen some dental offices that have been tricked out to make the little patients to think that he or she is in a much different place than the dentist office. Historically the building was built in the 1950s and the office used to belong to an opthamologist.
Response from the owner:Thank you for your thoughtful review! We're dedicated to creating a comfortable space for all our patients—especially the little ones.
Absolutely highest quality service and staff! My son was treated so well and it made a scary appointment easier for him to handle. If I could, I’d give 10 ⭐️!
Response from the owner:Thank you so much for your kind words! We're thrilled to hear that your son had a positive experience and that we could make his appointment easier.
Christy and Dr. Behl spent a lot of time with me making sure I was comfortable and my anxiety was not ramping up. They both explained exactly what they were doing before they did it and gave me frequent breaks to catch my breath.
Response from the owner:Thank you so much for your kind words! We're glad you felt comfortable and cared for throughout your visit. Your trust means a lot to us!
I've been with this group for about a decade & can't say enough good things about them. From the dentists to the hygienists to the desk staff, they are fabulous. I have incredibly high anxiety when it comes to dental work & they go out of their way to make me feel as comfortable as possible. I've never had a bad experience & if it wasn't for them I'd still be getting dental cleanings under real anesthesia due to the fear. They turned that around for me & while I still feel anxiety, I'm able to get cleanings without any anesthesia, pills, gas, etc. I've had both large scale & routine work done there & highly recommend them. Extremely helpful, professional & pleasant staff all around. Wonderful people.
Response from the owner:Thank you so much for your trust and kind words! We're honored to have helped you overcome your dental anxiety and appreciate your recommendation.
I cannot express how grateful we are for Dr. Thoms and his team! Their sensitivity, expertise, and dedication made a potentially challenging dental experience for our daughter as comfortable and stress-free as possible (for her AND us!).
We were very impressed by Dr. Thoms' thoroughness in explaining the procedure and his willingness to answer all of our questions, alleviating any anxieties we had. The ability to be present by our daughter's side as she was falling asleep was a huge comfort factor.
We felt a sense of genuine care and compassion towards our daughter and felt that they treated her as if she was one of their own. Dr. Thoms and his team clearly go above and beyond to provide exceptional patient care and makes a complex dental procedure feel safe, comfortable, and even reassuring. A huge THANK YOU to Dr. Thoms and his team!
Response from the owner:Thank you so much for your heartfelt review! We’re truly grateful for your trust and are so glad Dr. Thoms and our team could make the experience as comfortable and reassuring as possible for your family. It means the world to know you felt supported every step of the way!
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.
The Dental Anesthesia Center (DAC) is truly unique. They provide all forms of anesthesia - and a wide range of dental treatments. I have been a patient there for 17 years - and I continue to be impressed with the legacy of expertise and kindness built by Dr. Hoffmann and his team.
If your dental phobia and dental issues have made you feel hopeless ... I encourage you to contact the DAC for a consultation. That's what I did 17 years ago - and it proved to be a very good decision and a true blessing.
Response from the owner:Thank you for your continued trust and kind words! We're honored to have be part of your journey. It means so much to know we've made a lasting impact—your story is truly inspiring!
I just had my first visit with Dr. Thoms. He took his time and thoroughly explained everything to me about sedation and dental procedures. He is extremely knowledgeable and very friendly. Comfort of their patients is utmost in their minds at this practice and Dr. Thoms, Emily and Robyn are outstanding! Highly recommended!
Response from the owner:Thank you for the wonderful review! We're so glad your visit with Dr. Thoms was a great experience. We truly appreciate your kind words about our team and are grateful for your recommendation!
I just had my implant surgery 3/22 with Dr. Thoms.The patients Dr. Thoms has with me is simply INCREDIBLE!!!!! I know I’m a lot to deal with. I am so blessed to have crossed paths with Dr. Thoms.His entire staff goes above and beyond ANY dental office I’ve ever dealt with in the past. from the bottom of my heart, I am so glad that I made the decision to try the dental anesthesia center..
Response from the owner:Thank you so much for your heartfelt words! We're truly grateful you chose us and are honored to be part of your journey. Dr. Thoms and the entire team are so glad to have made a positive impact—your trust means everything to us!
Dr. Hoffman and team are the most amazing dental team you will ever meet. Have been a patient for years and will continue to do so. If you have nerves about going to the dentist, they will eliminate those fears very quickly.
Response from the owner:Thank you for your kind words and continued trust in our team! We're so glad to hear you've had a positive experience. We truly appreciate your support!
AS I SIT HERE THIS MORNING I AM GRATEFUL FOR GOD'S MERCY AND THE STAFF OF DOC. HOFFMAN !!! I AM HOWEVER STILL TO EMBARRASSED FOR THE WALK OF SHAME BRINGING HIS GIFT . I LOST TWO DAYS AND WAS CHOKING ON 19 STICHES EATING SUCKERS SAME DAY SEEMS TO BE WITH MYSELF !!! SO WITH MY SINCERE APPRECIATION, I APOLOGIZE TO ALL !!! EXCELLENT SKILLS IN ALL ASPECTS.
Response from the owner:Thank you so much for your 5 star review. We appreciate your support.
As a 73 year old man, I have been to several dentist’s and none compare to Dr. Thoms and Dr. Behl. The entire staff is very knowledgeable and accommodating. I have had some major work done and I/V sedation is definitely the way to go. Five stars to the entire team at DAC. I highly recommend their services.
Response from the owner:Thank you for your kind words and recommendation! We truly appreciate your trust in our team. It’s always our goal to provide comfortable, high-quality care to every patient.
These folks are great!! Always very professional and personable and don't try to over sell you on what you need done!! I would highly recommend!!
Response from the owner:Thank you for the kind review! We’re glad to hear you’ve had a positive experience with our team. Your recommendation means a lot to us!
I love my friends at the Dental Anesthesia Center! This place has the nicest clinical staff and they do such a wonderful job for any issue that arises. They are prompt and thorough. I love all the hygienists, but especially my personal hygienist, Carrie. My dentist, Dr. Biehl is knowledgeable, friendly, highly skilled and fun.
I started taking my kids here when they needed procedures under anesthesia. Once my former dentist retired (and I realized the DAC also does family dentistry), I switched the entire family to this office. Best decision I ever made.
I’m also so impressed with the experience this team has treating individuals with special needs.
Response from the owner:Thank you so much for taking the time to post your kind review!
I went for a consultation at the center. I was terrified. I saw Dr.Sean Thoms he was so professional and caring. I have had five different consultations at other dentist offices trying to make a final decision on who I feel more comfortable with and no other doctor was as caring or attentive as Dr. Thoms. He called me a couple of days later with SEVERAL different ways he could give the results I wanted. I’m truly blessed to have found Dr Thoms. The entire staff was so professional and attentive. I have made the final decision to put my care in the hands of Dr Sean Thoms
Response from the owner:Thank you for taking the time to share your experience with us, Juanita. Your positive words mean so much to us.
Cheers,
The Dental Anesthesia Center
Maris E. Behl DDS Is a wonderful dentist. She did extensive work including several dental crowns and fillings. There was little to no pain during all of her procedure’s. I am 86 years old and have been to more dentists than I can count. Dr Behl is by far the best of all. If you want a friendly disciplined and accomplished dentist, you will be glad you used her work.
Response from the owner:Thank you so much for your kind words, James. We really appreciate you taking the time out to share your experience with us.
Cheers,
The Dental Anesthesia Center
I recently had fillings done by Dr. Thoms. His crew that was helping prep me to go under did an amazing job. I have really bad trauma (& anxiety) from previous dental work and permanent nerve damage from a surgery I had in 2021. The staff and Dr. Thoms made sure that I was calm and comfortable. This has probably been the best experience I have ever had, thanks to this dental clinic. The front end staff is patient and kind to their patients. I would most definitely recommend anyone to go here if they have dental anxiety. Dr. Thoms explained everything very thoroughly during our consult months prior and also the day of my fillings. After we were finished with my filings, I told him about my bottom teeth pushing too much on my 8 and 9 (another issue I had been dealing with after my last dental surgery), he was more than happy to help and filed down my bottom teeth. I am relieved that he was able to do that for me, even though it was not initially planned. The price of the fillings, anesthesia and odontoplasty/enameloplasty was reasonable. I wouldn't want to pay any less because the outcome was worth it.
Response from the owner:Thank you for your kind and detailed feedback. We're so glad to hear you felt comfortable and supported throughout your experience. It means a lot to know our team made a positive impact—we truly appreciate your recommendation!
The entire staff is always very compassionate and patient with my daughter who’s autistic😊 I am a patient as well the staff and the doctor are very knowledgeable and are capable of answering every question explaining in detail to my satisfaction. I am in the process of bringing my grandson to become a patient as well keep up the superb service 👏
Response from the owner:Thank you for your thoughtful review! We truly appreciate your trust in our team. Your kind words mean a lot to us.
I would highly recommend DAC to anyone. I brought our two boys (ages 6 & 3) in to have their routine cleaning. The moment we walked in we were greeted with smiles and warm hellos. The staff does a great job of talking to the boys, saying hello, and making them feel extra special. Carrie cleaned their teeth, and she is awesome. The boys were both so comfortable, she tells them exactly what she is doing, and makes sure they are ok the whole time. She talked with them about their summer plans, school, and fishing. Then Dr. Behl came in to check everything out. She was so personable, informative and positive with the little ones. She explained things very well, and she was so patient as they asked questions or had something to tell her. Thank you to all of the staff at DAC, for being so warm and making this a great experience for the little ones.
Response from the owner:Thank you for your wonderful feedback! Our goal is to make every visit comfortable and enjoyable, and we appreciate your kind words about our staff.
I skipped going to the dentist for 6 years and what a mistake that was. Everyone at this office is extremely nice and a pleasure to deal with.
Laina, their hygenist is awesome even though she is a Cubs fan. I actually look forward to my 3 month cleanings now and will not miss another.
Dr. Thoms and his team (I requested Julie as an assistant I would do the same :)) were amazing. As I said I skipped going for 6 years so I had some work to be done and chose to be put to sleep instead of 4 visits. They make sure you are as comfortable as possible and even take the time to check up on you after to make sure you are healing properly.
Last but not least, Marie and the entire front office are great. Always a pleasure to deal with and are very accommodating. They are the face of the operation and the tone of the visit is set with them. The amount of care and compassion they show the patients in the waiting room is beyond extraordinary.
Response from the owner:Thank you so much for your generous feedback! The pic really puts this review over the top! We truly appreciate your trust in our team. We're so glad your experience has been positive.
I have a special needs son that needed some work done. The Dental Anesthesia Center is an amazing place I can't imagine Trevor being in any better hands. We love Dr. Thoms and his staff. So nice and caring. A little on the expensive side but very well worth the care he received. I would recommend to anyone that has special needs, fear of dentistry or just in need of a dentist.
Response from the owner:Thank you for your kind words and trust in our team. We’re honored to provide care in a supportive and compassionate environment. Your recommendation means so much to us!
It can be frightening to have to put a two-year-old under anesthesia. The staff and Dr. Thoms took the time to explain the treatment options. The process went well, and the services were outstanding. Everyone was polite and empathetic, from the front desk receptionist to the dentists. The customer service was excellent. I rarely post reviews, but I do so because I want others to know that they can trust and feel safe with their care. The Dental Anesthesia Center comes highly recommended from this mama bear.
Response from the owner:Thank you for your thoughtful words and recommendation. We understand how important trust and compassion are, especially when it comes to little ones, and we’re honored to have create a positive experience!
My son has autism and a lot of anxiety around medical procedures. This is the most understanding and compassionate group of people, I am so grateful we found them. The doctor calls personally to check up on us after the appointment. Even though we only come once a year they remember my son's needs without me having to explain everything all over again. They are always on time, organized, and transparent about billing. I wish all of our medical appointments could go as smoothly as they do here.
Response from the owner:Thank you for your kind words! We are so happy to hear that your experience with our team has been positive. Providing compassionate care is our top priority, and we truly appreciate your trust in us.
Absolutely wonderful! My five year old had to have extensive dental work done and from start to finish the dental anesthesia center delivered five star work ! Going to the dentist is scary enough but having to take your own child to be put under was next level and the care he received from the nurses and dr was mind easing.
Response from the owner:Thank you for your kind review! Your trust in our team means a lot to us, and we’re grateful to have been able to support you both.
Very kind and compassionate staff. They took excellent care of my special needs kiddo and took extra time to make sure it was done right. I would highly recommend.
Response from the owner:Thank you for your kind feedback! It means a lot to us that you’d recommend our team, and we truly appreciate your trust in us.
beyond pleased with our experience with Dr. Hoffman!! My son, Cameron, had work done and everything turned out way better than I could've ever expected. Dr Hoffman saved all of his teeth, where other dentist told me the only option for two of his teeth were to be pulled. His smile is so beautiful and I couldn't think them enough! They were sooo kind!! The dental hygienist were so sweet, and throughly explained everything to me. There was no judgement. They made this whole process so comfortable. Yes, it was pricey, but worth EVERY penny. Thank you, thank you, thank you!!!
Response from the owner:Thank you so much for taking the time to share. We are so appreciative.
Dr Sean Thoms and his staff were great! The office is very welcoming and they yook very great care of my 2year old. I would recommend them to the world!
Response from the owner:Thank you so much for the 5-star review!
Understanding the Dental Challenges Faced by Patients with Cognitive Disabilities
Patients with cognitive disabilities—including those with autism spectrum disorders, Down syndrome, cerebral palsy, traumatic brain injuries, and other developmental or acquired conditions—often face multiple barriers to dental care:
Cardiovascular or respiratory conditions requiring monitoring
The Importance of Individualized Sedation Planning
The diversity among patients with cognitive disabilities means that no single sedation approach works universally. Effective care requires a comprehensive assessment that considers:
Patient-Specific Factors
The nature and severity of cognitive disability
Previous dental experiences and responses
Communication abilities and preferred methods
Sensory sensitivities and triggers
Behavioral patterns and coping mechanisms
Treatment-Related Considerations
Complexity and duration of needed dental procedures
Urgency of treatment needs
Frequency of treatment requirements
Long-term dental care goals
Support System Dynamics
Caregiver preferences and concerns
Home care capabilities
Transportation and recovery assistance
Financial and insurance considerations
Sedation Options for Patients with Cognitive Disabilities
At The Dental Anesthesia Center, we offer a spectrum of sedation approaches that can be tailored to individual needs:
What it involves: Taking prescribed medication (usually in pill form) before the dental appointment to induce a state of deep relaxation while remaining conscious.
Advantages for patients with cognitive disabilities:
No needles required for administration
Creates significant anxiety reduction
Produces partial amnesia of the procedure
Allows basic communication during treatment
Can be administered at home before arriving (reducing anticipatory anxiety)
Best suited for:
Patients with moderate anxiety or sensitivities
Those requiring longer appointments for multiple procedures
Individuals who can take oral medication reliably
Patients with a reliable caregiver for transportation and monitoring
What it involves: Medication administered intravenously to create a state of deep relaxation where the patient may drift in and out of consciousness but can be roused with stimulation.
Advantages for patients with cognitive disabilities:
Precise control over sedation levels
Rapid onset of sedation effect
Significant amnesia of the procedure
Ability to complete extensive treatment in one visit
Reduced awareness of sensory triggers
Best suited for:
Patients with significant anxiety or sensory sensitivities
Those requiring extensive dental work
Individuals who have had unsuccessful experiences with lighter sedation
Patients who can tolerate initial IV placement (with topical anesthesia)
Patients with involuntary movements that could compromise safety
Those who have had unsuccessful experiences with other sedation methods
Beyond Sedation: Creating an Approach
While sedation is often essential for providing dental care to patients with cognitive disabilities, we recognize that it’s just one component of a comprehensive approach. Our care model also incorporates:
Environmental Accommodations
We can modify the dental environment to reduce potential triggers:
Scheduling appointments during quieter times
Minimizing waiting time in an unfamiliar environment
Dimming lights or providing sunglasses
Offering noise-canceling headphones
Using weighted blankets for comfort and security
Creating a “sensory-friendly” treatment room
Communication Adaptations
We tailor our communication approach to each patient’s needs:
Using simple, concrete language
Employing visual schedules and social stories
Offering communication boards or assistive technology
Demonstrating procedures on models first
Using consistent, predictable sequencing of events
Behavioral Support Strategies
We incorporate positive behavioral approaches:
Utilizing tell-show-do techniques adapted to cognitive ability
Breaking treatment into manageable steps
Providing positive reinforcement for cooperation
Offering frequent breaks when using lighter sedation
Collaborating with behavioral specialists when appropriate
The Role of Regular Preventive Care
While sedation dentistry provides a solution for necessary treatment, our ultimate goal is to minimize the need for extensive interventions through:
Preventive Focus
We emphasize:
Frequent, brief maintenance visits (potentially with minimal sedation)
Aggressive preventive measures like sealants and fluoride treatments
Modified home care approaches tailored to cognitive ability
Caregiver training on effective oral hygiene assistance
Desensitization When Appropriate
For some patients, gradual desensitization to dental environments may be possible:
Beginning with very brief, positive exposures to the dental office
Gradually increasing familiarity with dental equipment
Using positive reinforcement for each successful step
Potentially reducing sedation levels over time as comfort increases
Dignity Through Specialized Care
At The Dental Anesthesia Center in St. Louis, we believe that all patients deserve access to compassionate, high-quality dental care that respects their dignity and addresses their unique needs. For patients with cognitive disabilities, appropriate sedation approaches can transform dental care from a source of distress to a manageable part of their healthcare routine.
By carefully assessing each patient’s individual needs, collaborating with caregivers, and drawing on our specialized training in sedation techniques, we create personalized care plans that allow patients with cognitive disabilities to receive essential dental treatment while minimizing stress and discomfort.
Contact The Dental Anesthesia Center Today
If you care for someone with a cognitive disability who struggles with dental visits, we invite you to contact our team to explore how our individualized sedation approaches might help. Together, we can develop a sustainable plan for maintaining oral health that respects both physical and emotional well-being.
Contact The Dental Anesthesia Center at (314) 862-7844 to schedule a consultation with our specialized team, which is experienced in caring for patients with cognitive disabilities.
