Pediatric dentist with an anesthesiologist in Walnut Creek
When parents search for a pediatric dentist who has an anesthesiologist on staff, they are usually doing so because their child has significant dental needs, high anxiety, special needs, or is very young — and they want to know that if sedation or general anesthesia is involved, the person managing it is not also the person holding the drill.
That distinction matters more than most families realize. And in the East Bay, it is exceptionally rare.
Tooth + Tongue – Specialized Dentistry and Anesthesia in Walnut Creek is the only pediatric dental practice in the area where the treating dentist is also a fellowship-trained dental anesthesiologist. This is not a marketing claim. It is a clinical differentiator that directly affects the safety, comfort, and quality of care your child receives.
What is a dental anesthesiologist — and how is it different from a dentist who offers sedation?
A dental anesthesiologist is a dentist who has completed an additional two to three year accredited residency in anesthesiology following dental school. This residency is hospital-based and involves training in the full spectrum of anesthetic management — from nitrous oxide and oral sedation through IV sedation and general anesthesia — as well as airway management, emergency response, and monitoring of medically complex patients.
This is categorically different from a general dentist or pediatric dentist who has completed a weekend certification course in oral or IV sedation. Those courses provide limited training in a narrow range of sedation techniques. They do not train providers in advanced airway management, full monitoring protocols, or emergency response at the level that a residency-trained anesthesiologist receives.
The practical difference is significant. When a dental anesthesiologist manages your child's sedation, they are drawing on the same depth of training as a hospital anesthesiologist. The monitoring, the protocols, the emergency preparedness, and the clinical judgment are all held to that standard.
Why it matters for your child's safety
Safe pediatric sedation requires more than the right medication at the right dose. It requires continuous monitoring of oxygen saturation, heart rate, blood pressure, and airway patency throughout the procedure. It requires the ability to recognize and respond to changes in a child's status in real time. And it requires emergency preparedness — the equipment, the training, and the protocols to manage an adverse event if one occurs.
At Tooth + Tongue – Specialized Dentistry and Anesthesia in Walnut Creek, every sedation and anesthesia case is managed according to the same standards that apply in a hospital operating room. This includes pre-operative medical review, continuous monitoring throughout the procedure, and full emergency preparedness including airway management equipment.
California has specific regulations governing who can administer pediatric deep sedation and general anesthesia in a dental setting, and the requirements are stringent for good reason. Choosing a provider who exceeds those requirements — not merely meets them — is the clearest way parents can protect their child when dental care requires sedation.
When a child needs anesthesia-level care
Not every child who comes to Tooth + Tongue – Specialized Dentistry and Anesthesia needs sedation or general anesthesia. The majority of our patients receive care under local anesthesia with nitrous oxide, or with nitrous oxide alone for preventive visits.
However, there are specific situations where anesthesia-level care is genuinely the safest and most humane option:
Very young children — typically under three — who cannot cooperate with dental treatment regardless of technique and who have significant decay requiring treatment
Children with extensive decay across multiple teeth where completing treatment in one appointment under general anesthesia is safer and less traumatic than multiple distressing awake visits
Children with autism, sensory processing differences, intellectual disabilities, or significant medical complexity for whom standard dental care is not manageable without sedation support
Children with severe dental anxiety or dental phobia who have had traumatic prior experiences and for whom awake treatment is genuinely not achievable. If your child cries or struggles at dental visits, you are not alone — and it does not mean sedation is the only answer.
In all of these situations, having an anesthesiologist — not a sedation-certified dentist — managing the case is the highest standard of care available in a dental setting.
What to look for when choosing a provider
When evaluating a pediatric dental practice that offers sedation or general anesthesia, the questions worth asking are specific:
What is the treating provider's anesthesia training and credentialing? A fellowship or residency in dental anesthesiology is meaningfully different from a sedation permit obtained through a short course.
Is the anesthesia managed by the same person performing the dental work, or by a separate dedicated provider? When one clinician is responsible for both the dental procedure and the sedation management simultaneously, neither receives full attention.
What monitoring equipment is used, and what emergency protocols are in place? The answer should be detailed and specific.
Is the facility inspected and permitted for the level of sedation being provided? California's Dental Board has specific permit requirements for different levels of sedation, and those permits require facility inspections.
At Tooth + Tongue – Specialized Dentistry and Anesthesia, we welcome these questions and answer them directly. Transparency about training, protocols, and safety standards is part of how we build the trust that families bringing an anxious or medically complex child to us deserve.
Meet Dr. Boloorchi
Dr. Negar Niki Boloorchi is the founder of Tooth + Tongue – Specialized Dentistry and Anesthesia and the only dentist-anesthesiologist in private pediatric dental practice in the Walnut Creek area.
Her path to this specialty was intentional. After completing dental school, Dr. Boloorchi pursued an anesthesiology residency with a specific focus on pediatric patients — recognizing that the children who needed the most from dentistry were often the ones least able to access it safely in a standard dental setting. Her additional training with the Breathe Institute and Dr. Baxter expanded her expertise in airway-focused care and tongue tie treatment, making Tooth + Tongue one of the few practices in the East Bay that approaches pediatric oral health through the lens of breathing, development, and function — not just teeth.
For families in Walnut Creek and across the East Bay whose children have been told they need general anesthesia for dental work, or who have struggled to find a provider who can safely manage their child's complex needs, Tooth + Tongue – Specialized Dentistry and Anesthesia represents a level of care that simply is not available elsewhere in the region.
To learn more about what sedation dentistry in Walnut Creek looks like at our practice, or to read about the real experiences families have had with our approach, visit our sedation services page or explore our patient stories.
If your child has significant dental needs and you want to understand whether anesthesia-level care is appropriate — and what that would look like at Tooth + Tongue — we invite you to schedule a consultation. The conversation is straightforward, the evaluation is thorough, and the goal is always to find the safest and most comfortable path forward for your child.
Written by Dr. Negar Niki Boloorchi, Dental Anesthesiologist and Founder of Tooth + Tongue – Specialized Dentistry and Anesthesia. Dr. Boloorchi completed her anesthesiology residency with a focus on pediatric patients and holds advanced training in airway-focused pediatric care and tongue tie treatment through the Breathe Institute.
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1800 San Miguel Dr.
Walnut Creek, CA 94596
