Having anesthesia in the oral surgeon’s office is frightening whether you are having it to help get through your surgery or it’s used for your child. I go through an agonizing array of details to determine what I think is the best way to treat a patient. I am acutely aware of the responsibility I have when I choose all types of anesthesia but especially intravenous sedation and general anesthesia. We see many children in the office, and I understand how important these children are having children myself. Our world today is filled with media events and an anesthetic problem in a dentist’s office is particularly of media interest. I have looked at cases from both the patient and the doctor’s perspective and some of the situations and have attempted to achieve a progressive understanding of both sides of these challenges. From any perspective when there are anesthetic challenges, emotions are high. Having. worked as an oral surgeon for 22 years and been involved in dental school, residencies, and medical schools for another 12 years,I take my responsibility in providing anesthesia seriously. There is medical knowledge, dental knowledge, anesthesia knowledge, experience as well as a certain art to deciding on a type of anesthetic for a patient. Certainly, choosing a type of anesthesia is a joint decision with the patient or the parent. Despite occasional situations occurring, the safety of anesthesia events causing serious harm or death is about one in 1 million when the patient follows the doctors instructions. We are all affected when an anesthetic issue happens in the dental setting. Patients picking a doctor that they can work with this extremely important. A consultation is an opportunity for the patient to ask questions, gain information, and determine whether the doctor is someone that he or she can work with easily. To some extent, this type of approach can help reduce the patient or appearance anxiety in deciding the type of anesthesia to use in the oral surgeon’s office.