Hospital Dentistry

Dentistry in the Hosptial Operating Room

Who We Treat

General anesthesia is safe, but it is also not without risk. General anesthesia is the most aggressive and expensive method of dental care. For that reason, it is reserved only for those who have no other options. If general anesthesia is not right for the patient, we help find the right option. We also know that a trip to the operating room is not going to solve somebody's dental problems long-term. Ongoing preventative care is important. We are a REFERRAL ONLY practice. What that means is that we only take patients who are referred to us from a dentist who has agreed to see them for regular follow up preventative care. If the patient struggles to find a practice that will see them, scroll down to see a list of practices who are interested in working with us and are taking new patients who have special healthcare needs. We also only treat adult patients (14 and older) unless referred specifically by a pediatric dentist. There are many great pediatric practices in our area who take great care of children.

Services We Provide:

We also can't do everything. With the nature of the operating room and our limited time available we have limited services we can offer. We offer the following:

  • Exam and Radiographs
  • Scaling and root planning (deep cleaning)
  • Scaling in the presence of moderate to severe gingival inflammation (moderate cleaning)
  • Prophylaxis: (regular cleaning)
  • White and Silver Fillings
  • Sealants
  • Silver Diamine Fluoride Treatment
  • fluoride varnish treatment
  • Simple Root Canals
  • Extractions (Some may require oral surgery referral)
  • minor biopsy of gum tissue

WE DO NOT PROVIDE THE FOLLOWING SERVICES: Dentures, partial dentures, implants, bridges, crowns, bone grafts, complex root canals, root canals on back teeth, difficult extractions, whitening, or comprehensive preventative care

IMG_1135 (2)
Dr.Brooke in the operating room with overhead light and instruments. Alicia, the surgical tech is helping.

The Process

  1. The Referral :
    • Have the patient's regular dentist send us a secure email THAT INCLUDES THE FOLLOWING:
      1. Required in the Body of the Email:
        • Patient's Full Name and Birthday
        • Legal Guardian and Contact for Guardian (email and phone)
        • Caregiver and Contact for Caregiver (if different)
        • Brief Narrative of why they are referring
        • A statement that says they will be seeing that patient for ongoing care after the surgery
      2. Required Attachments:
        • The patient's most recent History and Physical from primary medical doctor
        • The patient's guardianship paperwork if not their own guardian
        • Consent for Teledentistry Consult Signed by Patient: 2023 Teledental Consent Hospital Form
      3. Optional Helpful Attachments:
        • Any radiographs, photos or treatment plans
        • Face Sheets from care facilities and group homes
      4. Once all this information is prepared, the referring office can click on this link to send the complete packet:
  2. The Virtual Consult:
    1. Once all the required paperwork is received and reviewed, Dr. Brooke will contact the patient for a virtual consult. This will initially occur through an email invite to join the patient portal and will come from teledent or mailhippo. After this consult a date for the case will be chosen.
  3. Obtain Clearance from Primary Care Physician: (Pre-operative physical AND PCP Recommendations Sheet)
    • At the date of surgery this physical must be NO GREATER THAN 30 DAYS OLD
    • Pre-operative physical:
      • If the PCP feels that it is safe to proceed with "dentistry under general anesthesia including potential extractions", make sure that somewhere in the physical exam it  states  " Cleared/Medically optimized for "dentistry under general anesthesia including potential extractions"​.
    • Recommendations Sheet:
      • Download the recommendations sheet here:   Word document:   2023 YSS PCP Letter    PDF :2023 YSS PCP Letter
      • The PCP should fill this out at the pre-operative physical visit SEND WITH THE PHYSICAL IN THE SAME EMAIL
    • Please have BOTH the pre-operative physical note and our PCP recommendations sheet sent to BOTH of the following:
      • Hospital Triage Nurse: FAX: 208-814-2915  Email:
        • Any questions contact the triage nurse M-F 6:30am-3:00pm 208-814-2832
      • To Dr. Brooke: (copy an paste this web address in address bar)
    • It is also valuable to talk about your medications and how your doctor recommends you take them the day of surger
    • If this pre-operative physical is not received at least one week before the surgery the case will likely be canceled.
  4. Obtain COVID Test 48 hour prior to surgery
    • Any questions call the triage nurse M-F 6:30am-3:00pm 208-814-2832
  5. Arrive Early and Plan to Be at the Hospital All Day: The day of surgery you will arrive 2 hours early to the hospital.  Check in and then they will help you get where you need to go.  Plan to be there  ALL DAY (though you probably won't be).
  6. Surgical Records Will be Sent to the Patient's Dentist:  Please let us know if your primary dentist does not receive records of the surgery within a week of the case.

Other Paperwork: Please review before the case and let us know if you have any questions. If you will not be there for the case, or if you want to get this done beforehand so you don't have to do it the day of the case, feel free to download and send them to Dr. Brooke securely by pasting this address in the address bar of your browser:

Payment & Insurance

Billing for Dental Services:  We do accept Idaho Smiles (Medicaid coverage managed by MCNA) and Delta Dental of Idaho. IF YOU HAVE ANOTHER INSURANCE YOU WILL BE BILLED AND IT WILL BE UP TO YOU TO WORK IT OUT WITH YOUR INSURANCE CARRIER. We will provide you with an ADA Claim form filled out for services rendered, our clinical notes, and our radiographs. If you would like to discuss costs prior to the case please notify Dr. Brooke.  She may not know what services are needed until after the exam, but you can request to be called during the case with cost estimates. The dental billing is pretty easy and we do understand how it works with MCNA and Delta Dental. No prior authorizations are required for billing MCNA and Delta Dental for these cases and those are the only insurances we work with.

Billing for Other Services:  We are NOT the only bill

  • You may receive a bill for hospital services (They will likely bill your medical insurance then you. Also there may be more than one bill from the hospital. This has nothing to do with us. Please contact St. Luke's Magic Valley hospital billing for questions about hospital services billing.
  • You may receive a bill from the anesthesia team. This also has nothing to do with us. The hospital may have a better idea of who to contact about this.
  • If other services were combined with our dental services, you may receive a bill from those other providers for their services.  For example, if you have your ears cleaned, the doctor who does that may bill separately. This has nothing to do with us. Please contact the partnering providers for questions on their billing.
  • Above are the common bills we see, there may be some others that we are not aware of. If you receive a bill from a service not mentioned here, please let us know so we can add it to the list for others to know what to expect.

We do NOT Complete Prior Authorizations:

  • The Services We Bill Do Not Require Prior-Authorization:  MCNA and Delta Dental of Idaho work with us on this as they are familiar with our services. We do not accept insurances that require prior authorizations as such authorizations may require unnecessary sedation for diagnostics.
  • The Services Other Entities Bill May Require Prior-Authorization: Hospital Services, Anesthesia Services, or other services may require Prior-Authorizations. We are not insurance liaisons and we do NOT file prior authorizations for any services billed by other entities. We are happy to provide a letter of medical necessity for any entity that needs one to file their Prior-Authorizations. You may need to work with the hospital authorizations department or your insurance provider if your Medical insurance requires prior-authorization. They may require you to do some paperwork for your insurance before the surgery. Make sure to contact the hospital authorizations department about this. This may be different from what you may have experienced in the past as some dental practices do act as insurance liaisons for other entities. If there is no authorization, or it is not back in time, the hospital may ask you to sign a paper saying you will pay for the hospital costs if your insurance does not. Do not sign this form unless you are willing to pay for their services. Sometimes prior authorization forms require the surgeon's NPI even if the surgeon is not the one billing the services. If that is the case, a providers NPI is public information and ours is 1932466489.


Dental Care Partners:

Establishing a dental home is important. While providing this service under general aesthesia can help people who have extensive needs or emergent needs, every patient who we see in the operating room needs to have a dental home for regular preventative care at least every 6 months.  Going to the hospital every 2-4 years is NOT the solution.  Though we can not provide a stable preventative dental home for these patients, there are multiple practices that will. We work with health centers and private practice dentists to make this happen.   To get an appointment with us, we require that the patient has a dentist and ongoing care plan.  If you don't already have a dental home, below are offices that will likely help.

  • Family Health Services Advanced Delivery Dental Clinic. Family Health Services is a Federally Qualified Health Center. While people who have special healthcare needs are welcomed at all FHS clinics, the Advanced Delivery Dental Clinic was custom created for patients who have special healthcare needs.  Dr. Brooke Fukuoka (yep our same doctor) has particular interest in working with people who have disabilities.
    •  114 Pioneer Ct. Jerome, ID.
    • Call: 208-737-6778 Monday, Tuesday or Wednesday
  • Terry Reilly Health Services. Terry Reilly Health Services is a Federally Qualified Health Center in Western Idaho. While people who have special healthcare needs are welcomed at all Terry Reilly clinics, Dr. Melinda Jensen in their Nampa clinic has a particular interest in working with people who have disabilities.
    • 11136 Moss Lane, Nampa, ID​
    • 208-466-0515
  • Private Practice Options (NEW):  We have enjoyed working with multiple excellent private practice dentists who treat patients who have special healthcare needs with and/or without sedation. Light and moderate sedation is a better option than general anesthesia when possible. This list is NOT a comprehensive list, but rather a short list of providers who have requested to be put on this list because they enjoy treating patients who have special healthcare needs.  Being on this list does NOT mean the provider accepts Idaho Smiles (Medicaid) or any other type of dental benefits plans as payment.
    • Dr. Travis Shepherd at Infinity Dental 
      • 901 Center St W Ste. A, Kimberly, ID 8334
      • (208) 423-5001
      • Offers comprehensive dentistry. They offer limited in-office sedation for healthy adult patients who have disabilities. They offer more services than we do such as crowns and root canals.  ​
      • Not a Medicaid Provider
    • Dr. Thomas Patterson at Smart Mouth Dental
      • 236 River Vista Pl Suite 100, Twin Falls, ID 83301​
      • (208) 737-5253
      • Offers comprehensive dentistry. They offer limited in-office sedation for healthy adult patients. They also combine virtual reality with sedation, or use virtual reality alone for a unique innovative experience.
      • Not a Medicaid Provider
  • If you are a private practice dentist who enjoys working with patients who have special healthcare needs, you are accepting new patients,  and want to be listed here contact Dr. Brooke and we would be happy to add you to our list. ​​