Anesthesia

Several methods of anesthesia are available. The method of anesthesia that is chosen for or by a patient depends upon the nature of the surgical procedure and the patient’s level of apprehension. 

Anesthesia Options

The following table illustrates the choices of anesthesia, a description of the anesthetic technique, and the usual indications for that technique.

  • Types of Anesthesia
  • Method Local Anesthetic
    Description of Technique The patient remains totally conscious throughout the procedure. A local anesthetic (e.g. lidocaine) is administered in the area where the surgery is to be performed. Local anesthetic is used in conjunction with the other methods of anesthesia in all oral surgery procedures.
    Usual Indications Simple oral surgery procedures such as minor soft tissue procedures and simple tooth extractions.
  • Method Nitrous Oxide  with Local Anesthetic
    Description of Technique A mixture of nitrous oxide (laughing gas) and oxygen is administered through a nasal breathing apparatus. The patient remains conscious in a relaxed condition. Nitrous oxide has a relaxing and analgesic (pain- controlling) effect.
    Usual Indications Simple oral surgery procedures such as single tooth removal or biopsy procedures.
  • Method Office Based General Anesthesia with Local Anesthetic*
    Description of Technique Medications are administered through an intravenous line (I.V.). The patient falls asleep and is completely unaware of the procedure being performed. Medications most commonly used are Fentanyl (opiate), Versed (benzodiazepine), along with Propofol. Supplemental oxygen is delivered through a nasal breathing cannula and the patient’s vital signs are closely monitored.
    Usual Indications General anesthesia is available for all types of oral surgery. A patient may choose general anesthesia for simple procedures depending on their level of anxiety. Most people having their wisdom teeth removed or having a dental implant placed will choose general anesthesia. General anesthesia may be necessary if the procedure is considered invasive.
  • Method Hospital or Surgery Center Based General Anesthesia
    Description of Technique A patient is admitted to a hospital or surgery center where anesthesia is administered by an anesthesiologist.
    Usual Indications Indicated for patients undergoing extensive procedures such as face and jaw reconstruction or fracture repair. 

To administer general anesthesia in the office, an oral surgeon must have completed at least three months of hospital based anesthesia training. Qualified oral surgeon applicants will then undergo an in office evaluation by a board certified examiner. The examiner observes an actual surgical procedure during which general anesthesia is administered to the patient. The examiner also inspects all monitoring devices and emergency equipment and tests the doctor and the surgical staff on anesthesia related emergencies. If the examiner reports successful completion of the evaluation process, the state dental board will issue the doctor a license to perform general anesthesia. The license is renewable every two years if the doctor maintains the required amount of continuing education units related to anesthesia.

Again, when it comes to anesthesia, our first priority is the patient’s comfort and safety. If you have any concerns regarding the type of anesthesia that will be administered during your oral surgery procedure, please do not hesitate to discuss your concerns with your doctor at the time of your consultation.

Intravenous Sedation 

Our office offers our patients the option of Intravenous Sedation or Dental Intravenous Anesthesia for their dental surgery. any oral surgery procedure can be completed under I.V. sedation. This sedation is designed to better enable you to undergo your dental procedures while you are asleep; it will enable you to tolerate, as well as not remember those procedures that may be very uncomfortable for you. IV sedation will essentially alleviate the anxiety associated with your treatment. 

If you choose the option of intravenous sedation your IV sedation/anesthesia is administered and monitored by our oral surgeon, therefore eliminating the costly expense of having your treatment carried out in an operating room with an anesthesiologist.

How is the IV sedation administered?

A thin catheter will be introduced into a vein in your arm or hand. The catheter will be attached to an intravenous tube through which medication will be given to help you relax and feel comfortable. A different medication will then be used to fully sedate the patient.  Some patients with medical conditions and/or on specific drug regimens may only be lightly sedated or “titrated”.

The goal of IV sedation is to use as little medication as possible to get the treatment completed. It is very safe and effective option. With IV sedation a constant “drip” is maintained via the intravenous tube. At any time an antidote can be administered to reverse the effects of the medications if necessary. 

Nitrous Oxide (Laughing Gas)

Nitrous Oxide is a non irritating, colorless gas which you can breathe. Nitrous Oxide has been the primary means of relaxation in dentistry for many years. Nitrous oxide is safe; the patient receives 50-70% oxygen with no less than 30% nitrous oxide. Patients are able to breathe on their own and remain in control of all bodily functions. The patient may experience mild amnesia and may fall asleep not remembering all of what happened during their appointment.

There are many advantages to using Nitrous Oxide

  • There is no after effect such as a “hangover”.
  • Inhalation is safe with no side effects on your heart and lungs, etc.
  • It works rapidly as it reaches the brain within 20 seconds. In as few as 2-3 minutes its relaxation and pain reducing properties develop.

Reasons to Not use Nitrous Oxide

Though there are no major contraindications to using nitrous oxide, you may not want to use it if you have emphysema, exotic chest problems, M.S., a cold or other difficulties with breathing. Nitrous oxide may not be effective in adult patients.