Four methods of anesthesia, matched to your procedure and your level of apprehension. Comfort and safety come first, with the choice always made with you.
The method of anesthesia chosen for or by a patient depends on the nature of the surgical procedure and the patient’s level of apprehension. The following illustrates the choices, a description of each technique, and its usual indications.
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, such as minor soft tissue procedures and simple tooth extractions.
A mixture of nitrous oxide (laughing gas) and oxygen is administered through a nasal breathing apparatus. The patient remains conscious and in a relaxed condition. Nitrous oxide has a sedative and analgesic effect and is commonly used in simple oral surgery procedures through to more involved cases like wisdom tooth removal and dental implant placement.
Intravenous Sedation, often called “Twilight Sedation,” helps you stay comfortable and calm during dental procedures. You may not always be asleep but you will be calm and relaxed, drifting in and out of sleep so you tolerate and don't remember procedures that would otherwise be uncomfortable.
Medications are administered through an IV. The patient falls asleep and is completely unaware of the procedure. Most commonly used medications include Fentanyl, Versed, Ketamine, and Diprivan. Supplemental oxygen is delivered through a nasal breathing apparatus and vital signs are closely monitored throughout.
For extensive procedures such as face and jaw reconstruction, TMJ surgery, or for patients with heart or lung disease, a hospital or surgery center is used with an anesthesiologist administering anesthesia.
Nitrous Oxide is a sweet-smelling, non-irritating, colorless gas that you breathe through a nasal apparatus. It has been the primary means of sedation in dentistry for many years. Nitrous oxide is safe; the patient receives 50 to 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. You may experience mild amnesia and may fall asleep, not remembering all of what happened during your appointment.
There are no major contraindications to using nitrous oxide, but you may not want to use it if you have emphysema, exotic chest problems, multiple sclerosis, a cold, or other difficulties with breathing. You can ask for a five-minute trial to see how you feel about this method before proceeding.
The depth of sedation can be altered at any time to increase or decrease sedation.
There is no after effect such as a “hangover.”
Inhalation sedation is safe with no side effects on your heart and lungs.
Inhalation sedation is very effective in minimizing gagging.
It works rapidly, reaching the brain within 20 seconds. Relaxation and pain-killing properties develop in two to three minutes.
IV sedation alleviates the anxiety associated with treatment. You may not always be asleep but you will be comfortable, calm, and relaxed, drifting in and out of sleep, a true “twilight sleep.”
A thin needle is introduced into a vein in your arm or hand, attached to an intravenous tube through which the medication is given to help you relax and feel comfortable.
Some patients sleep through the procedure while others slip in and out of sleep. Patients with specific medical conditions or drug regimens may only be lightly sedated; the level is tailored to you.
IV sedation is administered and monitored by the doctor in our office, eliminating the cost of carrying the treatment out in a hospital operating room or same-day surgical facility.
General anesthesia is available for all types of oral surgery and is the common choice for wisdom tooth removal and dental implants. It can also be necessary when local anesthesia fails to anesthetize the surgical site, often in the presence of infection.
For extensive procedures such as face and jaw reconstruction, TMJ surgery, or for patients with heart or lung disease, a hospital or surgery center is used with an anesthesiologist administering anesthesia.
To administer general anesthesia in the office, an oral surgeon must have completed at least three months of hospital-based anesthesia training plus an in-office evaluation by a state dental board-appointed examiner who observes a live surgical case and tests the entire team on emergency response.
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 them with your doctor at the time of your consultation.
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