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. The following table illustrates the choices of anesthesia, and a description of the anesthetic technique.
|Method of Anesthesia||Description of Technique|
|Local Anesthetic||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.|
Nitrous Oxide Sedation with Local Anesthetic
|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 sedative and analgesic (pain- controlling) effect.|
Non-intravenous conscious sedation with oral premedication and Nitrous Oxide with Local Anesthetic
|A pill or liquid is given to the patient at the office one hour prior to beginning the surgical procedure. In addition, the patient will be given Nitrous Oxide and oxygen during the procedure.The patient will be conscious, but very relaxed and most often the patient falls asleep and will have no memory of their procedure.|
“IV Sedation”Office Based General Anesthesia with Local Anesthetic*
|Medications are administered through an intravenous line (I.V.). The patient falls asleep and is completely unaware of the procedure being performed. Supplemental oxygen is delivered through a nasal breathing apparatus and the patient’s vital signs are closely monitored.|
To administer general anesthesia in the office, an oral surgeon must have completed at least three months of hospital based anesthesia training. Qualified applicants will then undergo an in office evaluation by a state dental board appointed 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.
Our office offers our patients the option of Intravenous Sedation for their dental treatment. Intravenous Sedation or “twilight sleep” helps you to be comfortable and calm when undergoing dental procedures. Your treatment can be completed under intravenous sedation. Intravenous sedation or “IV sedation” (twilight sedation) is designed to better enable you to undergo your dental procedures while you are very relaxed; it will enable you to tolerate as well as not remember those procedures that may be very uncomfortable for you. IV sedation will essentially help alleviate the anxiety associated with your treatment. You may not always be asleep but you will be comfortable, calm and relaxed, drifting in and out of sleep – a “twilight sleep”.
If you choose the option of intravenous sedation your IV sedation/anesthesia is administered and monitored by the doctor therefore eliminating the costly expense of having your treatment carried out in an operating room or same day surgical facility.
How is the IV Sedation Administered?
A thin needle will be introduced into a vein in your arm or hand. The needle will be attached to an intravenous tube through which medication will be given to help you relax and feel comfortable. At times a patient’s vein may not be maintainable, in these situations the medications will be administered and the needle retrieved – both scenarios will achieve the same desired level of conscious sedation. Once again some patients may be asleep while others will slip in and out of sleep. Some patients with medical conditions and/or on specific drug regimens may only be lightly sedated and may not sleep at all.
The goal of IV sedation is to use as little medication as possible to get the treatment completed. 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 sweet smelling, non irritating, colorless gas which you can breathe. Nitrous Oxide has been the primary means of sedation 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
- 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, etc.
- Inhalation sedation is very effective in minimizing gagging.
- It works rapidly as it reaches the brain within 20 seconds. In as few as 2-3 minutes its relaxation and pain killing 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.