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 Office Based Sedation with Local Anesthetic*
    Description of Technique Medications are administered through an intravenous line (I.V.). The patient may enter a state where they remember little to none of the procedure. Certain medical conditions may limit the depth of anesthesia such as lung and heart disease or obesity. Supplemental oxygen is delivered through a nasal breathing apparatus 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 sedation for simple procedures depending on their level of anxiety. Most people having their wisdom teeth removed or having a dental implant placed will choose sedation. 
  • 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 and TMJ surgery. Also indicated for patients with medical conditions such as heart disease or lung disease who require general anesthesia.

To administer general anesthesia in the office, an oral surgeon must have completed at least five 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.

Intravenous Sedation (“Twilight Sedation”)

Our office offers our patients the option of Intravenous Sedation, commonly referred to as “Twilight Sedation” for their dental treatment. Intravenous Sedation or “twilight sleep” helps you to be comfortable and calm when undergoing dental procedures. Intravenous sedation  is designed to better enable you to undergo your dental procedures while you are very relaxed; it will enable you to better tolerate procedures that may be 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 small catheter 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. It is very safe, much safer than oral sedation.  Having intravenous access allows for the administration of reversal of the effects of the medications if necessary.