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, a description of the anesthetic technique, and the usual indications for that technique.
MethodTypes of AnesthesiaDescription of TechniqueUsual Indications
Method Local AnestheticDescription 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 Sedation with Local AnestheticDescription 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 sedative and analgesic (pain- controlling) effect.Usual Indications Simple oral surgery procedures to more involved procedures such as extraction of teeth and placement of dental implants.
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) Propofol, Ketamine and 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 general anesthesia for simple procedures depending on their level of anxiety. Most people having their wisdom teeth removed choose to have 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 and office inspection from the Texas State Oral Maxillofacial Surgery Organization. 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 courses units related to anesthesia and are required to maintaining certification.
Method Office Base IV Moderate Sedation with Local AnestheticMedication is administered through an IV line. The patient falls asleep and is very relaxed, but amnesia is not as predicable as deep sedation/ General Anesthesia.Usual Indications Simple oral surgery procedures to more involved procedures such as extraction of teeth and placement of dental implants.
Method Non-IV SedationAn oral pill for relaxation is given along with Nitrous Oxide. Intramuscular injection for relaxation can be added if more relaxation is needed. Local Anesthetic used as usual.
Advantages to Non-IV Moderate Sedation:
– No IV Necessary
– Fee is less than all IV sedation techniques
– Effective in helping moderate gaggers
Reasons Not to Use Non-IV Moderate Sedation
– Procedure to in depth for this level of sedation
– If you don’t have an escort to drive you to and from appointment and stay at the office during surgery.Usual Indications Simple oral surgery procedures to more involved procedures such as extraction of teeth and placement of dental implants.
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 or Dental Intravenous Anesthesia for their dental treatment. Intravenous Sedation helps you to be comfortable and calm when undergoing dental procedures. Your treatment can be completed under intravenous sedation. Intravenous sedation or “IV 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.
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. The Doctor is fully credentialed in all levels of anesthesia
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. 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 depending on the severity of medical issues.
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 any time a reversal agent can be administered to reverse the effects of the medications if necessary. Along with IV sedation there are also other different “levels” of sedation available to you in our office.
Nitrous Oxide (Laughing Gas)
Nitrous Oxide is a s 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.
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. can decrease blood pressure and pulse by decreasing anxiety.
- 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 is experienced by the patient and it is completely reversible in serval minutes.
- Reasons to Not us Nitrous Oxide
- There are no major contraindicators to using nitrous oxide, People with inner ear, dizziness issues my get nauseated, and people that are claustrophobic may find mask confining.