4 Types of Anesthesia in Oral Surgery

Many people delay oral surgery recommended by their general dentist due to fear of the unknown. In some cases, patients have painful childhood memories that have haunted them for their entire life. Today, oral surgery procedures can be delivered in a safe and fearless environment thanks to several different anesthetic/sedative techniques.

When you come to see your oral surgeon for a consultation, the surgery will be discussed in detail with you. During this visit, it is important to let your doctor know if you are interested in one of the techniques listed below. Your surgeon will then review your medical history and perform an oral examination to select the safest option for you. Age, airway assessment, weight, smoking history, and heart and lung conditions are several of the many factors that are considered when determining a safe sedation option.

LOCAL ANESTHESIA

For those undergoing a quick, simple procedure or for patients in which sedation is not an option, local anesthesia will be the anesthetic of choice.

Local anesthesia is administered by various injections in the mouth, which then numbs the surgical site within minutes. Your doctor can first apply a topical anesthetic to numb the area and reduce the pain before injecting the local anesthetic. The effects last for anywhere from 2-10 hours depending on the type of anesthetic that is used and the location it is administered.

NITROUS OXIDE (LAUGHING GAS) 

Nitrous oxide is a mild sedative agent that calms patients during oral surgery procedures. Although the agent is often called laughing gas, laughing is not common. Instead, patients describe the feeling of being in a relaxed, calm state, which may also include tingling sensations in your fingers and toes or a feeling of heaviness or euphoria.

The nitrous is administered through a nosepiece. Occasionally, patients feel restricted and claustrophobic as the nosepiece is quite large and obtrusive. The amount of nitrous that can be administered is titrated to the desired level and takes effect within several minutes when breathing in through the nose. You may feel tired and relaxed, but you are aware of your surroundings and can follow the doctor’s instructions easily.

The effects of nitrous wears off after breathing five minutes of pure oxygen. While this type of anesthetic is cheaper and easy to administer, many patients desire a deeper plane of anesthesia where they are not able to participate with the surgery. 

INTRAVENOUS DEEP SEDATION

Oral surgeons are unique as they can administer intravenous anesthesia in the office setting. This requires starting an IV in the arm/hand and then this site is used to administer medications that provide a deep plane of anesthesia.  The various medications used provide pain control, amnesia, anti-nausea, and sedation. The patient is breathing comfortably on their own throughout the procedure, but is not aware of his/her surroundings. This type of sedation allows a patient to have multiple procedures or complex procedures done in a safe, low-anxiety manner.  For patients with a strong gag reflex, intravenous deep sedation suppresses the gag reflex, making things easier for the patient and surgeon alike. The patient’s vital signs are monitored throughout the procedure for safety.

Pursuing intravenous deep sedation requires several patient preparations including nothing by mouth (NPO) 8 hours before the appointment, arranging for a friend/family member to provide transportation to/from the office, and no current pregnancy. Patients are drowsy after surgery and should not drive, go to work/school, operate machinery, and should have assistance and monitoring within the first 24 hours at home.

GENERAL ANESTHESIA with INTUBATION

Physicians chiefly use general anesthesia with intubation for long procedures, for patients with complex medical histories that require close monitoring by an anesthesiologist/nurse anesthetist, or for patients desiring a sedation but heavy bleeding, saliva flow, or irrigation will be encountered during the procedure.

This form of anesthesia involves the placement of a “breathing tube” to secure the airway from harmful irritants such as saliva or irrigation used during surgery. The tube is placed once the patient is asleep and is removed prior to waking up. Conestoga Oral Surgery has the unique opportunity to offer this anesthesia service in our fully-equipped operating room at our Good Drive location in Lancaster. Close post operative monitoring occurs in our recovery bay prior to discharge to your home.

In conclusion, sedation dentistry reduces anxiety for patients and allows oral surgeons to complete the surgery in a safe and efficient manner. Oftentimes, when a patient is overcome with anxiety, movement and patient-required breaks lengthen the time needed for surgery, which only increases patient discomfort and stress. We encourage you to discuss these sedation opportunities with one of our skilled doctors when you arrive for your consultation. Contact us today for an anxiety-free surgical experience.