Oral Surgery Anesthesia / Sedation
To administer general anesthesia in-office, oral surgeons must complete at least three months of hospital-based anesthesia training. Eligible candidates undergo an in-office evaluation by a state dental board-appointed examiner. The examiner checks monitoring devices and emergency equipment, testing the doctor and surgical staff on anesthesia-related emergencies. Upon a successful evaluation, the state dental board issues a renewable general anesthesia license every two years, contingent on the doctor maintaining required continuing education.
A range of oral surgery anesthesia methods is accessible, chosen based on the specific surgical procedure and the patient’s anxiety level. The subsequent graph delineates the available anesthesia options, describes each technique, and outlines the typical scenarios where each method is commonly applied.
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. A 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.
Description 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 removal of wisdom teeth and placement of dental implants.
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), Ketamine, and Diprivan. 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 or having a dental implant placed will choose general anesthesia. General anesthesia may be necessary if local anesthesia fails to anesthetize the surgical site which often occurs in the presence of infection.
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.
Frequently Asked Questions
We offer multiple sedation options to ensure the most comfortable care possible.
- Local Anesthetics
- Nitrous Oxide
- IV Sedation
- General Anesthesia
Local anesthetics, such as lidocaine, are the most common form of anesthesia in oral surgery procedures. They are administered directly to the surgical site and numb the tissue so that you do not feel any pain. For some minor procedures, such as soft tissue and simple extractions, a local anesthetic is all that is typically needed to get the job done.
Commonly known as laughing gas, nitrous oxide is mixed with oxygen and administered through a breathing mask. This causes our patients to be conscious but relaxed during the procedure. Laughing gas provides some pain relief but is not comprehensive. It is used in conjunction with local anesthesia for total pain control.
IV sedation, or twilight sedation, is very comfortable and doesn’t involve a lengthy recovery phase like general anesthesia. With twilight sedation, our patients are awake—or drifting in and out of sleep—for the procedure but relaxed and calm and may have no memory of the surgery when it’s over. This type of sedation is administered through an IV in our office. It is a safe and very effective way to perform procedures on patients who have anxiety about surgery. IV Sedation is suitable for most oral surgery procedures.
General anesthesia has a longer recovery period than twilight sedation, requiring several hours for it to wear off. However, it is the preferred choice for some conditions that don’t otherwise allow for adequate anesthesia. For patients that aren’t at risk of needing ventilators and don’t necessarily need complete muscle relaxation, we can perform general anesthesia in our office to eliminate pain and anxiety. For procedures, such as jaw surgery, and patients with serious health conditions, we recommend anesthesia be administered in a hospital for safety reasons.
Your safety is our top priority. Oral and maxillofacial surgeons have an excellent safety record in anesthesia, as the training for anesthesia during oral surgery residency is very extensive, more so than for any other health specialist, with the exception of anesthesiologists.
No. It’s important that you fast before an oral surgery that requires general anesthesia or IV sedation. Do not consume food or drink 8 hours prior to your procedure if you are having IV (twilight) sedation or general anesthesia.
Yes. You will need an adult to accompany you to your appointment and drive you home after having undergone IV or general sedation. For patient safety, you cannot take public transportation or a ride service (Taxi, Uber, Lyft, etc.). The time allotted for your surgery and recovery may vary but plan on being in the office for approximately 1 ½ hours. You cannot drive an automobile for at least 24 hours following your surgery. No one under the age of 18 may serve as your escort day of surgery. Any patient under the age of 18-years-old must be accompanied by a parent or legal guardian. We will not get started on your procedure if you do not have someone with you to drive you home.
Your comfort and care is our top priority. We will make you comfortable before, during, and after your procedure, using the discussed anesthesia plan. If you have any concerns about an upcoming procedure, please give us a call. We are here to answer any questions you may have and ensure the best experience possible.
Most insurance plans cover anesthesia, but we know the importance of checking your plan and making sure of the details before moving forward with your procedure. We consider it our job to help you navigate your insurance plan, so you don’t have to figure it out on your own. We make every effort to keep you informed of all costs upfront while ensuring you get the most comfortable care possible.