Anesthesia Options for Oral Surgery
At 47 North Oral Surgery, we believe in empowering our patients. We offer several anesthesia options, taking into account the type of oral surgery, your medical history, and your preferences. Your level of anxiety and pain threshold are also key factors in choosing the appropriate anesthesia for your treatment plan.
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Anesthesia Options
The following illustrates the choices of anesthesia, describes the anesthetic technique, and lists the usual indications for that technique.
Local Anesthetic
You are conscious and aware throughout the procedure. A local anesthetic, such as lidocaine, is used to numb the area where the surgery is to be performed. Local anesthetics are also used in conjunction with other methods of anesthesia in more complex oral surgery procedures.
Simple oral surgery procedures such as minor soft tissue procedures and simple tooth extractions.
Nitrous Oxide Sedation with Local Anesthetic
The patient breathes in a mixture of nitrous oxide (laughing gas) and oxygen through a nasal breathing apparatus. The patient remains conscious but relaxed. Nitrous oxide is both a sedative and a pain reliever.
Simple oral surgery procedures to more involved procedures such as removing wisdom teeth and placing dental implants.
Office Based General Anesthesia with Local Anesthetic*
Medications are administered through an intravenous line (I.V.). The patient falls asleep and is unaware of the procedure being performed. Depending on the patient’s history and other factors, we may use fentanyl (an opiate), versed (a benzodiazepine), ketamine, or Diprivan. Supplemental oxygen is administered through a nasal cannula, and the patient’s vital signs are monitored at all times.
General anesthesia is available for all types of oral surgery to ensure our patients’ comfort. Individuals having their wisdom teeth removed or dental implants placed usually opt for general anesthesia.
Hospital or Surgery Center Based General Anesthesia
A patient is admitted to a hospital or surgery center where an anesthesiologist administers anesthesia.
Indicated for patients undergoing extensive procedures such as face and jaw reconstruction and TMJ surgery. It is 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 three months of hospital-based anesthesia training, administer anesthesia under the supervision of an examiner, pass a rigorous exam, and be licensed by the state dental board.
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 be sure to talk to your surgeon during your initial consultation.
Intravenous Sedation (“Twilight Sleep”)
Our office offers our patients the option of Intravenous Sedation or Dental Intravenous Anesthesia, which is sometimes referred to as “Twilight Sleep,” for their dental treatment. Intravenous Sedation relaxes and calms you. You may feel like you are floating in and out of a light sleep. Many patients report that they do not remember their procedure at all after the sedative wears off.
IV sedation allows your surgeon to carefully manage the amount of medication used during oral surgery. An IV drip slowly releases medication at a constant rate, so less medication is needed, and an antidote can be used at any time if necessary.
Nitrous Oxide (Laughing Gas)
Nitrous Oxide is a sweet-smelling, colorless gas breathed in through a mask before any procedure begins. It is quite safe, with patients receiving 50-70% oxygen and about 30% nitrous oxide. Patients can breathe independently and remain in control of all bodily functions but feel euphoric and relaxed. After nitrous oxide is discontinued, most patients experience mild amnesia.
Pros and Cons of Nitrous Oxide
Nitrous oxide has many advantages, including its almost immediate onset and the ease at which the depth of sedation can be changed. Patients do not get a hangover effect with laughing gas, which does not linger in your system like other forms of sedation. Inhaled sedation has no lasting side effects on your heart and lungs. It is especially helpful for patients with a strong gag reflex. Patients with emphysema, chest problems, Multiple Sclerosis, respiratory illnesses, or other breathing disorders should not use nitrous oxide.
At your initial surgical consultation, your oral surgeon will review your anesthesia options with you so that you can make an informed decision.
Anesthesia Frequently Asked Questions
Are there any side effects of local anesthesia?
Local anesthetics such as lidocaine have few side effects, and they usually wear off quickly. The most common are tingling at the injection site, temporary pain at the injection site, a headache, or drowsiness.
Why are there different levels of anesthesia?
Our doctors prefer using the least amount of medication possible to keep their patients comfortable during oral surgery. However, some patients have a lower pain threshold or higher level of dental anxiety than others and benefit from stronger levels of anesthesia. Children and those with a disability or who are neurodivergent may struggle to stay still during a lengthy dental procedure, and deeper levels of sedation can make treatment safer and easier for everyone.
Why can’t I eat before being given anesthesia?
Anesthesia may make you sick to your stomach or nauseous. If you have eaten less than six hours before receiving anesthesia, you could vomit up the remaining food and aspirate it into your lungs, triggering a dangerous infection.
Will I be groggy after surgery with anesthesia?
Yes, for a little while. We always keep our patients in our office for at least 30 minutes following oral surgery to monitor their vital signs and ensure the sedative effects are flushed out of their system. Most patients feel relatively normal by the time they return home, but they may be light-headed for up to 24 hours when IV or general anesthesia completely leaves their system.