Anesthesia
We Offer Several Methods of Anesthesia
Patients’ comfort is our priority, and we offer several methods of anesthesia. The anesthesia that we recommend for a patient depends on the nature of the surgical procedure and the patient’s level of apprehension. We encourage patients to express any concerns they many have.
Anesthesia Safety and Training
In order to administer general anesthesia in the office, oral and maxillofacial surgeons must have completed a minimum of three months of hospital-based anesthesia training, and our doctors have done more than this minimal requirement. They then undergo an in-office evaluation by a state dental board appointed examiner, who observes an actual surgical procedure during which general anesthesia is administered. The examiner inspects all monitoring devices and emergency equipment and tests the doctor and the surgical staff’s competence on anesthesia-related emergencies. Upon successful completion of the evaluation, the state dental board issues the doctor a license. The license must be renewed at least every five years and requires continuing education units.
Local Anesthetic
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.
Local anesthetic is used for minor soft tissue procedures and simple tooth extractions.
Intravenous Sedation (“Twilight Sedation”)
This type of anesthesia helps patients be comfortable and calm during their dental procedures, alleviates anxiety, and helps them not to remember procedures that may have been uncomfortable. With it, patients can drift in and out of sleep (a “twilight sleep”). The goal is to use as little medication as possible to get the treatment completed. A constant “drip” is maintained via an IV and, at any time, an antidote can be administered to reverse the effects of the medications if necessary. It is considered very safe, much safer than oral sedation.
Twilight sedation is administered and monitored by the doctor, eliminating the expense of having surgery performed in an operating room or surgical facility.
It can be used for simple procedures as well as those that are more involved.
Office-based General Anesthesia With Local Anesthetic
Medications are administered through an intravenous line (IV). The patient falls asleep and is completely unaware of the procedure being performed.
Medications most commonly used are fentanyl (an opiate), Versed (benzodiazepine), ketamine, and Diprivan. Supplemental oxygen is delivered through a nasal-breathing apparatus, and the patient’s vital signs are closely monitored.
General anesthesia is available for all types of oral surgery depending on a patient’s level of anxiety, from simple procedures to wisdom teeth removal and dental implant placement. 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.
Hospital- or Surgery Center–Based General Anesthesia
With this type of anesthesia, the patient is admitted to a hospital or surgery center and anesthesia is administered by an anesthesiologist.
General anesthesia in this setting is indicated for patients undergoing extensive procedures such as face and jaw reconstruction and TMJ surgery, as well as for patients with medical conditions like heart or lung disease.