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.
Dr. Korban and Dr. Clark discuss the method of anesthesia with each patient during the treatment consultation.
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 removal of wisdom 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), 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.
Method Hospital or Surgery Center Based General AnesthesiaDescription 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.
Our priority is patient comfort and safety. Dr. Korban and Dr. Clark discuss the recommended and appropriate anesthesia method during the consultation appointment.
Intravenous Sedation (“Twilight Sedation”)
Our office offers patients the option of Intravenous Sedation or Dental Intravenous Anesthesia (commonly called”Twilight Sedation”). Intravenous Sedation or “twilight sleep” helps patients to be comfortable and calm when undergoing dental procedures. Patients are not always fully asleep but are comfortable, calm and relaxed, drifting in and out of sleep – a “twilight sleep”.
The goal of IV sedation is to provide patient comfort during the treatment, using as little medication as necessary. IV sedation is very safe, much safer than oral sedation. With IV sedation the amount of medicine can be continuously controlled. If necessary, an antidote can be administered via the IV to reverse the effects of the medications.
IV sedation is administered by the doctor and monitored by the doctor and the surgical assistive staff.
All patients undergoing IV sedation must be accompanied home by a responsible adult.
Nitrous Oxide (Laughing Gas)
Nitrous Oxide (inhalation sedation) has been the primary means of sedation in dentistry for many years. Nitrous oxide is safe; the patient receives 50-70% oxygen with no more than 30% nitrous oxide.
Advantages to 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”. Patients can leave the office independently.
- Inhalation sedation is safe with no side effects on the heart and lungs, etc.
- Inhalation sedation is very effective in minimizing gagging.
- The response is rapid; in as few as 2-3 minutes the patient is relaxed and pain is managed.
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