Anesthesia
We Offer Several Methods of Anesthesia
Several methods of anesthesia are available in order to offer our patients maximum comfort during the procedure. The method of anesthesia for the procedure is dependent upon the nature of the surgical procedure and the patient’s level of apprehension, and will be determined by our doctors and the patient following a thorough pre-operative medical assessment. The following table illustrates the choices of anesthesia, a description of the anesthetic technique, and the usual indications for that technique.
To administer general anesthesia in the office, an oral and maxillofacial surgeon must have completed a minimum of five months of hospital-based anesthesia training, where they perform general anesthesia and intubate patients for a variety of procedures. Qualified applicants will then undergo an in-office evaluation by a state dental board-appointed examiner. The examiner observes an actual surgical procedure during which general anesthesia is administered to the patient. The examiner also inspects all monitoring devices and emergency equipment and tests the doctor and the surgical staff’s competence on anesthesia-related emergencies. If the examiner reports successful completion of the evaluation process, the state dental board will issue the doctor a license to perform general anesthesia. The license must be renewed at least every five years and requires the doctor to maintain the required amount of continuing education units related to anesthesia.
Comfort Is Our Priority
Again, when it comes to anesthesia, our 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 do not hesitate to discuss your concerns with your doctor at the time of your consultation.
Local Anesthetic
The patient remains totally conscious throughout the procedure. A local anesthetic injection (e.g. lidocaine) is administered in the area where the surgery is to be performed, which makes the area lose sensation to pain. Local anesthetic is administered for all oral surgery procedures, and is often used in conjunction with other forms of anesthesia for patient comfort.
USUAL INDICATIONS: Simple oral and maxillofacial surgery procedures, such as minor soft tissue procedures and simple tooth extractions.
Office-Based General Anesthesia With Local Anesthetic*
General anesthesia medications are administered through an intravenous line (IV). Supplemental oxygen is delivered through a nasal breathing apparatus and the patient’s vital signs are closely monitored. Depending on the pre-operative medical assessment, some patients may be fully sedated and asleep while others may be lightly sedated.
Intravenous sedation, also referred to as “IV sedation” or “twilight sedation”, enables the patient to tolerate procedures better by alleviating the anxiety associated with treatment. The patients are comfortable, calm, and relaxed, drifting in and out of sleep. Many patients do not remember the procedure at all afterwards. With this option of intravenous sedation, the IV sedation/anesthesia is administered and monitored by the doctor, therefore eliminating the costly expense of having treatment carried out in an operating room or same-day surgical facility.
USUAL INDICATIONS: General anesthesia/IV sedation is available for all types of oral and maxillofacial surgery. A patient may choose general anesthesia for simple procedures depending on their level of anxiety. Many patients having their wisdom teeth removed or having a dental implant placed will choose general anesthesia.
Nitrous Oxide Sedation With Local Anesthetic
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 mild sedative and analgesic (pain-controlling) effect. Patients breathe oxygen at the conclusion of the procedure until the nitrous oxide has fully dissipated from the body. For patients with increased anxiety, an oral sedative may also be prescribed to be taken before the appointment.
USUAL INDICATIONS: Simple oral and maxillofacial surgery procedures to more involved procedures, such as removal of wisdom teeth or placement of dental implants.
Hospital or Surgery Center Based General Anesthesia
The patient is admitted to a hospital or surgery center where anesthesia is administered by an anesthesiologist and generally involves use of an endotracheal tube (breathing tube).
USUAL INDICATIONS: Patients undergoing extensive procedures such as face and jaw reconstruction and TMJ surgery. Patients with certain medical conditions who are not candidates for in-office IV anesthesia may also require hospital-based anesthesia.
How Is the IV Sedation Administered?
A thin IV catheter will be introduced into a vein in the patient’s arm or hand. General anesthesia medications are administered through the catheter and titrated to effect, depending on the patient’s health status and response to medications. Once again, some patients may be completely asleep while others will slip in and out of sleep. Some patients with medical conditions and/or on specific drug regimens may only be lightly sedated and may not sleep at all.
The goal of IV sedation is to use as little medication as possible to get the treatment completed. IV sedation is safe and effective. At any time, an antidote can be administered to reverse the effects of the medications if necessary.