Anesthesia for Oral Surgery

Local Anesthesia

Many oral surgery procedures can be carried out under local anesthesia only. This is the same anesthesia technique that is used by all dental professionals. An injection of a local anesthetic medication is given, an appropriate amount of time passes to let the medication become effective and block discomfort, and then the procedure is carried out.

Local anesthesia and Nitrous Oxide

Nitrous Oxide or “Laughing Gas” is an anesthetic gas that, when combined with oxygen and administered via a nasal mask, can produce a feeling of relaxation, mild sedation and anxiety relief. When Nitrous Oxide is combined with local anesthesia, the procedure is more easily tolerated by the patient. Children usually do well with Nitrous Oxide and often laugh under its influence, hence the nickname, “Laughing Gas”.

Pre-operative Oral Sedation

In selected cases, where there is a history of anxiety relative to medical or dental treatment, a prescription can be provided pre-operatively for medication to be taken by mouth prior to treatment.

This facilitates reduction in treatment related anxiety and results in a better treatment experience for the patient.

General Anesthesia/ IV Sedation

The term “general anesthesia” refers to anesthetic or sedating medicines given intravenously that produce various states of sedation or unconsciousness, depending on the medication given and the needs of the patient. The purpose of general anesthesia is to provide optimal comfort for the patient during surgical treatment. The reasons to consider general anesthesia options for oral surgery include the following:

  1. A history of difficulty getting numb with the typical dental local anesthetic
  2. A history of moderate to severe emotional distress in the dental treatment setting
  3. The presence of moderate to severe dental infection which can render typical local anesthetic injections less effective
  4. A procedure in which local anesthetic alone is inadequate in providing a comfortable treatment experience for the patient
  5. A lengthy or technically difficult procedure

Oral and maxillofacial surgeons are unique among surgery specialists in that they are also formally trained in rendering anesthesia care. Most oral and maxillofacial surgeons employ the “oral surgery team based anesthesia” model in which the surgeon doing the procedure also provides anesthesia services. In order for this type of service to be rendered safely, the office, and anesthesia equipment and practices are reviewed on a regular basis by regulatory agencies. This model works well for most medically healthy patients and has an extensive record of safety and efficiency. However, there are cases in which relative medical health, age, and surgical difficulty dictate the need for a separate anesthesiologist. When this occurs, either an anesthesiologist attends the office surgery to provide anesthesia care, or the procedure is carried out in a hospital setting with the assistance of an anesthesiologist.