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. The following table illustrates the choices of anesthesia, a description of the anesthetic technique, and the usual indications for that technique.
|Method of Anesthesia||Description of Technique||Usual Indications|
|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.||Simple oral surgery procedures such as minor soft tissue procedures, dental fillings, simple root canal procedures.|
|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 sedative and analgesic (pain- controlling) effect.||More complex procedures such as complex dental fillings, crowns, deep gingival cleanings.|
|Office Based General Anesthesia with Local Anesthetic*||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.||General anesthesia is available for all types of oral surgery. Most people having their wisdom teeth removed or having a dental implant placed will choose general anesthesia.|
|Hospital or Surgery Center Based General Anesthesia||A patient is admitted to a hospital or surgery center where anesthesia is administered by an anesthesiologist.||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.|
To administer general anesthesia in the office, an oral surgeon must have completed at least three to six months of hospital based anesthesia training and must be certified by a Board Certified Anesthesiologist. After completion of training, oral surgeons must obtain basic cardiac and advanced life support certification and must have continuing education to maintain certification. The office must also maintain strict certification by the South Carolina Board of Dentisty and the American Association of Oral and Maxillofacial Surgeons to continue to provide advanced anesthesia services to our patients. Oral surgeons must also comply with strict DEA and DHEC licenses and inspections.
An oral surgeon will then undergo an in office evaluation by a state dental board appointed examiner.
Again, when it comes to anesthesia, 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 do not hesitate to discuss your concerns with your doctor at the time of your consultation.
Intravenous Sedation (IV Sedation)
Our office offers our patients the option of Intravenous Sedation in order to alleviate anxiety and provide relaxed comfort during your procedure. You may not always be asleep but you will be comfortable, calm and relaxed, drifting in and out of sleep. This sedation will also lessen head and neck movement during the procedure which can lessen complications during the procedure.
If you choose the option of intravenous sedation your IV sedation/anesthesia is administered and monitored by the doctor therefore eliminating the costly expense of having your treatment carried out in an operating room or same day surgical facility.
How is the IV Sedation Administered?
A thin catheter will be introduced into your arm or hand. This will be attached to an intravenous tube through which medication will be given to help you relax and feel comfortable. Some patients may be 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 eliminate anxiety and provide comfort while the treatment completed. It is very safe, much safer than oral sedation. With IV sedation a constant “drip” is maintained via the intravenous tube. At any time an antidote can be administered to reverse the effects of the medications if necessary. Along with IV sedation there are also other different “levels” of sedation available to you in our office. There is nitrous oxide analgesia.
Nitrous Oxide (Laughing Gas)
Nitrous Oxide is an odorless, non irritating, colorless gas which you can breathe. Nitrous Oxide has been the primary means of sedation in dentistry for many years. Nitrous oxide is safe. Patients are able to breathe on their own and remain in control. The patient may experience mild amnesia and may fall asleep not remembering all of what happened during their appointment, however this is not typical, and there are no lasting post-operative effects once the gas is no longer being administered.
Our Doctors will evaluate each patient independently to determine if you are a good candidate for Nitrous Oxide sedation.