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 and simple tooth extractions.
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. Simple oral surgery procedures to more involved procedures such as removal of wisdom teeth and placement of dental implants.

IV/”Twilight Sedation” (Often called “Monitored Anesthesia Care”) with local anesthetic

IV Sedation/Monitored Anesthesia Care involves the injection of medications through an IV catheter to help you relax, as well as to block pain. The depth of sedation will vary by procedure, as well as what is deemed safest for the patient.  This technique usually does not produce total unconsciousness. The anesthetic medications are administered through an intravenous (IV) line, breathing gases, intramuscular injection, or combination of the described techniques could also be used.  In addition, the surgeon will inject a local anesthetic at the site of the procedure for pain control. Please keep in mind that if for any reason you are unable to tolerate this type of anesthetic, there may be a need for a general anesthetic to be administered to complete the procedure safely.

A patient may choose IV Sedation for simple procedures depending on their level of anxiety. Most people having their wisdom teeth removed or having a dental implant placed will choose IV Sedation.

Office Based General Anesthesia with Local Anesthetic

There is a state of total unconsciousness. It is possible that a breathing tube is placed through the mouth or nose and into the trachea to help the patient breath. General anesthesia is achieved through injecting medications through an intravenous line or by breathing an anesthetic gas. Intramuscular injections and other techniques could be used. A combination of the described techniques could also be used.

General anesthesia is available for all types of oral surgery. A patient may choose general anesthesia for the “All on 4” or “Teeth-In-A-Day procedure, as well as more complicated or invasive oral surgery procedures. General anesthesia may be necessary if local anesthesia fails to anesthetize the surgical site which often occurs in the presence of infection.

When it comes to anesthesia, our first priority is the patient’s safety and comfort. If you have any concerns regarding the type of anesthesia that will be administered during your procedure, please do not hesitate to discuss your concerns with your doctor at the time of your consultation.