Anesthesia for Oral Surgery

Proper use of anesthesia ensures patient comfort and successful oral surgery. We offer several forms of anesthesia depending on the patient’s anxiety level, the type of procedure performed, and the patient’s overall health. Our surgeons have years of training in experience in using all forms of oral surgery sedation. In addition, we have a Certified Registered Nurse Anesthetist (CRNA) to monitor our patients at all times while using anesthesia.

Our goal is to provide the appropriate level of sedation while using as little medication as necessary. While some patients may be comfortable undergoing relatively simple oral surgery procedures using a local anesthetic, others may experience extreme dental anxiety and need a higher level of sedation for comfort.

Local Anesthetic

Our surgeons utilize a local anesthetic for every oral surgery procedure we perform. A local anesthetic is injected into the area to numb it. There are several forms of local anesthetic, including lidocaine, which wears off within a few hours. We may also add an additional form of sedation depending on the procedure and the patient’s stress level.

We may use Exparel for more complex procedures and to alleviate post-operative pain, as Exparel numbs the site for up to three days. This allows for a more comfortable recovery with less need for oral pain relievers.

Nitrous Oxide (Laughing Gas)

Nitrous Oxide has been the primary means of sedation in dentistry for many years. Nitrous Oxide is a sweet-smelling, colorless gas breathed in through a mask for oral surgery. Nitrous oxide is safe; the patient receives 50-70% oxygen with no less than 30% nitrous oxide. Patients breathe independently and remain in control of all bodily functions but are relaxed and at ease. The patient may fall asleep and experience mild amnesia, not remembering all of what happened during their appointment.
There are many advantages to Nitrous Oxide, including:

• We can increase or decrease the depth of sedation as needed.
• There are no lingering aftereffects such as headaches or hangovers.
• Laughing gas has no side effects that impact the heart or lungs.
• Inhalation sedation is very effective in minimizing gagging.
• Nitrous oxide reaches the brain quickly (usually in about 20 seconds), with relaxation and pain relief developing in just minutes.

Some patients may not want to use nitrous oxide, including those with emphysema, chest conditions, Multiple Sclerosis, or breathing difficulties from illness.

IV Sedation (Twilight Sedation or Twilight Sleep)

Intravenous sedation is the most popular form of sedation dentistry for individuals with dental anxiety. The medication is administered using a slender intravenous tube inserted in a vein in the arm or hand. The drug relaxes you and helps you feel comfortable and calm when undergoing dental and oral surgery. Once the IV sedation has entered your bloodstream, you can tolerate your procedure and may not remember it after it is over. The term “twilight sleep” refers to the semi-conscious produced. You will drift in and out of sleep but feel calm and peaceful.

The goal of IV sedation is to use as little medication as possible to complete the treatment. It is much safer than oral sedation. With IV sedation, a constant “drip” is maintained via the intravenous tube. An antidote can be administered at any time to reverse the effects of the medications if necessary.

General Anesthesia

In the case of the most complex oral surgery procedures, our oral surgeons may use general anesthesia. This deep level of sedation puts you to sleep completely. It is administered by your surgeon or our Certified Registered Nurse Anesthetist (CRNA), who is specially trained in administering general anesthesia and monitors each patient throughout their procedure. We reserve general anesthesia for patients suffering from severe anxiety or dental phobia or undergoing lengthy surgeries.

Wisdom Teeth and Anesthesia

If your teen has wisdom teeth removed, we usually use a local anesthetic and IV sedation. This combination keeps them comfortable and prevents wiggling or movement during wisdom teeth extraction. IV sedation is the best anesthesia option for most patients having wisdom teeth removed. However, we may recommend general anesthesia for surgeries that are likely to take longer or if your teen suffers extreme anxiety.

Is Sedation Safe for Oral Surgery?

Yes. Although there is always a risk of complication when sedation is used, it is rare. Rest assured, you are in good hands, as our oral surgeons have undergone years of additional training in using all forms of sedation. Our CRNA provides an extra level of safety by monitoring all patients throughout their surgery. Our focus is always on patient safety.

Most patients tolerate dental sedation very well, with few serious side effects. Some patients may experience mild symptoms after oral surgery, but these are short-lived and may include:

• Headache
• Nausea, vomiting
• Slurred speech
• Sore or parched throat
• Short-term confusion
• Numbness at the injection site (local anesthesia)
• Fatigue

Do I Have to be Sedated for Oral Surgery?

No. It is important to understand that any form of oral surgery can take time and requires the patient to sit still with their mouth open for a relatively long period. For this reason, most patients prefer sedation. If you are comfortable sitting still while a procedure is performed, you can ask your surgeon to skip sedation and administer only a local anesthetic.

You can learn more about how to prepare before sedation surgery on our anesthesia preparation page for patients.

If you have been referred to us for oral surgery, including wisdom teeth removal, we will review your anesthesia options with you at your first appointment. Contact our our Lebanon Office at Lebanon Office Phone Number (717) 273-6745 or our Lancaster Office at Lancaster Office Phone Number (717) 740-2373 to arrange a consultation.