Several methods of anesthesia are available at Wake OMS. 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.
MethodTypes of AnesthesiaDescription of TechniqueUsual Indications
Method Local AnestheticDescription of Technique The patient remains conscious throughout the procedure. A local anesthetic, “Novocaine” is injected in the area where the surgery is to be performed.Usual Indications Simple oral surgery procedures such as minor soft tissue procedures, single tooth extractions and single implants.
Method Nitrous Oxide with Local AnestheticDescription of Technique A mixture of nitrous oxide (laughing gas) and oxygen is administered through a nasal mask or hood. The patient remains conscious but in a relaxed condition. Nitrous oxide has both a sedative and analgesic (pain-minimizing) effect.Most effective in younger patients, (children and adolescents) undergoing relatively straightforward procedures. Best used to minimize procedural anxiety.
Method Office-Based General Anesthesia or Deep Sedation.Sedation/Anesthetic medications are administered through an intravenous line, (IV). The patient ideally is minimally conscious and completely unaware of the procedure being performed. Supplemental oxygen is delivered through a nasal apparatus and the patient’s vital signs are closely monitored. Medications commonly used include Fentanyl, Versed and Propofol.Usual Indications General anesthesia or Sedation is available for all types of oral surgery. A patient may also choose general anesthesia for simple procedures depending on their level of anxiety. Most people having their wisdom teeth removed or having a multiple dental implants placed will often choose general anesthesia/sedation. General anesthesia may be necessary if local anesthesia fails to anesthetize the surgical site which often occurs in the presence of infection.
Method Hospital or Surgery Center-Based General AnesthesiaDescription of Technique A patient is admitted to a hospital or surgery center where anesthesia is administered by a Physician anesthesiologist.Usual Indications 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 achieve the ability to administer general anesthesia or sedation in the surgery office, an Oral and Maxillofacial surgeon completes a rotation on the Hospital Anesthesia Service during their OMS residency training. Dr. Hum completed four months on the Ohio State University Anesthesia Service and an additional month at Children’s Hospital in Columbus, Ohio. During Dr. Hum‘s residency training at the Ohio State University he also completed hundreds of anesthetics while on the Oral and Maxillofacial Surgery Service in addition to many hours of didactic training and literature reviews.
When it comes to anesthesia, our first priority is the patient’s comfort and safety. Dr. Hum is ACLS certified and has years of experience providing outpatient anesthesia. Our clinical nurse will be with you throughout your anesthetic and into our monitored Recovery Room. 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 Oral Surgeon at the time of your consultation. With modern anesthesia monitoring equipment, we can make your surgical procedure predictable and comfortable.
Our office also offers our patients the option of Intravenous Sedation for their oral surgery care. Intravenous Sedation helps you to be comfortable and calm when undergoing dental procedures. Intravenous sedation or “IV sedation” is designed to better enable you to undergo your dental procedures while you are very relaxed; it will enable you to tolerate as well as not remember those procedures that may be uncomfortable for you. IV sedation will essentially alleviate the anxiety associated with your surgery. You may not always be completely asleep but you will be comfortable, calm and relaxed, drifting in and out of medically induced sleep.
If you choose the option of intravenous sedation your IV sedation/anesthesia is administered and monitored by your Oral and Maxillofacial Surgeon and the OMS Team therefore eliminating the costly expense of having your treatment carried out in an operating room or same day surgical facility.
Nitrous Oxide (Laughing Gas)
Nitrous Oxide is a sweet smelling, non irritating, colorless gas. Nitrous Oxide has been the primary means of sedation in dentistry for many years. Nitrous Oxide is safe; the patient receives 50-70% Nitrous Oxide with no less than 30% Oxygen. Patients are able to breathe on their own and remain in control of all bodily functions. The patient may experience mild amnesia and may even fall asleep not remembering all of what happened during their appointment.
There are several advantages to using Nitrous Oxide.
- There is no after effect once the Nitrous Oxide has been exhaled.
- Inhalation sedation is safe with no side effects on your heart and lungs.
- Inhalation sedation is effective in minimizing gagging.
- It works rapidly. In as few as 2-3 minutes its relaxation and pain suppressing properties develop.
Reasons to Not use Nitrous Oxide
Although there are no major contraindications to using nitrous oxide, you may not want to use it if you have emphysema, recent ear or ophthalmic surgery, a cold or other difficulties with breathing.