Finding Comfort and Safety in Oral Surgery
Have you ever found undergoing an oral surgery with anesthesia to be somewhat scary? For many folks, the idea of “going under” may cause a bit of nervousness as they come into the dental office. This is especially true if a patient has little or no previous experience with anesthesia.
Before undergoing any procedure, it is important to thoroughly understand your available options and have a grasp on the process your dental care provider uses. The more understanding provided about these details, the better prepared you can be for your actual experience. This article aims to give you precisely that kind of clarity, so you can remain calm and confident as you address your oral health needs.
General Anesthesia: The Basics
Anesthesia is just one type of sedation available to you today. A few common reasons folks may consider receiving sedation during their oral surgery are:
- Sensitive teeth
- An overactive gag reflex
- The patient is a child
- The patient is neurodivergent (in a way that makes them reactive to stressful situations or their behavior unpredictable)
- A heart condition
- A movement disorder
- A low pain threshold
General anesthesia is a comprehensive form of sedation that renders a patient completely unconscious during medical procedures. This does not merely numb a specific area of the body, or help relax you while keeping you awake and drowsy. Rather, general anesthesia puts you into a deep sleep-like state. This ensures that you feel no pain and have no memory of the actual procedure.
The administration of general anesthesia is performed by an anesthesiologist or a specially trained medical professional, given via an IV. Your vital signs (including heart rate, blood pressure, breathing, and oxygen levels) are carefully monitored throughout the procedure to ensure everything stays perfectly safe.
General anesthesia is used for more complex and lengthy procedures that would often be uncomfortable or impractical to perform otherwise. It is crucial for some procedures that require a high degree of muscle relaxation and a completely still patient. This would include surgeries like a full mouth reconstruction, maxillofacial surgery or the removal of wisdom teeth.
Exactly How Safe Is This?
Anesthesia used in oral surgery has been proven to be highly safe since its first use in 1846. It is widely regarded as a secure practice globally, shown to be 3.5 times safer than that of general anesthesia in hospitals. A study by the American Association of Oral and Maxillofacial Surgeons showed that only 6% of patients experienced minor side effects.
To enhance the safety of your surgery, it is crucial to follow pre-operative instructions closely. Do not eat or drink anything six hours prior to your surgery. This will allow you to completely avoid any risk of aspirating food or liquid into your lungs.
Getting Started…
Before administering general anesthesia, a reliable dentist or oral surgeon will conduct a comprehensive pre-anesthesia assessment. This involves completing a health history form and obtaining medical clearances from other specialists. These steps help to evaluate any risks for complications, so that the most appropriate sedation method can be determined for you.
Be sure to share all past surgeries and any contagious or life-threatening illnesses like HIV or Hepatitis C on your health history. Make your surgeon aware of any complications you may have had with previous anesthesia, allergies, the medications and vitamin supplements you take, and any use of drugs or alcohol.
Your pre-anesthesia assessment may also involve some specific diagnostic tests. These include blood tests to check for any underlying conditions that could affect the anesthesia process – such as kidney function tests, blood sugar levels, and a complete blood count (CBC). In some cases, an EKG (electrocardiogram) might also be performed to assess heart health (especially for older patients or those with a history of heart issues).
Addressing Anesthesia Complications
If you have already had previous complications with anesthesia, a detailed and cautious approach will be adopted by your care providers. A reliable surgeon will take the following steps:
- Review the specific details of the prior complications to understand the causes and risk factors involved.
- Consult with an anesthesiologist or other specialists if needed, to develop a tailored anesthesia plan that minimizes risks.
- Consider using alternative anesthesia techniques that are deemed safer for the patient, based on your past experiences and current health status.
- Closely monitor you during and after the procedure to quickly address any signs of adverse reactions or complications.
Types of General Anesthesia for Oral Surgery
For dental or oral procedures that require general anesthesia, a variety of agents can be used. Each of these have specific characteristics that suit different types of surgeries and patient needs. These can be categorized mainly into inhalation agents and intravenous agents.
Inhalation Agents:
- Nitrous Oxide: Commonly known as laughing gas, it is often used in conjunction with other forms of anesthesia. It is not strong enough for major surgery on its own but is excellent for reducing anxiety and pain in less invasive procedures.
- Sevoflurane, Isoflurane, Desflurane: These are volatile liquids that vaporize and are inhaled via a mask or a breathing tube. They are widely used due to their rapid onset and quick recovery times compared to older agents.
Intravenous Agents:
- Propofol: This is one of the most commonly used intravenous agents for inducing anesthesia quickly. Once the procedure is complete, its effects wear off rapidly, allowing for quicker recovery.
- Ketamine: Used for both induction and maintenance of anesthesia. It provides pain relief as well as sedation, making it particularly useful in painful oral procedures.
- Benzodiazepines: Often used for sedation before procedures or in conjunction with other anesthetics. They help to relax patients and reduce anxiety.
Constituents and Potential Allergies:
Each of these anesthetic agents is made up of different chemical compounds specifically designed to alter pain perception and consciousness:
Inhalation agents are generally ethers or nitrous oxide and have very few cases of allergies associated with them.
Intravenous agents like Propofol contain soybean oil and egg lecithin, which can trigger allergic reactions in some individuals.
While allergic reactions to general anesthesia are quite rare, they can occur. This is especially true with intravenous agents (due to their constituents). Symptoms of an allergic reaction can include rash, itching, difficulty breathing, or anaphylaxis in severe cases. This is why the pre-anesthesia assessment, where a patient’s allergies and medical history are thoroughly reviewed, is so crucial.
Considering Alternatives
Seek to choose a dentist or oral surgeon who understands the importance of your comfort with each anesthesia choice. If a chemical is being used that you are allergic to or would not like to receive, do not hesitate to discuss it with any dentist or surgeon.
Always look for care providers who commit to only using options that make you feel completely at ease. If for some reason you are not open to using the more typical general anesthesia, consider the following alternatives:
- Local Anesthesia: Administered to numb a specific area of the mouth during minor procedures. The patient remains fully awake and alert. This is appropriate for simple procedures like fillings, crowns and minor tooth extractions.
- Sedation Dentistry: This includes options like oral sedatives, IV sedation, or a limited use of nitrous oxide. These methods can be used alone or in combination with local anesthesia to help relax the patient, ranging from minimal to moderate sedation where the patient is relaxed but still awake.
- Conscious Sedation: Similar to sedation dentistry, this involves medications that relax the patient deeply enough that they are barely conscious but can still respond to verbal cues.
Put Your Teeth in the Right Hands
Oral and Maxillofacial Surgeons (OMS) are uniquely qualified among dental and medical specialists to administer both IV sedation and general anesthesia. OMS professionals undergo mandatory, extensive training that includes at least four years focused on anesthesia, alongside their surgical education.
During their residency, OMS trainees spend several months in hospital anesthesiology departments where they administer general anesthesia and manage ventilators. They also learn critical emergency procedures like tracheostomies and cricothyrotomies. This training ensures they are well-equipped to handle emergencies and maintain patient safety.
For those near Cincinatti, Ohio, we often recommend folks to the care of Dr. Scott Puckett and his office at Wilmington Oral Surgery. With over 20 years of experience, Dr. Puckett brings a wealth of knowledge and expertise in performing various oral surgeries using IV sedation and general anesthesia.
An Anxiety-Free Surgery Experience
General anesthesia is used not only to alleviate pain but also to minimize memory of the procedure, limit movement, and reduce anxiety. All of this helps ensure that you remain both comfortable and safe.
Wilmington Oral Surgery has for decades administered in-office general anesthesia for procedures such as wisdom teeth removal, dental implant surgeries, facial cosmetic operations, and jaw repairs. Their team adheres to hospital-level standards of care. This includes the use of EKGs, pulse oximetry, blood pressure cuffs, temperature probes, and capnography to continuously monitor patients under anesthesia.
By choosing Dr. Puckett’s clinic for your oral surgery needs, you place yourself in the hands of a skilled surgeon backed by a track record of excellence in surgical care. Let their team address your concerns and guide you through a smooth, anxiety-free experience.