Oral surgery treatment under sedation or sleep dentistry
Oral surgery is a procedure that many people will require at some point in their lives. Whether it’s pulling a tooth, extracting impacted wisdom teeth, or more invasive procedures like reconstruction, most of us will find ourselves sitting in that chair for more than a routine check-up. Oral Surgery can be defined broadly with procedures like guided tissue regeneration, osseous surgery, gum/tissue surgery, sinus lifts, partial bony or full bony impacted tooth, and many others. Our oral surgeon (or periodontist) would be able to handle oral surgery under sedation cases.
Many of the frequent questions we receive concern how they will be sedated during their operation. Will I be awake during the procedure? Will it hurt? Anxiety over oral surgery is completely normal and there are different kinds of anesthesia used in oral surgery.
Under most sedatives, you’ll remain somewhat conscious but many patients feel so relaxed and tranquil that they end up falling asleep during the procedure. Often times, they have no memory of the surgery at all. What type of sedation you’ll use depends on how invasive the procedure is.
Local anesthesia is a numbing medication that temporarily prevents the nerve fibers from sending signals to the brain. While using a local anesthetic, such as lidocaine, patients remain fully awake and aware. However, the area around the injection point doesn’t feel any pain. It’s typically used during minimally invasive procedures, such as removing an erupted tooth. But it’s also used alongside stronger forms of anesthesia for more invasive or complicated surgeries.
After a simple procedure using a local anesthetic, patients will feel numbness for several hours and won’t require precautions such as an escort to drive them home or fasting before the procedure.
Nitrous oxide (laughing gas)
Nitrous oxide, commonly known as laughing gas, is a form of conscious sedation. It’s administered through a mask worn by the patient who then breaths in a steady combination of nitrous oxide and oxygen. It is used with simple as well as more complicated procedures.
Patients feel relaxed and their anxiety is reduced. They may also control how much is administered by simply taking deeper and more frequent breaths. Within several minutes following the procedure, the effects will wear off and the patient will be able to drive themselves home. Another benefit is how little this method costs. There are typically no added expenses associated with nitrous oxide.
The oral medication method typically requires that patients take anti-anxiety pills such as Valium, Halcion, or Ativan, to achieve conscious sedation. This method is usually more effective at sedating patients than nitrous oxide and is also not costly to administer. Patients usually take the medication roughly an hour before the procedure.
One issue with this method is consistency. Some patients may react to unpredictably to the medication, i.e., taking longer to feel its effects, requiring stronger doses, etc. Patients will also require the help of a friend or family member to drive them to and from the office as they will feel very groggy afterward.
The intravenous (IV) sedation process involves administering medication through a vein. The medication is fast acting and is the most effective form of sedation for oral surgeries other than general anesthesia. Patients typically have no recollection of the operation. Like oral medication, patients will need assistance getting home and will feel groggy following the appointment.
General anesthesia is used for patients who require more extensive surgical procedures such as facial and jaw reconstruction. It is typically administered orally and intravenously and patients will become fully unconscious and have no memory of the procedure.
Every oral and maxillofacial surgeon receives training for all aspects of anesthesia administration, so patients don’t have anything to worry about. They can rest easy knowing their surgeon and staff are well-prepared professionals. And if you have any questions, don’t be afraid to ask your dentist or surgeon. They’re there to make the procedure as comfortable as possible.