If you’re scheduled for wisdom teeth removal or other forms of dental surgery, you may be wondering what kind of dental anesthesia will be used. There are a few different types of anesthesia that can be used, depending on your individual situation. In this article, we’ll discuss the most common types and in which cases each is used. We’ll also talk about the pros and cons of each type so that you can make an informed decision about which type is best for you.
Sedation and Anesthesia: What’s the Difference?
It’s important to understand the difference between sedation and anesthesia before we get into the different types of each. Anesthesia is a process of numbing the body so that surgery can be performed without pain. Sedation is the use of drugs to help a patient feel relaxed and pain-free during a dental appointment. Both of these techniques are used during wisdom teeth removal. The most common types used for wisdom teeth removal are broken down below.
Local Anesthesia
With local anesthesia, you are awake during the surgery but your mouth is numb. This type of anesthesia is injected into the gums around the teeth that are being removed. You may feel some pressure and movement, but you should not feel any pain.
Local anesthesia is always administered regardless of what other anesthesia/sedation techniques are done.
Local anesthesia works by temporarily blocking pain signals from being sent to your brain. However, since the anesthetic is only used in your mouth it does not result in loopiness. Typically, you will only feel some numbness in your mouth and jaw that will wear off after a few hours.
Minimal Sedation
Minimal sedation is when patients are awake during surgery but feel more relaxed.
This type of sedation is often achieved through the use of nitrous oxide, also known as laughing gas. Nitrous oxide is a gas that you breathe in through a mask which results in a relaxed and carefree feeling as well as reducing the ability to perceive pain. It’s a super-safe type of sedation that is frequently given to women going through childbirth to minimize discomfort and anxiety.
Laughing gas is a very straightforward sedation technique and typically fully wears off before patients leave the dental office. Thus it doesn’t usually cause loopiness. Although not as common, minimal sedation can also be achieved through oral sedatives which are discussed below.
Moderate Sedation
With this type of sedation, you are awake but may drift in and out of sleep. It is also extremely common to experience partial or complete amnesia. This means it is very common to not remember anything about your surgery once it is over. Moderate sedation also means you can be more easily woken in cases of emergencies.
In moderate sedation, you are typically given a sedative pill, which is either swallowed or dissolved under the tongue. The best class of drugs to use for oral sedation are benzodiazepines such as Diazepam (Valium), Triazolam (Halcion), Midazolam (Versed), Lorazepam (Ativan). These drugs work by depressing the central nervous system, resulting in relaxation and drowsiness that typically take hours to wear off.
Moderate sedation can also be achieved through a mix of oral sedatives and nitrous oxide. It can also be achieved through IV Sedation which is discussed below.
Deep Sedation
With deep sedation, you are on the edge of consciousness and may not be able to be easily awoken. You are also extremely unlikely to remember any part of your dental appointment. This type of sedation is typically only used in high-risk patients or for very long surgeries.
Deep sedation is usually achieved through IV sedation which involves the administration of drugs through an intravenous line directly into your bloodstream. The drugs used for IV sedation vary depending on how deep the sedation is required.
Moderate Sedation is achieved by using a benzodiazepine, most commonly midazolam or diazepam. Deep Sedation is achieved using a benzodiazepine and an opioid.
General Anesthesia
General anesthesia is used when a more complex surgery is being performed or if the person prefers to be asleep during the surgery. It will result in you being completely unconscious and unable to feel any pain. Usually, it is not required during wisdom teeth removal.
Whereas all other sedation/anesthesia techniques can be performed by dentists, general anesthesia requires a separate medical anesthesiologist to be present during your procedure. This is because general anesthesia is a lot deeper than all other procedures listed above and results in a complete inability to be woken up. It can also remove the ability of a person to maintain their airway to breathe.
General anesthesia is typically achieved through the drug propofol. Propofol is administered through an IV and works by depressing the central nervous system to the point where you are completely unconscious.
What Anesthesia will be used in my Situation?
The anesthesia that will be used during your specific procedure will depend on a variety of factors. This can include the severity of your case, whether you have any allergies, your age, your health history, and any other medications you are taking.
Other than those complex factors, which we won’t get into here, the biggest deciding factor on what type of anesthesia will be used is your comfort during the procedure. As a dentist, the comfort of one’s patient should always be taken into account when doing procedures.
If a patient is very comfortable with the procedure being done, Local Anesthesia will typically be more than sufficient. If the patient is a bit more anxious, they may prefer Moderate Sedation. In cases of extreme apprehensiveness, deep sedation or general anesthesia may be recommended. However, each level of deeper sedation carries with it more risks and room for error. For this reason, it is best to minimize the amount of sedation or anesthesia used whenever possible.
As always, be sure to consult with your dentist or oral surgeon to see what they recommend for you, as they will be able to take into account all the complexities and tailor a plan that is best for you.
Disclaimer
The contents of this website, such as text, graphics, images, and other material are for informational purposes only and are not intended to be substituted for professional medical advice, diagnosis, or treatment. Nothing on this website constitutes the practice of medicine, law or any other regulated profession.
No two mouths are the same, and each oral situation is unique. As such, it isn’t possible to give comprehensive advice or diagnose oral conditions based on articles alone. The best way to ensure you’re getting the best dental care possible is to visit a dentist in person for an examination and consultation.
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