Anesthesia is a means of pain and anxiety management used in a broad range of health procedures, including dentistry. Dental anesthesia encompasses a spectrum of treatments, each offering different benefits to the patient. There are several types of anesthesia, including:
- Local Anesthetic – Local anesthesia, also commonly known as novocaine, is used during most dental procedures. This medication is administered as an injection designed to temporarily prevent the teeth nerve fibers from transmitting impulses, thereby numbing the area. This local anesthesia is the only type of anesthesia which, used alone, will completely eliminate pain. It is possible, however, to combine local anesthesia with various types of conscious sedation techniques to further reduce your awareness and anxiety during the procedure.
- N2O – Nitrous oxide, or “laughing gas”, is the lightest form of conscious sedation. It is administered by breathing through a nasal mask. It has several very appealing properties. First, it is very short acting and is completely eliminated from the body minutes after turning it off. Since there is no hang-over effect, the patient may leave the office without an escort. Secondly, nitrous oxide can be patient regulated. If you want to feel more of its effects, you simply breath more frequently and deeply. Conversely, if you breathe through your mouth, you will feel less of its effects. Finally, the last appealing property is the cost. In most cases, there is little to no cost associated with the use of nitrous oxide. The big drawback to nitrous oxide is that even at its highest level of effectiveness, it is only minimally effective at reducing awareness and anxiety. Although its effects vary from patient to patient, most patients feel nitrous oxide “just takes the edge off.”
- Oral Sedation – Oral pre-medication or pills are the next step up in the conscious sedation spectrum. Many different medications can be used. The advantages to oral pre-medication are that it is more effective than nitrous oxide and it is also very inexpensive to administer. The patient will usually take the medication a half hour to one hour prior to the appointment and the duration of the effects will vary. But, in all cases, the patient must have an escort both to and from the office. Although more effective than nitrous oxide, the effectiveness and onset of action are unpredictable.
- Conscious IV Sedation – Intravenous Sedation, also known as “Twilight or Conscious Sedation”, will put you in a safe, relaxed, and comfortable state throughout your surgery. It is the most effective means of reducing awareness and anxiety for dental procedures. It is administered through an intravenous line (I.V.), and is therefore much more predictable in terms of effectiveness due to the quick onset of action. Although the patient is technically conscious throughout the procedure, in most cases, they will be completely unaware of dental procedure. The disadvantage of conscious sedation is, of course, the increased cost and the need for an escort home after the procedure. But, for the patient who wants to feel “the most” comfortable during the procedure, it is certainly the best in terms of cost.
Did You Know…
that Lidocaine – the primary local anesthetic used in U.S. dentistry – has been used for dental pain management since the 1950’s?
Frequently Asked Questions
What type of anesthesia will I need for my dental procedure?
Dentists usually assess the type of anesthesia necessary based on the nature of the procedure and anxiety level of the patient. If you are visiting the dentist for a routine filling or a crown, you’ll probably only require a local anesthetic. If you experience moderate to severe anxiety prior to and during your dental appointment, you may be prescribed a sedative to take in combination with a local anesthetic. If, however, your procedure is more invasive, such as impacted wisdom teeth extractions or implants, you may opt to be placed under conscious IV sedation.
What should I expect under anesthesia?
A local anesthetic will cause your mouth, teeth and gums to become numb for several hours. You may feel heat, cold or pressure, but you will not feel pain. A sedative, such as nitrous oxide, will cause you to feel groggy, relaxed or even euphoric, but these feelings wear off almost immediately at the end of your procedure when the dentist administers oxygen. If you are under conscious IV sedation, you will have no memory of your procedure.
Are there any special instructions I need to follow before or after being conscious IV sedation?
If you will be put under conscious IV sedation, you will need to avoid eating and drinking the night before and morning of your procedure. You may also need to submit to some screenings to ensure you are healthy enough for IV sedation. After you awake, you will not be allowed to drive yourself home, so be sure to bring a responsible driver with you to your procedure.