Dental Anesthesia FAQs

Most minor dental procedures like fillings, crowns, and even extractions can be done under local anesthesia. The dentist administers numbing injections that numb the teeth and surrounding soft tissues to prevent you from feeling any pain. Sometimes, nitrous oxide (“laughing gas”) is also used to provide some anxiety relief. However, patients with extensive treatment plans, dental phobias, anxiety, severe gag reflexes, local anesthetic allergies or immunity, and physical or mental disabilities require a deeper level of sedation or general anesthesia. Children that are of pre-cooperative or uncooperative age that are unable to sit still or have an extensive treatment plan may also benefit from being seen under general anesthesia to prevent multiple and potentially traumatic experiences at the dentist.

When a patient is under general anesthesia, time taken to suction the mouth is reduced and reflexes of the tongue are eliminated. This makes it easier for the dentist to work efficiently, which can reduce the number of appointments necessary to complete the dental treatment. With more sophisticated advances in technology and in dentistry, complex treatments such as implants and periodontal/oral surgery can be very long and tiresome. General anesthesia or IV sedation makes the entire experience significantly more comfortable and satisfying because the patient does not have to open their mouth for hours, hear unpleasant sounds, or deal with the stinging pain of local anesthetic injections. Most patients are unable to recall portions or any of their procedure at all!

Almost all medical procedures require a breathing tube, but most dental procedures allow for maintenance of spontaneous breathing and therefore do not always require one. Depending on the situation, something called nasopharyngeal airways (NPAs) may be used versus an endotracheal breathing tube, which is a breathing device that passes through your trachea or “wind pipe”. These are standard and routine airway management devices that are used to ventilate and deliver oxygen while under sedation or general anesthesia. The decision to use an endotracheal breathing tube or NPAs for an “open airway” technique will be made on a case by case basis. Our doctors are trained in all aspects of airway management and can answer any questions on the techniques utilized.

Dentist anesthesiologists have completed four years of dental school to be trained as a dentist but have also completed an additional two to three years of dental anesthesiology residency solely dedicated to the field of anesthesia. Dentists who provide sedation complete continuing education courses (two to three days) that only cover conscious oral and/or intravenous sedation.

Outpatient sedation and general anesthesia is similar if not the same as a hospital grade anesthetic. However, physician anesthesiologists and nurse anesthetists are trained mainly in hospital operating room settings. Although dentist anesthesiologists are trained for eleven months in a hospital setting, we also have extensive training in outpatient dental based anesthesia. We are familiar with the requirements of the procedures being performed by dentists and how their offices operate. Any logistics involved with mobility in providing sedation and anesthesia in an ambulatory setting like a dental office are taken care of. Since dentist anesthesiologists are dually trained in both dentistry and anesthesiology, we can anticipate and adjust the level of anesthesia according to the phase of treatment and amount of cooperation needed from the patient. Dentist anesthesiologists also proportionately see more pediatric patients and are specialists in nasal intubations. Since all dental procedures are concentrated in the oral cavity, a nasally inserted breathing device ensures that patients receive the oxygenation that they need while providing the dentist unrestricted access to the mouth.