Anesthesia Frequently Asked Questions
Yes! When administered properly by vigilant anesthesiologists, anesthesia in the dental office is extremely safe for children and adults. In fact, many daily activities such as driving are much more dangerous than dental office anesthesia. You can rest assured that your anesthesiologist has undergone years of extensive training, has administered thousands of anesthetics, is board-certified, and is prepared to handle any possible emergency or complication (which again, are extremely rare). We have over 225 years of combined experience handling the most complicated cases, and our safety record is stellar.
We uphold the highest standards in our field. Our doctors are not only board-certified but have safely administered hundreds (if not thousands) of anesthetics in the dental office. We use the same type of equipment, monitors, and medications that we use in our hospitals. We are prepared for any emergency, and we will always be vigilantly monitoring you during the procedure until you are awake and ready to go home.
There are two broad types of anesthesia. First, is general anesthesia, which means you are completely asleep and often have a breathing tube placed to protect your breathing during the procedure. This breathing tube is placed AFTER you are asleep and taken out before you are fully awake. The breathing tube is very safe and inserted very gently. This breathing tube is very important in protecting your breathing from being obstructed during the surgery. It will also help protect foreign material, secretions, and other fluids from going into your lungs.
The second type of anesthesia, Monitored Anesthesia Care is more commonly known as “twilight sleep” anesthesia. This is a lighter level of sedation than general anesthesia, but from your perspective, you will still be “asleep” during the procedure. A breathing tube is usually not placed during Monitored Anesthesia Care as the lighter level of anesthesia allows the patient to safely breathe on their own.
Because circumstances may change during a procedure, we ask that you initial your consent for BOTH types of anesthesia. The specific type of anesthesia that will be used will be discussed with you, and it will depend on your medical history, the dentist/oral surgeon, and the type and length of the procedure.
There are procedures in which general anesthesia is actually safer than monitored anesthesia care, and vice versa. But both types of anesthesia are EXTREMELY safe.
No one likes to be poked by a needle, but for most of our anesthetics we do need to place an IV catheter for your safety. This also allows us to give you the best and safest medicines for your comfort. We are very gentle when placing the IV, and we will often use ancillary techniques to make the IV insertion as painless for you as possible. Once the IV has been placed, we can then give you medications quickly and painlessly. For adults and older children who have severe anxiety about needles, we can discuss options such as pre-medication with an oral sedative to help make the process more comfortable for you.
Most small children (and many patients with special needs), are not able to cooperate with the IV placement. For these patients, we use the same technique that we use at our children’s hospitals. The child simply breathes in our hospital “candy air,” which will render them asleep within several minutes. We often make this into a game, and we use distraction techniques to make the breathing game as smooth as possible. Often, we will allow a parent to be with their child during this process. Once your child is asleep, we then ask parents to leave the operatory room. This is very important, as we need to focus our attention on several critical medical tasks to ensure the safety and comfort of your child.
Sometimes we may have to administer an intra-muscular injection of a sedative to safely start the anesthesia process (for example: a young adult with severe developmental delay who is not able to communicate nor cooperate). If we feel this option may be necessary, we will be sure to discuss this with you beforehand.
We use only the best sedatives that are rapidly metabolized and thus provide a safe, smooth, but also very quick anesthesia start and finish. As a result, most of our patients wake up comfortably and quickly with minimal grogginess. In contrast, most hospital anesthetics use “heavier” techniques and longer-acting medications. Because our medications are metabolized so quickly, most patients will wake up with much less grogginess or heaviness than after a hospital procedure. Of course, the reaction to the anesthesia will vary with each individual, and the length and type of dental surgery.
Again, we pride ourselves on using more modern sedatives and techniques to provide the best anesthesia experience for our patients.
Overall, most of our patients wake up quickly and comfortably. Adverse side effects of our anesthesia technique (such as nausea) are very uncommon. The most common side effects are minor sore throat or nasal irritation (from the breathing tube if receiving general anesthesia). Occasionally, some patients may experience transient delirium after waking up from anesthesia. This is self-limited and resolves on its own quickly, but it can be disturbing to the patient or family members to experience. If you have any history of delirium or concerns about this issue, we will be happy to discuss options with you.