Fear and trepidation are a common emotions that my patients admit to when they first see me for a consultation for Oral Surgery or Dental Implants. They are universally relieved to know that we can safely sedate them or even have them completely asleep for any of the procedures that are performed at our clinic. It seems there is significant confusion though, about the different options available for sedation during Oral and Facial Surgery. In this article, I would like to address many of the questions that seem to arise from patients over my 20 years in practice.
There are three types of sedation or “going to sleep”: Conscious sedation which includes oral sedation and/or nitrous oxide. IV sedation which is very common throughout many types of medical clinics. It allows most patients to sleep during the procedure with no memory of the surgery. Finally, there is a General Anesthetic where patients are given medications that allow them to be fully asleep during the procedure. The level of and type of anesthesia is determined by myself and my patient at the consultation visit and we confirm this the day of the surgery.
Conscious Sedation: It is used for reducing the patient’s anxiety and is often all that is needed during a procedure. Conscious sedation calms a patient and makes him/her feel more comfortable with the procedure.
Inhaled sedation: It involves the inhalation of nitrous oxide. Nitrous oxide, commonly known as laughing gas, is a mild sedative and alleviates pain. It is a safe gas and its effects wear off quickly. Nitrous oxide is ideal for some procedures such as simple extractions or a biopsy. Inhaled sedation needs no preparation in advance and the patient can even drive back home.
Oral sedation: It is stronger than inhaled sedation. Oral sedation as the name suggests involves the use of prescription drugs. Oral sedatives calm the central nervous system and thus helps the patient feel relaxed and comfortable. The effects of oral sedation last longer than inhaled sedation. Oral sedatives belong to a class of drugs called Benzodiazepines. You must have someone drive you to and from the appointment as some patients feel light headed and sedated for several hours.
IV sedation: Intravenous sedation is useful for both simple and complex procedures in anxious patients. Sedation is administered intravenously and the dosage is controlled throughout treatment. IV sedation is safe when monitored by trained staff which is why all staff members at Harbour Point Oral Facial and Advanced Implant Center are trained and updated in the latest sedation techniques. IV sedation allows most patients to be asleep during the procedure and unaware of their external environment. Recovery time from IV sedation varies based on the individual and dosage. Again, you must have someone take you home from the appointment since you will be sedated for some time. A good rule of thumb is to avoid operating heavy machinery for 24 hours after surgery.
General anesthesia: Although general anesthesia can be used in hospital cases, I have not found this necessary in my practice. The comfort that patients feel with IV sedation is all that is needed to complete our procedures whether it is for biopsies, extractions, or implants. Using light and deep IV sedation we can often accomplish the same outcome of a general anesthetic comfort. There always seems to be some confusion about the difference between sedation and general anesthesia. Ultimately, it is the type of medications we deliver through the IV and the expectation that the patient has prior to the procedure that determine which anesthetic we choose.
Regardless of the type of sedation used, we always combine this with local anesthesia which is given in the form of an injection at the site of the surgical procedure. Oral Surgery and Dentistry have made huge advances in technology and no longer need to be painful or uncomfortable to patients. This is the reason we encourage patients to consider some type of sedation if they are anxious.
For more information on Sedation Options for Oral Surgery and Dental Implant procedures contact Dr singulair asthma. Brian Hart or Dr. Kathleen Isdith at 425–353–1009 or at hporalsurgery@gmail.com.