Sedation

Types of Anesthesia:  General Information

As we all know, any never-before-experienced event can cause a certain amount of anxiety and even fear within us; and, dental procedures are no exception to this rule. Many times the most common concern is: will I experience pain during my dental procedure? Fortunately, modern anesthesia technology now makes it possible to perform even complex surgeries in the dental office (rather than in the hospital) with little or no discomfort to the patient. In cases involving dental surgery, local anesthesia that numbs the surgical area (Novacaine) is used either by itself or in combination with one or more of the following: nitrous oxide (sometimes called "laughing gas") to relax you; oral pre-medication; intravenous "I.V." sedation (also known as "twilight sleep" or "conscious sedation") for relaxation. In fact, many patients report that their surgeries were remarkably pain- and anxiety-free!

During his university-based hospital training, Dr. Pulsipher received extensive training in medical and dental aspects of anesthesia. Prior to your surgery, you can expect Dr. Pulsipher to give you a complete review and description of the specific types of anesthesia you will receive. There will also be time to ask any questions you may have or to express your concerns. And remember. . .when it comes to anesthesia, the more you know, the less you will have to be anxious about.

Local Anesthesia

Local anesthesia, also commonly known as Novacaine, 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. The local anesthesia is the only type of anesthesia, which when 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 with the procedure.

Nitrous Oxide

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, thereby allowing the patient to leave the office without an escort because there is no hang-over effect. 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 or 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 Pre-medication

Oral pre-medication or pills are the next step up in the conscious sedation spectrum. Many different medications can be used, with Valium, Halcion, and Ativan some of the most common ones. 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.

Intravenous "I.V." 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 the 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 be "the most" comfortable during the procedure, it is certainly the best way to go.