ANESTHESIA & SEDATION
Several methods of anesthesia (insensitivity to pain, especially as artificially induced) and sedation (producing a state of calm or sleep) are available. The method that is chosen by a patient depends upon the nature of the surgical procedure and the patient’s level of anxiety.
Our first priority is your safety. If you have any concerns regarding the type of anesthesia or sedation that will be administered during your procedure, please do not hesitate to discuss your concerns with Dr. Doan at the time of your consultation.
Anesthesia & SEDATION Options
MethodTypes of AnesthesiaDescription of TechniqueUsual Indications
Local AnestheticDescription of Technique The patient remains totally conscious throughout the procedure. A local anesthetic (e.g. lidocaine) is administered in the area where the surgery is to be performed. Local anesthetic is used in conjunction with the other methods of anesthesia.Usual Indications Simple oral surgery procedures such as minor soft tissue procedures and simple tooth extractions.
Method Nitrous Oxide Sedation (with Local Anesthetic)Description of Technique A mixture of nitrous oxide (laughing gas) and oxygen is administered through a nasal breathing apparatus. The patient remains conscious in a relaxed condition. Nitrous oxide has a sedative and analgesic (pain- controlling) effect.Usual Indications Simple oral surgery procedures to more involved procedures such as surgical tooth extractions and placement of dental implants.
Oral Sedation (with Local Anesthetic)Method
IV Sedation (with Local Anesthetic)Description of Technique Medications are administered through an intravenous line (I.V.). The patient falls asleep and is completely unaware of the procedure being performed. Medications most commonly used are Versed (benzodiazepine) and Demerol. Supplemental oxygen is delivered through a nasal breathing apparatus and the patient’s vital signs are closely monitored.Usual Indications IV sedation is available for all types of oral surgery. A patient may choose IV conscious sedation for simple procedures depending on their level of anxiety.
Nitrous Oxide (“Laughing Gas”)
Nitrous Oxide is a sweet smelling, non irritating, colorless gas. Nitrous Oxide has been the primary means of sedation in dentistry for many years and is very safe. Patients are able to breathe on their own and remain in control of all bodily functions.
If you have had a bad experience with nitrous in the past, especially many years ago, it is worth another try. Becoming lightheaded or dizzy is a sign of overdose and nausea can be caused by the gas being turned on or off too quickly.
- Medical conditions such as COPD, emphysema, MS, a cold or other difficulties breathing.
- Cannot tolerate tubing or object covering your nose.
- It works rapidly and is flushed out of your system by the end of your appointment.
- The depth of sedation can be altered at any time–you can control with the depth and rate of your breathing or the doctor can control by adjusting the flow rate
- There is no after effect such as a “hangover”.
- Inhalation sedation is safe with no side effects on your heart and lungs, etc.
- Lowers blood pressure, especially due to “white coat hypertension”
- Inhalation sedation is very effective in minimizing gagging.
Intravenous Sedation (“Twilight sleep”)
Intravenous Sedation is sometimes referred to as “Twilight Sleep.” IV sedation helps alleviate the anxiety associated with your treatment and typically causes you not to remember the appointment. You will not be completely “knocked out,” but you will be calm and relaxed, drifting in and out of sleep.
If you choose IV sedation, it is administered and monitored by Dr. Doan, therefore eliminating the costly expense of having your treatment carried out in an operating room. Dr. Doan received specialized training at the VA Hospital to be able to provide this service.
A thin needle will be introduced into a vein in your arm or hand. The needle will be attached to an intravenous tube through which medication will be given to help you relax and feel comfortable. At times a patient’s vein may not be maintainable, in these situations the medications will be administered and the needle retrieved – both scenarios will achieve the same desired level of conscious sedation. Once again some patients may be asleep while others will slip in and out of sleep. Some patients with medical conditions and/or on specific drug regimens may only be lightly sedated and may not sleep at all.
The goal of IV sedation is to use as little medication as possible to get the treatment completed. It is very safe, much safer than oral sedation. With IV sedation a constant “drip” is maintained via the intravenous tube. At any time an antidote can be administered to reverse the effects of the medications if necessary.