The medical community has made great strides in improving pain management practices over the past two hundred years. While dentists and doctors of the 1800s may have once prescribed opium, morphine, cocaine, heroin, and laudanum to numb the pain of surgery, today’s dental patients have much safer and legal options. There has never been a better time to take care of your oral surgery needs.
Thanks to modern advances in anesthetics and pharmaceutical painkillers, oral surgery doesn’t have to be something to fear. Instead, your dentist or oral surgeon will show you how today’s anesthesia options will keep you calm and comfortable during your procedure. Here is an overview of the most common types of anesthetics used today, as well as their specific applications.
There are three main types of anesthesia used today – local, regional, and general.
Local refers to the application of an anesthetic that only numbs or deadens the pain in a small, focused area. Locals are generally delivered via a small injection or a topical cream. You’re wide awake when given a local, so you’ll see and hear everything that happens during your procedure. Local anesthetics are commonly used in dental procedures or oral surgery; sometimes combined with regional or general anesthesia.
A regional anesthetic, on the other hand, blocks virtually all sensations – pressure, pain, and more, to a much larger part of the body. A common example of a regional anesthetic is the epidural or spinal block. During childbirth, some women opt for an epidural to minimize or block pain in the abdomen, lower back, and hips. Another type of regional anesthetic is a peripheral nerve block, where the anesthesiologist administers a targeted dose of sedative to block pain around a certain group of nerves. Nerve blocks are often used during surgeries of the extremities, including the face.
General anesthesia is the third option, and it is reserved for those having more serious surgery or for patients who want little to no memory or awareness of the surgery. The brain and entire body are affected by general anesthesia, and it can be delivered directly to the bloodstream or through an inhalation mask, where it will take effect rather quickly. Proper administration of general anesthesia renders the patient completely unaware of the surgery and free from pain.
Prior to your oral surgery date, your health care professional will conduct a health survey that will ask you to list any present health concerns, surgeries, or medical procedures you’ve had in the past even beyond the dentist’s office. Diabetes and heart disease are two medical issues that may eliminate certain kinds of anesthetics from being used and expect to be asked if you’ve had an adverse reaction to anesthesia in the past. If you’re not sure, ask an older sibling or parent if you’ve ever had a poor experience with anesthesia, or pull your health records from any previous surgeries you’ve had.
Your oral surgeon will also explain how certain sedatives are better suited to different procedures. But, if you’re nervous about the dentist’s chair or simply don’t want to be conscious during the process – you and your dentist may create a course of action that includes various levels of sedation to ensure your optimal level of comfort.
Sedation medication is delivered via several methods. The first is in the form of nitrous oxide, also known as “laughing gas,” which is then mixed with oxygen and administered through a mask that is placed over the mouth and nose. This method delivers the lightest form of sedation and many patients can even drive themselves home after the surgery since it wears off quickly.
Next up is oral sedation, generally taken in the form of a Halcion pill, itself a member of the same drug grouping as Valium. Halcion is taken about 60 minutes before surgery and enables most patients to fully relax, while still remaining conscious. Some individuals may react more acutely to the medication, and may even fall asleep during surgery, but they can be awakened quite easily in most cases.
IV or intravenous sedation is advantageous because the dentist can continually modify the amount of sedative received to match the patient’s needs. If the patient needs an increase in IV medication to keep comfortable and immune to the pain of surgery, the sedative dose is easily manipulated and goes to work quickly.
General anesthesia is typically delivered via either an IV or a mask and is designed to make the patient completely unaware of the surgery or related pain. It takes some time to recover after general anesthesia, so if your dentist recommends this type of sedative during your pre-operation meeting, make sure you arrange for a ride home.
Beyond receiving some type of sedative during your surgery, your dentist will likely also administer a local anesthetic to help numb the surgical site. This can help minimize pain in the area most affected by the surgery and can reduce discomfort when you’re first coming out of surgery.
Sedation dentistry has been around for quite some time but is now en vogue among patients who simply do not want to be fully aware of any dental work completed, or are generally nervous in the dentist’s chair. By varying the level of sedation and the volume of anesthesia administered, patients might feel just a bit more relaxed. If you’re scheduled for oral surgery or a procedure of any kind, talk to your oral care specialist about your sedation options.
Today’s dental professionals have elevated the art of pain management to new heights. If you have additional questions about anesthesia and which type of sedative is right for you, contact your preferred, Philadelphia-area dental implant and oral surgery associates today –Michael D. Sock, DMD, MD, FACS and Michael T. Dachowski, DMD at 215-938-7860.