Once your dental situation has been assessed and oral surgery has been scheduled, there are certain ways you need to prepare for the appointment depending on the type of procedure you’re having and the anesthetic that will be used.
Local Anesthetic
If your procedure will be done under local anesthetic only, you won’t need to do anything extra to prepare. This method of anesthesia is used for minor procedures. For more invasive procedures like extraction of wisdom teeth, it is used in addition to the IV sedation or general anesthesia. The area of the treatment will be numbed using a topical anesthetic, and then the local anesthetic is injected usually into different points around the affected site. Epinephrine also may be injected at the same time to help control bleeding by constricting blood vessels and making the anesthetic last longer. Root canals, fillings, root planing or scaling, some biopsies, tongue tie removal and minor extractions.
The local anesthetic lasts approximately two hours. A certain pins-and-needles or burning sensation is normal. However, if you continue to experience lingering or intermittent numbness once the local anesthetic has worn off, you should mention it to your dentist or oral surgeon. This numbness may have been caused by the needle coming too close to the inferior alveolar canal or if the roots of the tooth/teeth being extracted were too close to the canal.
Nitrous Oxide
Nitrous oxide or “laughing gas” may be used for children or adults. It’s ideal to provide a light sedation for tongue tie removal, minor extractions, root canal therapy and simple implant placements. It is common for people to fall asleep with it. There are very few to no side effects from the use of nitrous. Some people report some nausea as it is still wearing off. If this is a concern that you discuss with the dentist prior to your oral surgery, he/she may recommend that you fast (nothing to eat or drink) for a period of time before the surgery, or to take anti-nauseant medication before presenting to the office.
The fact there are very few patients who experience side effects is one advantage to using nitrous oxide. Another is that because it is a gas, it is administered using an inhalation mask rather than a needle, very few people are allergic to a gas, and, once the mask is removed, the effects of the gas wear off quickly, much faster than IV sedation or local anesthetic.
Oral Sedation
If your oral surgery is being done using oral anti-anxiety medications such as diazepam or lorazepam, you will need to take the prescribed dose one hour prior to the anticipated start of the treatment. The main challenge with this type of sedation is that by the time the patient actually gets in the chair and the procedure is underway, the oral sedative may wear off before the treatment is finished.
You will need to have someone with you to drive you home following the procedure as well. You will not be able to drive with the oral sedative still in your system.
IV Sedation
IV or ‘intravenous’ sedation is used a lot in oral surgery cases because most peoples’ anxiety toward such involved treatment is pretty high. Some of these treatments may include: multiple extractions (incl. wisdom teeth), root canals, biopsies and other more invasive treatments. This kind of sedative is administered via a small needle (IV) placed in the back of the hand. A local anesthetic also is used.
Preparations for intravenous sedation include:
Fasting for six to eight hours prior;
Taking a preemptive (prophylactic) antibiotic if you have a pre-existing medical condition that leaves you susceptible to infections;
Adjustments to your use of blood thinners; and,
Making arrangements for someone to drive you home and stay with you for at least the first 18 to 24 hours.
You also should allow yourself time to recover and recuperate, at least a day or two, and know that you won’t be able to drive for up to 18 hours following the procedure.
General anesthetic
General anesthetic will be used with major jaw surgery (orthognathic), reconstructive procedures, some wisdom teeth extractions, bone grafts to be harvested from the hip area, and some implant placements. General anesthetic is administered by an anesthetist or anesthetic specialist who will monitor the patient throughout the procedure. Treatments performed under general anesthetic can be done in a private facility or hospital.
If your surgery is being done under a general anesthetic, the main reminder is to be fasting for eight to 12 hours prior to the procedure, arrange for someone to drive you home and stay with you following the procedure, to arrange for two to three days of recovery time and to not drive within 24 hours after the time of surgery to ensure the effects of the anaesthetic are gone.
The best dentists in Dallas know the value these various anesthetics have in performing oral surgery care. They are part of an effective, overall treatment plan and need to be used carefully and properly. Not every dentist can offer sedation or general anesthetic and referrals should be made to dentists or specialists more skilled in those areas.