San Benito Surgery

Anesthesia in the Dental Office: An upcoming visit to an oral and maxillofacial surgeon is a potential anxiety producer. In this case, the individual typically is most concerned with possible pain. Modern technology now makes it possible to perform complex surgery in the office with little or no discomfort. Knowing this should start to bring your anxiety level down to a minimum.

During surgery, one or more of the following is used in controlling pain and anxiety: local anesthesia, nitrous oxide, intravenous sedation and general anesthesia.

Local Anesthesia is the anesthesia known to you from your family dentist. After placing a topical anesthetic on the injection site, a local anesthetic (usually lidocaine--novocaine is no longer used) is injected to numb the surgical area. You can eat before the surgery if only local anesthesia will be used. Local anesthesia is advised for simple extraction but not for complex or surgery of impacted teeth. During the surgery you will feel pressure, but you experience no pain.

Nitrous oxide (laughing gas) is used to relax you. You breathe in the gas through your nose and start to feel light-headed and you will notice some tingling in your arms and legs. The laughing gas does not put you to sleep but it is very valuable for relaxation.

Intravenous sedation requires the placement of a needle in your blood vessel. This allows us to give you the necessary medications which will make you sleepy. Most frequently used medications are the benzodiazepines (Versed®, Valium®) in combination with narcotics (Demerol®, Fentanyl®). Often the surgeon also uses nitrous oxide with an intravenous medication. These medications make you sleepy and you forget about the surgical procedure. During the surgical appointment, we use monitoring devices such as ECGs (shows your heartbeat), a blood pressure cuff and a pulse oximeter (measures the oxygen content of your blood). After the procedure you will spend some time in a recovery room, and you will need someone to drive you home. Occasionally you will feel sleepy for hours, and it will take 6-8 hours for the numbness in your lips and tongue to wear off.

General anesthesia is a similar procedure to intravenous sedation, but the level of sedation is deeper. The intravenous medication will be given and the same monitoring devices are used. The most commonly used drug is Brevital® and Propofol. As with intraveneous sedation, you need someone to drive you home.

Pain Medication

The surgeon can prescribe for you a variety of pain-relieving drugs. The main categories are the narcotics, the non-steroidals (NSAID) or plain Tylenol®.

Narcotics are usually combined with Tylenol® or Aspirin.

Tylenol III® (Tylenol® with codeine)
Vicodin® or Vicodin ES® (Tylenol® with hydrocodone).
Darvocet® (Tylenol® with propoxyphene).

Side effects of these drugs are sleepiness, nausea, and vomiting. The best way to avoid nausea and vomiting is to not take the medication on an empty stomach and to reduce the dosage. These side effects are very common and you should contact your surgeon if you are concerned about the response you have to the medication.

Nonsteroidals (NSAID) are a large group of very effective painkillers without the side effects seen by narcotics.

Aspirin
Ibuprofen (Motrim®, Advil®)
Naprosyn

These drugs are usually not used in patients who have asthma or a history of stomach problems.

Your surgeon will usually prescribe narcotics for the first few days. After the initial trauma from the surgery has gone, the nonsteroidal drugs are very effective for pain control. A possible plan to control your pain would be the following: the first few days, Vicodin®; after that, Ibuprofen during the day and if necessary Vicodin® at night.

Oral Surgery | Wisdom Teeth | Anesthesia
Dental Implants | Orthognathic Surgery | Oral Pathology

890 Sunset Drive, Suite B-1A
Hollister, California 95023

Telephone: (831) 636-9808
Facsimile: (831) 636-9843

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