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Anesthesia for Dental Treatment

Learn more about reasons for use, types, and side effects of anesthesia

Why Anesthesia for Dental Treatment?

Anesthesia is used to help manage pain during surgical or dental procedures and is an integral part of dental care. Most of us are familiar with Novocain or lidocaine - a local anesthetic used to numb a treatment area - but did you know there are other reasons a dentist might recommend a different type of anesthesia? Dentists will determine which type of anesthesia is appropriate based on:

  • The complexity of the procedure (how invasive or the length of time to complete procedure)
  • The age of the patient and level of patient cooperation (small children, special needs, dementia/Alzheimer's)
  • Patient medical history (allergies, special needs, Parkinson's)
  • Patient mental health history (phobias, anxiety)

Types of Anesthesia

Anesthesia options are broken into three categories:

Local Anesthesia - the most commonly used anesthetic, local anesthesia is used to numb a specific area of the mouth and are applied topically or by injection. Both the pre-injection numbing gel the dentist uses (topical anesthetic) and the Novocain/lidocaine shot itself are different examples of local anesthetics. Local anesthesia is used for minor dental procedures like fillings, extractions, root canal treatments, crown placement, and deep cleanings. The numbing sensation can last for hours, but leaves the patient conscious.

Sedation - most often used to help alleviate anxiety or help keep patients from moving during a procedure, sedation can be administered in mild, moderate, or deep strengths, placing the patient in different levels of consciousness. Sedation can be administered before the appointment via pill (Valium), or during the visit via laughing gas or IV.

General Anesthesia - most often used for longer dental procedures, general anesthesia results in a complete, but temporary, loss of consciousness. It is mostly commonly used for invasive dental procedures performed in a hospital setting, like bone grafts, jaw surgery, cancer surgery, complicated extractions, or cleft lip/palate surgery.

General anesthesia is normally inhaled by the patient or administered by IV. Unlike IV sedation, where the patient remains semiconscious (where they are somewhat responsive and can breathe on their own), patients receiving general anesthesia become completely unconscious and require breathing assistance.

Side Effects of Anesthesia

Dental anesthesia is a commonly used and safe treatment, however, it is very important that the dentist is made aware of the patient?s full medical history, allergies, and substance abuse history (including alcohol), so complications can be avoided. Generally, side effects only occur with sedation or general anesthesia; however, some may find they are allergic to a certain local anesthetic. Though these allergic reactions are extremely rare with the types of local anesthetics used today, when they do occur, patients who are allergic may experience:

  • Rash
  • Hives/itchy skin
  • Facial swelling

Though side effects of sedation or general anesthesia are also rare when pre-procedure instructions are followed, side effects may include:

  • Nausea and/or vomiting
  • Dizziness
  • Swelling
  • Confusion or hallucinations
  • Sweating or shivering
  • Fatigue
  • Lockjaw

Again, side effects of anesthesia are rare; however, there are certain groups that have a higher risk of side effects. Before beginning a dental procedure for which anesthesia is planned, those who should speak to the dentist before the procedure include:

  • Pregnant women
  • Pediatric patients
  • Special needs patients
  • Older/elderly adults
  • Those with liver, lung, heart, or kidney problems
  • People with neurological conditions
  • Patients currently taking other sedative medications, like opioids
  • Those with a history of allergy to anesthesia medications

Ultimately, the dentist will determine the appropriate level of anesthesia needed for each patient based on many criteria. As a patient, it is important to discuss medical history and individual needs with the dentist so they can make an informed decision and keep the patient as healthy and safe as possible.

Risks of Anesthesia

Though complications from dental anesthesia are rare, there are some risks involved, including:

  • Allergic reactions
  • Low blood pressure
  • Heart attack/failure
  • Stroke
  • Breathing failure
  • Death

If you are planning dental treatment using anesthesia, discuss any concerns with your dentist.