Dental Anesthesia

Key Takeaways

• Dental anesthesia is a safe and effective way to eliminate pain and reduce anxiety during dental surgery and other common procedures.
• Anyone feeling anxious about their dental visit should speak with their doctor beforehand.
• Share your medical history with them and mention any other medications you are currently taking (over-the-counter or prescription).
• Your doctor will be able to explain your different options for anesthesia or sedation and recommend the best choice for you. They will also provide instructions to follow before and after the procedure.

What is Dental Anesthesia?

Dental anesthesia helps manage pain during dental procedures and surgeries. It blocks painful sensations in specific areas of your mouth. 

It can be used while you are awake or asleep, depending on the procedure, your needs, and your doctor’s recommendation.

Anesthesia is a safe way to help patients relax, feel safe, and experience less pain before, during, and after procedures are complete. Anesthesia can cause you to be in a semi-conscious or unconscious state.

Some anesthetics will have specific diet restrictions, while others may require you to arrange transportation from your dentist’s office.

3 Types of Anesthesia

There are three types of dental anesthesia: local, intravenous conscious sedation, and general. Each type is used for specific pain control purposes.

Dentists determine which anesthesia is best for each patient based on:

• The type of procedure (invasive or minor)
• Patient’s personal preference and needs
• Patient’s medical history

The following describes each type of anesthesia and their use cases.

1. Local Anesthesia

Local anesthesia is the most common type that begins working in less than 10 minutes. It is applied topically or injected into a specific location in your mouth. 

Local anesthesia makes parts of your mouth numb. However, you’ll remain conscious and able to communicate throughout the procedure. The effects typically last for a few hours after the treatment.

Doctors administer it during minor dental procedures, such as:

• Cavity fillings
• Tooth extractions
• Root canal treatment
• Dental crown placement
• Scaling and root planing

Commonly used dental anesthetics include lidocaine, articaine, prilocaine, mepivacaine, and bupivacaine.

Local anesthetics are also available as prescription or over-the-counter medications. They come in gel, cream, liquid, ointment, spray, patch, and injectable forms.

2. Sedation

Sedatives and anesthesia are used for different reasons.

Sedation dentistry can help relieve nervousness and anxiety during dental work, reduce pain, and/or help keep patients from moving. Meanwhile, anesthesia is used to eliminate pain and discomfort.

Sedation can be administered in three different strengths: 

1. Mild sedation — keeps you conscious, and you can respond to commands
2. Moderate sedation — puts you in a state of semi-consciousness
3. Deep sedation — makes you unaware of your surroundings and unable to respond to stimulation

A popular sedation option is nitrous oxide (laughing gas), an inhalable gas that can be administered via a nasal hood over the nose. Other examples include diazepam (Valium), midazolam (Versed), and propofol (Diprivan).

People with severe anxiety typically need a sedative before receiving an injection of anesthesia, especially if they have a fear of needles. Those with dental phobia often visit sedation dentists to receive care.

3. General Anesthesia

General anesthesia results in a temporary loss of consciousness. It is used for longer procedures or if someone cannot tolerate dental treatment under local anesthesia or sedation. 

This type of anesthesia is often referred to as a medically induced coma. You will be unresponsive during the entire procedure and not feel any pain. The medication is normally inhaled or administered intravenously.

The difference between general anesthesia and IV conscious sedation is your ability to respond and breathe on your own.

General anesthesia is also typically administered to patients in a hospital setting undergoing invasive oral surgeries, including:

• Extensive bone grafts
• Corrective jaw surgery
• Multiple tooth extractions
• Oral cancer surgery
• Sleep apnea surgery
• Cosmetic dental procedures
• Cleft lip/palate Surgery

5 Benefits of Dental Anesthesia

People with anxiety or fear of injections are more likely to refuse local anesthetics during minor dental procedures.

However, after your dentist explains the benefits of anesthesia in detail, you can relax during the procedure and feel less pain.

The primary benefits of anesthesia include:

1. Can consolidate multiple appointments into one appointment
2. Prevents pain during the procedure
3. Can be used with sedation to relieve anxiety, pain, fear, and discomfort
4. Safe and effective when properly used
5. Helps make procedures easier to perform

It’s important to know that anesthesia is not a medication to put you to sleep. This means you will remain conscious during the procedure (except general anesthesia).

Side Effects of Dental Anesthesia

Dental anesthesia is a common and safe treatment.

Before administration, the dentist should be aware of your full medical history, alcohol abuse history, and any allergies to ensure complications are avoided.

Side effects are rare and are usually only felt with sedation or general anesthesia. These may include:

• Nausea
• Dizziness
• Vomiting
• Swelling (in the mouth or at the injection site)
• Sweating or shivering
• Confusion
• Hallucinations
• Tiredness
• Lockjaw

Potential Risks of Anesthesia

Anesthesia is considered a safe, effective, and necessary component of dental care. However, certain groups are at a higher risk for adverse effects.

Those who should speak to a dental office or anesthesiologist before using anesthesia include:

• Pregnant women
• Pediatric patients
• People with special needs
• Elderly adults
• Anyone with liver, kidney, lung, or heart problems
• People with neurological conditions
• People taking other medications, such as opioids
• History of allergy to anesthesia medication

Though complications are rare, there are some risks involved in dental anesthesia.

Anesthesia Complications

Potential adverse reactions and complications include:

• Allergic reactions
• Nerve damage
• Low blood pressure
• A dangerous increase in body temperature (malignant hyperthermia)
• Heart attack
• Heart failure
• Stroke
• Failed breathing
• Death