Anesthesia

How we deliver the easiest dental visit
you’ll never remember

There are several forms of anesthesia used in dentistry, other than local anesthesia (numbing the mouth). These include nitrous oxide analgesia (laughing gas), Oral Mild and Oral Moderate Sedation, IV Moderate Sedation, IV Deep Sedation/General Anesthesia. Below is a comparison of the various differences between the forms of anesthesia.

Nitrous Oxide (Laughing Gas) Mild Oral Sedation (Anti-anxiety medications) Moderate Oral Sedation ("Twilight Sleep") IV Moderate Sedation ("Twilight Sleep) IV Deep Sedation/ General Anesthesia
Will I hear and feel everything (pressure)?
Yes
Yes
Yes
Some
NO
Will I be awake when I am numbed?
Yes
Yes
Possibly
Possibly
NO
Will I remember it? (amnesia)
Yes
Yes
Possibly
Possibly, but greater amnesia than oral sedation
NO
Will it seem like I fell asleep and woke up minutes later?
No
No
Possibly, but uncommon
Possibly
YES
Ability to treat immediate post op pain?
No
No
No
Yes
Yes
Required training (Iowa) to administer
None
None
ADA accredited program for Moderate Sedation, AEGD/GPR, or within your specialty residency training, STATE PERMIT REQUIRED
ADA accredited program for Moderate Sedation, AEGD/GPR, or within your specialty residency training, STATE PERMIT REQUIRED
OMS residency training, OR a Moderate Sedation Permit holder working with an medical provider (such as a CRNA),STATE PERMIT or Waiver to use medical provider
PT safety training required
Basic Life Support
Basic Life Support
Advanced Cardiac Life Support
Advanced Cardiac Life Support
Advanced Cardiac Life Support
Safety Equipment Required On Site
Minimal
Minimal
Minimal to Moderate
Moderate
Extensive

Why is it called
IV Deep sedation/General Anesthesia?

Sedation is a continuum. There is no hard boundary between different levels of sedation, deep sedation or general anesthesia. The differences are distinguished between various characteristics of each with the last being IV general anesthesia. We generally call it “Deep Sedation” because all of our patients breathe on their own throughout the procedure and wake shortly after completion. They do not wake during the procedure, nor feel anything, or remember anything. We do not intubate any patients or use inhaled anesthetic gases as you would at a hospital.  However, a Certified Registered Nurse Anesthetist is in charge of the anesthesia at all times (not the dentist doing the procedure). She can rapidly change the level of anesthesia or treat any mild side effects of the anesthesia drugs.

Dr. Danny Binkowski setting up for IV Sedation
Story-City-Dental-2019-JPG-0037web

What is “IV Deep Sedation”?

IV deep sedation is the most-effective method for achieving rapid sedation, completely controlling dental anxiety and producing a semi-conscious state. You will achieve a deeper level of sedation bordering on unconsciousness — which is why we use this for wisdom tooth removal on ALL patients. Sleep is expected as the patients fall into a “depressed level of consciousness” where they may or may not be able to respond to stimuli. No memory of the procedure will exist.

While our CRNA has extensive experience with a wide range of medications, the main IV medication used for deep sedation is Propofol. Depending on the patient, sometimes Ketamine or Dexmedetomidine are used in conjunction. The main difference between what we offer and what you will find in an oral surgery office is that our CRNA is responsible for patient monitoring and anesthesia, so Dr. Binkowski can concentrate on the procedure. Thus, anesthesia and surgery are administered by different providers at our office.

The effects of the drugs are seen immediately, and recovery tends to be substantially more rapid than oral sedation or moderate IV sedation.

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