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.
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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