Oral and maxillofacial surgeons are unique among the surgical specialties with regard to anesthesia training. During their residency, every oral and maxillofacial surgeon receives formal anesthesia training with the department of anesthesia. They are taught the skills to safely administer anesthesia to patients. This includes IV sedation, general anesthesia, airway management and intubation techniques. This also includes complete training in Advanced Cardiac Life Support. It is our utmost goal to make your surgical experience as pleasant and stress free as possible while maintaining the highest levels of safety.

During the initial consultation your oral surgeon will discuss the type of procedure involved, your medical history and your level of anxiety. Some procedures, due to their nature, require the use of general anesthesia or IV sedation; whereas, others are best accomplished under local anesthesia. The choice of anesthesia is always a personal decision and should be made only after an informative consultation with the oral and maxillofacial surgeon. In addition, during the initial consultation, you will also be given instructions to prepare for surgery such as: wearing loose, comfortable clothing, not having anything to eat or drink for 6–8 hours prior to surgery, taking all of your regular medications, bringing an escort with you and making arrangements for your recovery at home.

Coming to our office for the day of surgery and anesthesia is no different than having surgery in the hospital and it is often much more user friendly. The equipment in our surgical suites and recovery room are similar to those used in the hospitals. When you arrive in the surgical suite the nurse or dental assistant will connect you to a number of monitors. These devices are typically a blood pressure cuff, an EKG (electrocardiogram) and a pulse oximeter (a device that painlessly measures both your pulse rate and the amount of oxygen in your blood) and capnography (which measures and evaluates your breathing pattern). Therefore, it is suggested that you wear loose clothing to facilitate the application of these important devices. Our doctors rotate on-call and they can also answer any emergency questions you may have in regards to your care following your surgery. They can be reached by the phone number provided on your post op instruction sheet.

WHAT IS IV (INTRAVENOUS) SEDATION?
This technique uses similar medications as IV general anesthesia but the patient is not "ASLEEP". Sedated patients are more aware of their immediate surroundings but are in a relaxed mood.

WHAT IS LOCAL ANESTHESIA?
This involves administration of a "Novacaine" shot which numbs or freezes a small area so surgery can be performed without altering consciousness. Using local anesthesia only, the patient is completely alert and fully aware of his or her surroundings. Local anesthesia does not decrease the patient's level of anxiety towards the surgical procedure.

ARE THERE TIMES WHEN LOCAL ANESTHESIA DOESN'T WORK DURING ORAL SURGICAL PROCEDURES?
YES. In order for the local anesthetic to work, the tissue pH must be neutral or slightly alkaline. Fortunately, local anesthesia works well in noninfected tissue because normal tissue pH is slightly alkaline. However, many patients whom oral surgeons need to treat have infections which cause the tissue pH around the infected tooth to become acidic. This acidic pH does not allow for optimal effectiveness of the local anesthetic which results in the patient experiencing pain during the extraction. IV office general anesthesia allows the removal of infected teeth without causing distress and pain to the patient because tissue pH is not a factor in its effectiveness. Finally, local anesthesia does not treat the anxiety many patients have associated with dental surgical procedures. IV anesthetics effectively treat dental anxiety and allow for a safe and more comfortable enviroment for the patient to undergo surgery.

ARE THERE ANY SPECIAL REQUIREMENTS FOR ANESTHESIA?
YES. Nothing by mouth, no food or liquids for 6 to 8 hours is recommended. While six to eight hours is suggested as a minimum time of not eating or drinking, each case is evaluated individually. A person who had a recent fatty meal (ie. Bacon and eggs), may require 10 hours with nothing to eat or drink in order to safely perform IV office general anesthesia.

ARE THERE ANY EXCEPTIONS TO THE RULE NOTHING TO EAT OR DRINK?
YES. Regular medications for heart, blood pressure, seizure disorders, thyroid conditions, ulcers, gastric reflux, and asthma should absolutely be taken with the smallest amount of fluid which easily permits the pill to be swallowed. Patients who require antibiotic premedication should also take their medication with a small amount of water. Patients who are on chronic steriod (e.g. prednisone) therapy may actually need to take more prednisone than they normally would take. Please bring your prednisone pills with you to the office.

ARE THERE PATIENTS WHO SHOULD NOT TAKE THEIR REGULAR MEDICATIONS?
YES. Patients who have diabetes medications or are taking prednisone, anticoagulants, diet drugs, and anti-hyperactivity drugs should speak with the doctor prior to any surgical procedure. Patients who take anti-hyperactivity drugs and diet medications should not take these medications on the day of surgery. Patients who are insulin-dependent diabetics should be appointed early in the morning and will take 1/2 of their long acting insulin (NPH) and not take their regular insulin dose.

If you have questions, please e mail our office.