Anesthesia
Oral surgery can be done with local anesthetic alone, with IV sedation, or under general anesthesia. Local anesthetic numbs the area while you stay fully awake. IV sedation places you in a deeply relaxed, drowsy state and most patients remember little of the procedure. General anesthesia makes you completely unconscious. The right choice depends on the procedure, your health, and your anxiety level, and is decided with your surgeon at the consultation.
Key takeaways
- All three options fully numb the surgical area; the difference is how aware you are.
- IV sedation and general anesthesia require fasting, a responsible adult escort, and no driving for 24 hours.
- Oral and maxillofacial surgeons complete hospital-based anesthesia training as part of their specialty residency.
- Your medical history, medications, and airway are reviewed before any sedation is offered.
Comparing Your Anesthesia Options
| Local anesthetic | IV sedation | General anesthesia | |
|---|---|---|---|
| How aware you are | Fully awake | Drowsy and relaxed; many patients remember little or nothing | Fully unconscious |
| How it is given | Injection in the mouth | Medication through a small IV in the arm or hand, plus local anesthetic | IV medications, with the airway supported and monitored, plus local anesthetic |
| Common uses | Single simple extractions, biopsies, some implant procedures | Wisdom teeth, multiple extractions, implants, anxious patients | Complex or lengthy surgery, significant anxiety, selected medical situations |
| Fasting required | No | Yes | Yes |
| Escort and no driving for 24 hours | Not usually | Yes | Yes |
| Recovery from anesthetic | Numbness for a few hours | Drowsiness for the rest of the day | Drowsiness for the rest of the day |
What Does IV Sedation Feel Like?
A small IV line is placed in your arm or hand. As the medication takes effect, you feel relaxed and sleepy within a minute or two. Local anesthetic is then given to numb the surgical area, and most patients are not bothered by it. You may be able to respond to simple requests, but many patients remember little or nothing afterward. When the procedure ends, you rest in a recovery area until you are ready to go home with your escort.
When Is General Anesthesia Recommended?
General anesthesia may be recommended for longer or more complex surgery, when several procedures are combined, for patients with severe dental anxiety, or when a patient cannot tolerate treatment while awake. Some patients with significant medical conditions are better treated in a hospital setting, and your surgeon will explain if that applies to you.
Is Sedation Safe In An Oral Surgery Office?
Oral and maxillofacial surgery residency programs in Canada include training in anesthesia, medicine, and acute care. In Ontario, the use of sedation and general anesthesia in dental offices is regulated by the Royal College of Dental Surgeons of Ontario, including standards for training, equipment, monitoring, and staffing.
During sedation or general anesthesia, your oxygen levels, heart rate, and blood pressure are continuously monitored, and the team is trained to manage emergencies. Dr. Kevin J. McCann trained in Oral and Maxillofacial Surgery and Anesthesia at the University of Toronto, holds Diplomate status with the American Dental Society of Anesthesiology, and has held leadership roles, including President, with the Canadian Dental Society of Anesthesiology.
Tell the office about every medication and supplement you take, any heart, lung, or kidney conditions, sleep apnea, pregnancy, previous reactions to anesthesia, and blood thinners such as warfarin, apixaban (Eliquis), rivaroxaban (Xarelto), or dabigatran (Pradaxa). Do not stop any medication on your own; the office will give specific instructions.
How To Prepare For IV Sedation Or General Anesthesia
Follow the written pre-operative instructions you receive. The key rules at our Waterloo office are:
- Fasting. For morning surgery, nothing to eat or drink, including water, after midnight. For surgery after 1:00 pm, nothing after 7:00 am; before 7:00 am you may have two slices of dry toast and clear fluids as described in your instructions.
- Escort. A responsible adult must bring you, take you home, and stay with you for the rest of the day, even if you travel by taxi.
- Clothing. Wear loose, comfortable clothing with short sleeves. Remove contact lenses, makeup, jewellery, and nail polish.
- No alcohol for 24 hours before surgery, and no recreational drugs for 72 hours.
- No driving or important decisions for 24 hours after sedation.
Fasting rules exist to protect your airway. If you eat or drink outside these instructions, your surgery may need to be rescheduled for your safety.
For a step-by-step view of the appointment, watch the video on our day of surgery page.
After Sedation: The First 24 Hours
Expect to feel sleepy for the rest of the day. Rest with your head elevated, start with cool clear fluids once fully alert, and follow your pain management schedule. Nausea is uncommon and usually settles with rest and small sips of fluid. Call the office if vomiting continues or you cannot keep fluids down.
Choosing The Right Option
At your consultation, the surgeon reviews your procedure, imaging, health history, and preferences, then explains which options are appropriate for you. It is completely normal to feel anxious about surgery; say so, and the team will talk you through what to expect. Our guide to preparing for oral surgery covers more practical steps.
Sedation And Anesthesia In Waterloo Region
Our office at 96 Union Street East, near Uptown Waterloo, offers local anesthetic, IV sedation, and general anesthesia for patients from Waterloo, Kitchener, Cambridge, Guelph, and Stratford. Plenty of parking makes drop-off and pickup straightforward for escorts. If you are anxious about surgery, tell the team when you book; your anesthesia options are discussed at the consultation. Call +1 (519)-743-7811.
Sources
- Royal College of Dental Surgeons of Ontario, standards of practice for sedation and general anesthesia in dentistry.
- Pre-operative instructions and pre-surgical instructions, Dr. Kevin J. McCann Oral & Maxillofacial Surgery.
- Dr. Kevin J. McCann, professional background and training.
FAQ
Will I Feel Pain During IV Sedation?
The surgical area is numbed with local anesthetic in addition to the sedation, so you should not feel pain. You may feel pressure, and most patients remember little of the procedure.
What Is The Difference Between IV Sedation And Being Put To Sleep?
With IV sedation you are deeply relaxed and drowsy but still breathing on your own and may respond to simple requests. With general anesthesia you are fully unconscious and unaware.
Can I Drive Home After Sedation?
No. You need a responsible adult to take you home and stay with you, and you should not drive, operate machinery, or make important decisions for 24 hours.
Why Can I Not Eat Before Sedation?
An empty stomach reduces the risk of stomach contents entering the lungs while your protective reflexes are reduced. Follow your fasting instructions exactly.
Is General Anesthesia Safe For Teenagers Having Wisdom Teeth Removed?
Healthy teenagers are commonly treated with IV sedation or general anesthesia for wisdom teeth removal. The surgeon reviews each patient's medical history and discusses risks and benefits with the patient and parent before surgery.
This article is general patient education and does not replace an examination, diagnosis, or the written instructions from your own surgeon or dentist. If you have heavy bleeding, trouble breathing or swallowing, or rapidly spreading swelling, call the office or go to the nearest emergency department.