Neponset Valley OMS
Oral and Maxillofacial Surgery Associates
841 Main Street, Walpole, Ma 02081
Phone: 508-660-2900
Fax: 508-660-0134

Anesthesia

You will always be given local anesthesia for your surgery, but you may choose to also have nitrous oxide (laughing gas) or intravenous sedation. Each choice requires different preparation on your part, and for your safety it is important that you read and follow the instructions carefully. If you are unclear about anything, please ask your doctor.

For all surgery, please wear comfortable, loose-fitting clothing. Tops/shirts should have sleeves that are easily drawn up above the elbows. Women should remove nail polish before surgery, and apply as little makeup as possible.

LOCAL ANESTHESIA

Local Anesthesia will produce a numb feeling in the area being operated on and a feeling of pressure during surgery. You will be awake and recall the surgery, but there should be no significant discomfort.

  1. Have a light meal a few hours prior to surgery.
  2. For more extensive procedures you may wish to have someone drive you home.
  3. Plan to rest for a few hours after surgery.

ORAL PREMEDICATION

Oral Premedication may be a supplement to local anesthesia and is medication taken by mouth to produce relaxation before and during your operation.

  1. Take the medication at the time directed before your surgery.
  2. Have a light meal a few hours prior to surgery unless you are also having intravenous or general anesthesia.
  3. It is not safe to drive after taking sedative drugs, and you MUST have someone drive you to and from surgery.
  4. Plan to rest the remainder of the day. Do not operate power tools, machinery, etc., for 24 hours after surgery.

Nitrous Oxide (Laughing Gas)

Nitrous oxide is a sweet smelling, non irritating, colorless gas which you can breathe. Nitrous Oxide has been the primary means of sedation in dentistry for many years. Nitrous oxide is safe; the patient receives 50-70% nitrous oxide with no less than 30% oxygen. Patients are able to breathe on their own and remain in control of all bodily functions. The patient may experience mild amnesia and may fall asleep not remembering all of what happened during their appointment.

There are many advantages to using Nitrous Oxide

  • The depth of sedation can be altered at any time to increase or decrease sedation.
  • There is no after effect such as a "hangover."
  • Inhalation sedation is safe with no side effects on your heart and lungs, etc.
  • Inhalation sedation is very effective in minimizing gagging.
  • This type of anesthesia works particularly well for young children.
  • You may have a light meal four (4) hours prior to surgery.
  • It is best to have someone drive you home.
  • Plan to rest for the remainder of the day.

Intravenous Sedation ("Twilight Sedation")

Our office offers our patients the option of intravenous sedation or to some it is referred to as "Twilight Sedation" for their dental treatment.  intravenous sedation or "twilight sleep" helps you to be comfortable and calm when undergoing oral surgery. Your treatment can be completed under intravenous sedation. Intravenous sedation or “IV sedation” (twilight sedation) is designed to better enable you to undergo your oral surgery while you are very relaxed; it will enable you to tolerate as well as not remember those procedures that may be very uncomfortable for you. IV sedation will essentially help alleviate the anxiety associated with your treatment. You may not always be asleep but you will be comfortable, calm and relaxed, drifting in and out of sleep – a “twilight sleep”.

If you choose the option of intravenous sedation your IV sedation/anesthesia is administered and monitored by your doctor therefore eliminating the costly expense of having your treatment carried out in an operating room or same day surgical facility.

How is the IV Sedation Administered?

A thin needle will be introduced into a vein in your arm or hand. The needle will be attached to an intravenous tube through which medication will be given to help you relax and feel comfortable. Once again some patients may be asleep while others will slip in and out of sleep. Some patients with medical conditions and/or on specific drug regimens may only be lightly sedated and may not sleep at all.

The goal of IV sedation is to use as little medication as possible to get the treatment completed. It is very safe, much safer than oral sedation. With IV sedation a constant “drip” is maintained via the intravenous tube. At any time an antidote can be administered to reverse the effects of the medications if necessary.

  1. Do not eat or drink anything for six hours prior to surgery. You may have water up to 2 hours prior to surgery.
  2. Certain patients such as those with diabetes and young children should be scheduled as early as possible in the morning. You doctor will review your medical history at the consultation visit and determine if this is necessary.
  3. A responsible adult must accompany the patient. Whoever accompanies the patient should plan to: arrive with the patient, remain in the office throughout the surgery and drive the patient home.
  4. It is important that you take any regular medications (high blood pressure, antibiotics, etc.) or any prescription medications that your doctor has provided with a small amount of water.
  5. Women are requested to remove makeup prior to surgery (lipstick and fingernail polish).
  6. You should remove any contact lenses before surgery.
  7. You should not have any plans for the remainder of the day of surgery. He/she may, under no circumstances, drive an automobile (or motorcycle) or operate machinery for at least 24 hours after having a general anesthetic.
  8. It is important for you to not ignore a head or chest cold when anesthesia is to be administered. Call immediately if you have any symptoms as a change in appointment may be necessary. Please give a 24 hour notice.

To administer intravenous sedation in the office, an oral surgeon must have completed at least three months of hospital based anesthesia training. Qualified applicants will then undergo an in office evaluation by a state dental board appointed examiner. The examiner observes an actual surgical procedure during which general anesthesia is administered to the patient. The examiner also inspects all monitoring devices and emergency equipment and tests the doctor and the surgical staff on anesthesia related emergencies. If the examiner reports successful completion of the evaluation process, the state dental board will issue the doctor a license to perform general anesthesia. The license is renewable every two years if the doctor maintains the required amount of continuing education units related to anesthesia.

Again, when it comes to anesthesia, our first priority is the patient's comfort and safety. If you have any concerns regarding the type of anesthesia that will be administered during your oral surgery procedure, please do not hesitate to discuss your concerns with your doctor at the time of your consultation.