Types of Anesthesia
Thursday June 5, 2003
Dear Dr. Mady: Whenever I go to the dentist I like to be as comfortable as possible. What types of anesthesia are available today?-Shelly in Tilbury
Dear Shelly: If you want to be as comfortable as possible, then some type of anesthesia for dental procedures is warranted. However you may be selective with respect to limiting it to certain treatments such as fillings and not cleanings. The main goal of anesthetic administration is to eliminate or significantly reduce any anxiety or discomfort that may be related to one’s dental treatment.
Actually the type of anesthesia you will require is more dependent on your personal preference than the actual procedure that you will be receiving. The actual anesthesia accomplished is produced by the application or injection of a certain drug to eliminate sensation and feeling in a specific, localized area of the mouth. For local anesthetic injected intra-orally, most dentists will apply topical anesthetic at the site prior to needle penetration to diminish the initial feeling. Topical usually comes in Vaseline based or spray form. It works fairly well in most cases while there are some but few reports that it does nothing at all.
A common local anesthetic used is lidocaine, although when most individuals speak of it they use the term “novocaine”. All local anesthetics are typically effective for a short period of time usually in the area of a couple of hours. Some patients say it lasts many hours. I feel that it is dependent on how fast each person metabolizes the medicine. Some local anesthetics contain epinephrine in varying doses, which helps keep the anesthetic localized in the area for a longer period of time. Epinephrine can also cause the desired level of anesthesia to be more profound. This most common form of anesthesia is commonly used for procedures such as fillings and oral surgery, but may be used for most treatments in the dental office.
Another type of anesthetic used by many practitioners is conscious sedation. This helps patients to relax during procedures and makes delivery and acceptance of injections much easier. Nitrous Oxide is often used. This is especially a good option as an anti-anxiety agent and it helps you to remain calm. While under conscious sedation the patient remains responsive to touch and speech and after treatment is completed you will feel normal within minutes. Many people feel “good” when under nitrous oxide. This is why it is often called “laughing gas” by the general public.
The last form of anesthesia that I would like to describe is deep sedation, also known as general anesthesia. It is used the least and mostly for more complex procedures and when patients suffer from moderate to severe dental apprehension. Basically you will be asleep and not remember anything after the treatment is completed. It is an excellent choice when getting impacted wisdom teeth removed and for more serious oral surgeries.
When having any type of anesthetic it is imperative to advise your dentist or anesthetist about any current medications that you are taking to avoid possible negative drug interactions. Also inform with respect to known allergic reactions and history of other recent general anesthetics. Communication with your dentist will assure you have the type of anesthetic needed and ensure safety.
This column is reprinted with the permission of the author and The Windsor Star. "Ask the Dentist" is written by Windsor dentist (and ECDS member), Dr. David Mady Jr.. The column appears the first Thursday of each month in the Windsor Star. Readers with questions can write to "Ask The Dentist", c/o The Windsor Star, 167 Ferry St., Windsor Ontario, N9A 4M5