Anesthesia Information

Anesthesia General Information | Nitrous Oxide (Laughing Gas) | IV Sedation | Oral Sedation (Pills)

Anesthesia General Information

Anesthesia General Information

With over 16 years of providing IV sedation and other forms of anesthesia, Dr. Noren will custom tailor your treatment for comfort and safety. Our goal is to make the surgical experience as stress-free and uneventful as possible.

Frequently patients tell us that they were once very stressed about previous dental experiences and that our office helped them become relaxed and accepting of those services.

Occasionally, local anesthesia only or "numbing the surgical area" is all that a patient may need or desire. The following sections explain other techniques that are often indicated to relax patients for more extensive procedures.

Nitrous Oxide (Laughing Gas)

Nitrous Oxide

For minor procedures, nitrous or laughing gas may be recommended. It is also used when IV sedation cannot be used, or, to lower someone's blood pressure somewhat when high. If someone wants light sedation and has difficulty obtaining an escort/ride, we sometimes recommend nitrous. Pregnant patients and patients with recent or past history related to certain retinal/eye conditions should not have nitrous oxide sedation. Examples of when we use it are with children for minor/quick procedures, single tooth extractions, and occasionally during biopsies.

IV Sedation

IV Sedation

Over the last few decades, IV sedatives have been improved remarkably. Occasionally people report nausea or vomiting from experiences in the operating room or recovery room. In the Oral Surgery Office setting, the medications we use in the IV rarely ever cause these symptoms. In fact, we give some medications to those with a history of unsettled stomach to prevent this. When it does occur, it is generally short-lived. Again, in our office, we rarely ever have those symptoms arise. With IV and nitrous sedation, it especially important to know what to do the night before and the morning of regarding diet and other instructions. At the end of this anesthesia section, please read those instructions.

Our patients report a very pleasant experience with IV sedation. It can be planned as light, moderate or deep. When people say, "I just want to be knocked out" that would imply general anesthesia. General anesthesia though is when the patient is not breathing spontaneously and has a breathing tube temporarily as in when having your appendix removed. That is not our technique in out-patient treatments. Deep sedation generally results in little or no memory of the procedure. Moderate sedation may also result in this, although some parts of the procedure may be remembered but the patient is very comfortable. Light sedation can be very desirable as the patient is very relaxed but can freely communicate. These three states are custom to every patient in our practice.

Typically, wisdom tooth cases, longer cases, or more difficult cases are usually done with moderate or deep sedation. Even healthy elderly patients may undergo light IV sedation when indicated. We do not do deep IV sedation on very young (1- 7) or very elderly patients in our office. We will try using oral sedation and/or nitrous sedation on younger children when possible. Some multiple extractions in children aged 9-14 are done with light to moderate IV sedation. Children 12 and older can have deeper sedation when indicated, in general. There are always exceptions to these general guidelines.

Our goal is to make the experience as stress-free as possible, and the nurses are very helpful along with Dr. Noren in making that happen. We don't rush anyone through or out, and we explain everything that patients are needing to know about each procedure that we perform.

Instructions to follow the night prior to IV Sedation Surgery

Eat well and drink plenty of fluids the night before, you'll feel better.
Have bland snacks after dinner, like pasta or mashed potatoes.
Avoid spicy or greasy foods.
Drink plenty of clear liquids, avoid orange juice or lots of soda or acidic drinks (water, powerade, etc ok.)

No food or liquids 6 hours prior to IV sedation
Exception is water in small amounts up to 2.5 hours before IV sedation.
The other exception is a small sip of water to take indicated/approved morning medications.

Loose fitting comfortable clothes, short-sleeved shirt or a sweater/coat in cold weather, but bottom layer as above

You must have a ride or escort with you.
They should monitor you at home if possible for 1-2 hours.
Have a cell phone near you too.

Have ice packs in the freezer and soft foods ready (pasta, ice cream, yogurt, crock-pot type foods).

Turn off your cell phone during surgery.
No perfume or colognes please.

If you have any questions, call (607) 273-0327.

Oral Sedation

Oral Sedation

Occasionally we will recommend oral sedation (taking pills before surgery) by itself or in combination with nitrous oxide (laughing gas). The advantages can be lower cost and less complicated surgeries or procedures. General dentists who are licensed to do oral sedation (check your dentists' certificate) can do this for general dental procedures. The goal for oral sedation is not unconsciousness or deep sedation; that is not indicated for this technique. If a dentist does not have this certificate to do oral sedation, or, they sedate patients deeply, they are not practicing within standards of care.

Dr. Noren will explain if Oral Sedation may be indicated in your case; the main disadvantage to oral sedation is lack of control of under or over sedation as there is no IV access. In our case, our office can immediately start an IV if need be unlike in a general dental office.

Our office will give you instructions on eating and drinking rules also. Generally, it follows the same times as nitrous sedation (see that section) as well as needing an adult escort that can drive you to and from the appointment. With IV sedation, no medication is on board until the start of the procedure; with oral sedation, we may need to complete consents and payments prior to the surgery date. Call our office with any questions.