Fear to Freedom: We Want to Help You Combat Your Dental Anxiety!

Dental Anesthesia

Several methods of anesthesia are available. The method of anesthesia that is chosen for or by a patient depends upon the nature of the surgical procedure and the patient’s level of apprehension.

Anesthesia Options

The following table illustrates the choices of anesthesia, a description of the anesthetic technique, and the usual indications for that technique.

• MethodTypes of Anesthesia
  Description of Technique
  Usual Indications
• Method Local Anesthetic
  Description of Technique The patient remains totally conscious throughout the procedure. A local anesthetic (e.g. lidocaine) is administered in the area where the surgery is to be performed. Local anesthetic is used in conjunction with the other methods of anesthesia in all oral surgery procedures.
  Usual Indications Simple oral surgery procedures such as minor soft tissue procedures and simple tooth extractions.
• Method Office Based IV Conscious and Deep Sedation or General Anesthesia with Local Anesthetic*
  Description of Technique Medications are administered through an intravenous line (I.V.). The patient is may be lightly sedated (Conscious), deeply sedated (Asleep) and completely unaware of the procedure being performed or General Anesthesia (Anesthesia where support of breathing is required). Medications most commonly used are Fentanyl (opiate), Versed (benzodiazepine), Ketamine, and Diprivan. Supplemental oxygen is delivered through a nasal breathing apparatus and the patient’s vital signs are closely monitored. Dr. Pollaccia will titrate the appropriate dose of medication for each patient, maintaining the patient at an appropriate level of anesthesia.
  Usual IndicationsIV Conscious and Deep Sedation along with General anesthesia is available for all types of oral surgery. A patient may choose IV Conscious sedation for simple procedures, depending on their level of anxiety most procedures can be performed with this type of sedation. Most people having their wisdom teeth removed or having multiple implants placed will choose IV Deep Sedation. General Anesthesia may be necessary if local anesthesia fails to comfortably anesthetize the surgical site which may occur in the presence of infection.
• Method Hospital Based General Anesthesia
  Description of Technique A patient is admitted to a hospital or surgery center where anesthesia is administered by an anesthesiologist. In this scenario your muscles are paralyzed and you have no ability to breathe own your own and a machine is breathing for you.
  Usual Indications Indicated for patients undergoing extensive procedures such as face and jaw reconstruction and TMJ surgery. Also indicated for patients with medical conditions such as heart disease or lung disease who require general anesthesia. Or pediatric patients requiring General Anesthesia.

To administer general anesthesia 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 five years if the doctor maintains the required amount of continuing education units related to anesthesia.

Please understand that some patients may have certain medical conditions that only allow for them to be lightly sedated or not sedated at all. The goal of all IV sedation and GA is to use as little medication as possible to safely and comfortably complete the treatment.

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 Dr. Pollaccia at the time of your consultation.

LOCAL ANESTHESIA

30% of our cases can be completed with local anesthesia without discomfort. 

Intravenous Sedation (“Twilight Sedation”)

50% of our cases can be completed with Conscious IV “Twilight Sedation”

Conscious Sedation or “twilight sedation” allows you to be comfortable, calm and relaxed when undergoing dental procedures. Conscious sedation will essentially help alleviate the anxiety associated with your treatment, as well as forget (amnesia) the majority of the procedure. Although termed conscious sedation, many patient will go in and out of consciousness or sleep during the procedure.

INTRAVENOUS SEDATION (DEEP)

99% of our cases can be completed with Deep IV Sedation

Unlike “Twilight Sedation” the patient stays asleep throughout the procedure only awakening at the end of treatment once the doctor is finishing the surgery.

General Anesthesia

1% of our cases need to be performed under General Anesthesia

Here the surgical staff must support the patients head and airway to prevent the patient from becoming (apneic) not breathing. This technique is reserved for patients with severe infections or extremely complicated deeply impacted teeth with associated pathology (cyst/tumors).

How & BY WHO is IV sedation administered

At Peoria Oral & Implant Surgery we recognize that patients who have fear of needles will often become anxious with having an IV placed. Unlike the majority of offices where the IV is placed by a dental or medical assistant, at Peoria Oral & Implant Surgery Dr. Pollaccia comfortably places all IV’s. Even those of you that have had difficulty in the past will find that the procedure is relatively painless and performed with ease. Throughout his career Dr. Pollaccia has placed over 20,000 patients under anesthesia starting the IV on every case. Once the IV is introduced into your arm or hand, an IV line will be connected through which fluids and medications will be administered. Again, Dr. Pollaccia does not rely on staff to perform these duties, but instead administers all medications himself eliminating any possibility of confusion or error in medications delivered. Lastly, IV sedation is generally safe, often considered much safer than oral sedation. Unlike oral sedation, with an IV in place Dr. Pollaccia can reverse the effects of most sedation medications, if needed.