Safety of anesthesia for oral surgery (2023)

If you must have yourswisdom teeth removedor if a child has a lot of cavities that need filling, you may be concerned about the safety of the anesthesia used in oral surgery. However, studies show that oral anesthesia administered by dentists and oral surgeons in the office is safe and helps alleviate patients' fears of pain during dental procedures.

More than a third of adults are afraid of going to the dentist.This can prevent regular checkups and cleanings, which affects your oral and general health.

Read on to learn about the different types of anesthesia used in oral surgery, how they are administered, how safe they are, and how dentists and oral surgeons decide which methods to use.

How anesthesia is administered

Anesthesia during dental procedures can be done in a number of ways. The method dentists and oral surgeons use may depend on factors such as the person's age, general health, history of allergies, anxiety, preferences, and the length and complexity of the required dental procedure.

Local anesthesia

Dentists apply local anesthetic injections for routine dental procedures, such as filling cavities. Depending on the position of the tooth, a local anesthetic can take up to seven minutes to take effect. The lower molars usually take longer to become numb. Your dentist may apply a topical anesthetic to relieve the stinging of an injection so you don't feel pain.

Local anesthesia is considered very safe. The biggest risk is allergies. A patient may be unusually sensitive to a medication and experience side effects such as itching, swelling, or hives. In the worst case, a patient may develop breathing problems and need emergency care. This is extremely rare, occurring in less than 1% of all cases.

From time to timevasoconstrictorMedications such as epinephrine are used to help anesthesia work or to make it last longer. Epinephrine can make your heart race and cause anxiety, headaches, and tremors, but this is not an allergic reaction.

Safety of anesthesia for oral surgery (1)

laughing gas

Patients who are as afraid of dentists as they are of injections can be drugged by dentists by inhaling them with a mixture of oxygen and nitrous oxide, or "laughing gas." The mixture works in two to three minutes.

Patients often tingle or float, but are awake, calm, and pain-free. Side effects are extremely rare.Dentists advise you not to eat before the procedure to reduce the risk of vomiting.

The mixture will disappear three to five minutes after the patient removes the mask. Dentists advise patients to wait at least five minutes before getting up to avoid the risk of falls.


Other levels of sedation include deep and intravenous sedation. Patients may be given pills to swallow, asked to inhale medication from a mask, given an injection, or given anesthesia through an intravenous line (IV, into a vein). You can even get a combination of these methods.

Different levels of sedation range from conscious sedation, where you can follow commands, to not being aware of your surroundings at all.

If you receive deep or intravenous sedation, the dental team will monitor your vital signs, such as breathing and heart rate, temperature, and blood pressure throughout the procedure.

Review studies show that although intravenous sedation is slightly riskier, sedation is safe for outpatient oral surgery.

general anesthesia

General anesthesia is what is commonly known as going to sleep for a procedure. It is generally used for longer and more complicated procedures, such as B. removal of impacted wisdom teeth or insertion ofdental implants.

It can also be used for highly anxious patients, patients with disabilities, and children who cannot sit still. General anesthesia is administered through a face mask or is administered intravenously.

Patients are unconscious and, as with deep and intravenous sedation, heart rate, blood pressure, and breathing are monitored. General anesthesia is riskier than local anesthesia and sedation, but it is still considered very safe.

side effects

A multi-year review found that oral anesthesia is very safe. The risk of death from oral anesthesia is estimated at three deaths per million cases.

However, there are several known side effects. For this reason, you should always schedule someone to accompany you who can drive you or help you get home after the procedure.

Side effects include:

  • headache
  • nausea vomiting
  • Confusion, delirium, amnesia
  • difficulty speaking
  • Sore throat or dry throat
  • numbness at the injection site
  • fatigue

risks of anesthesia

Most patients do not have problems with local anesthesia. Sedation and general anesthesia are more risky for people with health problems such as heart, liver, lung, or kidney problems. People with disabilities, elderly patients, and young children are also at higher risk of complications from anesthesia.

Possible complications include:

  • Allergic reaction:Reactions can range from itching or hives to difficulty breathing. Tell the dentist about any allergies you have and if you have had a previous reaction to anesthesia.
  • nerve damage:This can happen after a tooth extraction or even after an injection in the mouth. Patients may lose feeling or have trouble speaking or drooling. Some oral anesthetics can cause tingling. It is usually temporary, but in rare cases it can last up to six months or more.
  • embargo:People with epilepsy and other medical problems can have seizures under anesthesia. If this is the case, it is usually at the start of surgery or 20 to 30 minutes later when the concentration of anesthetic in the blood is highest. Be sure to tell your doctor or oral surgeon about your seizure disorder and ask if they are trained to treat it.
  • Arrival:This terrifying complication is very rare and is often due to underlying metabolic or neurological disorders. However, young children can go from a level of sedation to a deeper level if too much medication is given.
  • breathing difficulties:The muscles of the tongue or soft palate can relax too much and narrow the airway. Patients may also have some form of apnea or shallow breathing. A dental team will monitor you closely during deep sedation and general anesthesia.
  • Heart failure or stroke:One study found that oral surgery was associated with an increased risk of heart attack or stroke within four weeks of the procedure.If you're worried about having a heart attack or stroke during surgery, ask if the anesthetic contains a vasoconstrictor such as epinephrine, which can put pressure on the heart. Before undergoing any treatment, you can also ask your dentist if the office has emergency oxygen and medications such as nitroglycerin.

Precautions and Interactions

Certain medical conditions, such as heart, lung, and thyroid disease, can increase the risk of an anesthetic side effect.

Dentists and oral surgeons should carefully evaluate and monitor elderly patients, children, and patients with disabilities during surgery to avoid overdose. One study found that children with cerebral palsy had a higher risk of side effects, such as a drop in temperature, a drop in blood pressure, or shortness of breath during general anesthesia.

In recent years there has been a trend towards sedation or general anesthesia to treat children with cavities. However, when they are used, certain precautions are required.

The American Academy of Pediatrics and the American Academy of Pediatric Dentistry recommend that during an emergency involving a child, two people trained in advanced life support should be present. The practice must be equipped with the proper rescue equipment and sedation or general anesthesia must also be administered by a trained anesthetist.

redhead and anesthesia

If you have natural red hair but dye your hair, you may want to tell your dentist or oral surgeon. Studies have found that due to a gene mutation, redheads are more sensitive to pain and tend to need more pain relievers. One study found that redheads require up to 20% more anesthesia than blondes and brunettes.


Whether you're a redhead, a child, an older adult, or someone with underlying medical conditions, local anesthesia, sedation, and general anesthesia can alleviate pain and help you get the cleanings and treatments you need to maintain your oral health.

Oral anesthesia is considered very safe and can reduce anxiety about going to the dentist. However, people with certain medical conditions or allergies may be at higher risk for a side effect.

That is why it is important to discuss the medical history with the dentist and oral surgeon before any operation. Tell them about any allergies you have, any medications you are taking, and if you have had a bad reaction to anesthesia in the past.

A word from Verywell

Many people hate going to the dentist. The noise of the drill and the fear of pain can cause people to avoid walking, which is bad for their oral and general health. Studies show that local anesthesia, sedation, and general anesthesia methods for oral surgery are safe and help calm patients.

However, there are some risks, especially if you have certain health conditions. To avoid an allergic reaction or an undesirable outcome, it is important to provide your dentist or oral surgeon with a detailed medical history, including whether you have ever had a reaction to anesthesia, if you have any allergies, and any medications or supplements you may be taking. I am taking is currently taking.

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