With the removal of wisdom teeth anesthesia is an important consideration. Dentists and oral surgeons usually use local anesthesia which numbs the surgical site. Local anesthesia is administered in the form of an injection and prevents the nerve fibers of the tooth from transmitting impulses. Local anesthesia numbs the area temporarily and completely eliminates pain.
Dentists also make use of other sedation techniques as to reduce anxiety and awareness. One antipanic and anxiolytic agent that is used as an adjunct to local anesthetic is nitrous oxide. It is commonly used in ambulatory surgery centers, emergency centers, and in dentistry as an inhalation anesthetic. While it cannot produce general anesthesia reliably, it provides moderate or minimal sedation to apprehensive dental patients.
Cost is one of the major advantages. No or little cost is associated with the use of this anxiolytic agent in most cases. With extraction of wisdom teeth anesthesia methods differ depending on the patient and how complicated the surgery is expected to be. Oral pre-medication is used in some cases, but it is more expensive to administer than nitrous oxide. The patient usually takes it 30 minutes to 1 hour prior to the surgery, and the effects and duration vary.
Oral pre-medication is more effective as anesthetic than nitrous oxide, but its onset and effectiveness are said to be unpredictable.
Another type of anesthetic is intravenous sedation, which puts patients in a comfortable, relaxed, and safe state. An intravenous line is used to administer it, making its onset of action and effectiveness more predictable. Some dental practices and offices use terms like ‘twilight sleep’ and ‘sleep dentistry’ to describe IV or intravenous sedation.
This is confusing for patients as it suggests that intravenous sedation will put them to sleep. In fact, the patient remains conscious during the procedure. Patients are able to respond to questions and understand what their dentist is saying and doing. However, during the surgical removal of wisdom teeth anesthesia induces a feeling of not being bothered and a state of deep relaxation. For this reason, patients may not remember anything or much about the procedure.
The medications used may produce full or partial amnesia or memory loss(1) for a certain period of time or until the medication wears off. Patients may not recall much because time will appear to be passing very quickly.