Board Certified Anesthesiologist

Patient Care Comes First

Anesthesia for Dentistry: Adults

Dentists routinely give topical and local anesthesia for most procedures and the dental experience is well tolerated. Some patients unfortunately have had unusual situations which make dentistry very difficult for them. Problem areas include:

  1. Gagging – hyperactive gag reflex makes it difficult and sometimes impossible for patients to cooperate for dental treatment. Intravenous anesthesia eliminates the gag problem during the procedure.

  2. Cannot Get Numb – Some patients simply do not get adequate anesthesia in spite of the dentist’s best efforts. Every patient is different. Some require much more anesthetic for numbness, and whatever effect they get wears off much to fast for effective treatment. Other patients are very sensitive to vibration, which is not eliminated by local anesthesia. Some patients have infections or abscesses. This tissue area is acidic, and is resistant to the effect of local anesthesia. The combination of local and intravenous anesthesia is extremely effective, and patients typically wake up pain free without awareness of their treatment.

  3. Small Mouth – Dentists are used to working upside down with a mirror. But, access to certain areas can be very difficult. A “small mouth” is an obstacle for the patient and the dentist. The mouth can be small because of opening difficulty from TMJ problems, arthritis, anatomic variation, or previous injury. Sometimes, the mouth is small because the tongue is relatively large, or from a combination of factors. Intravenous anesthesia effectively relaxes the jaw and tongue muscles, and improves access significantly.

  4. Extensive Procedures – Some dental and oral surgery treatments are difficult for patients because they are invasive, and/or they are very lengthy. Some relatively brief cases especially involving extractions and dental implants include deep work involving bony structures. Many patients will be uncomfortable even with good local anesthesia. Some procedures such as veneers, crowns, dental restorations, and gum work may not be very invasive extensive crown work and restorations not very invasive, but can be scheduled for many hours in one sitting. It is difficult for most patients to comfortably maintain an open mouth for long periods. The dentists and surgeons also have difficulty with frequent interruptions at critical points in treatment. Dr. Einstein’s combination of intravenous anesthesia and pain medication together with the operator’s local anesthetic makes the time pass in an instant. Patients will wake up quickly, and be ready to go home in about thirty minutes after treatments lasting less than two hours. Recovery time after longer cases is variable, but patients usually go home within one hour of the end of the procedure.