Board Certified Anesthesiologist

Patient Care Comes First

Anesthesia for Dentistry: Medical Problems

Dentists and oral surgeons take care of many patients with medical problems. For most short simple procedures, the only necessary anesthesia is local and topical, and no specialized anesthesia care is necessary. Most oral surgeons are used to performing anesthesia for many of their own patients. When patients have significant underlying medical problems, and sedation is necessary, most dentists and many oral surgeons will turn to an anesthesiologist for help. Patients with significant medical issues are encouraged to see their own medical doctor before their dental/oral surgery procedure, to make sure they are in the best possible medical condition. Some common medical problems requiring an anesthesiologist include:

  1. Smoking – Patients with a history of smoking have increased risk of periodontal disease leading to dental decay and loss of teeth and bone. Long-term smokers commonly have airway problems. They also suffer from heart, blood vessel, and lung disease.

  2. Obesity and Obstructive Sleep Apnea – Obese patients and others with difficulty breathing at night have difficulty lying flat on their back in a dental chair, especially if any sedation is required. Dr. Einstein is equipped to make sure that these patients maintain a good airway, and remain safe and comfortable throughout their procedures.

  3. Heart Disease – Patients with significant heart disease can react even to local anesthetics and epinephrine injected in the mouth. Dr. Einstein monitors these patients very closely, and uses medication as necessary to adjust heart rate and blood pressure. In many cases, he will call the patient’s specialist physicians to make sure the patient is in optimum condition for dentistry and sedation.

  4. Dementia and Neurological Diseases – Older patients and those with previous developmental and psychiatric problems can be very difficult for dentists and oral surgeons to treat. Dr. Einstein can facilitate their treatment using IV sedation. Pre-procedure consultation with the patient’s private physician is often very helpful.

  5. Diabetes – Carbohydrate metabolic disease is the primary diabetic problem. In addition, diabetics have other medical problems involving the cardiovascular system and the kidneys. Some diabetics are obese, and have obesity related issues, especially breathing problems. Dr. Einstein coordinates the usual medical treatment with the patient and if necessary the primary physician. Glucose levels can also be closely monitored under anesthesia.