Many of patients experience considerable anxiety when confronted with the need for an oral surgical procedure. This is a natural response, and is often worsened by misconceptions about the procedure, or by advice provided by well-meaning, but misinformed friends or relatives. It has been experienced over the years that patients who undergo a minor oral surgical procedure under local anesthesia had often grossly overestimated the associated difficulty and discomfort, and find that the experience was significantly less stressful than they had anticipated. Despite this however, we still see a large number of patients who express extreme fear and apprehension about the proposed procedure, and request that they be sedated or “put to sleep” for their surgery. Conversely, there are certain more difficult procedures, for which patients may initially wish to consider having performed under local anesthesia, but for which we would highly recommend some form of sedation.
If there are no medical contraindications to intravenous sedation (and there are very few patients who are too medically compromised to benefit from some form of sedation), patients can be sedated safely and comfortably in the office, even for relatively minor procedures. The technique normally employed is that of Intravenous (or I.V.) Sedation. This involves the slow and careful administration of sedative medications through a small butterfly intravenous needle, which can normally be placed easily and painlessly in the arm. This is not the same as the full general anesthetic in the hospital setting, which requires breathing tubes, ventilators, etc. Instead, patients breathe in a normal fashion throughout the anesthetic (just as if one were sleeping at night), remain numb throughout the procedure (as the local anesthetic is given after the patient is “asleep”), and have no recall of anything during the procedure itself.