General anesthesia at the dentist

General anesthesia at the dentist makes it possible to perform extensive dental treatments while the patient is in deep sleep. Especially people with dental fear and anxiety who are need a major dental restoration benefit from general anesthesia.

Before making such a decision, it is important to learn about general anesthesia.

In this article, we would like to inform you about all aspects of this topic. This will help you find out if this method is right for you. If you have any questions, please feel free to contact us. Both the dentist and the anesthesiologist are available for you at any time before and after the general anesthesia.

What does general anesthesia mean?

This sleep-like state is created by administering various anesthetic medications. Administration is intravenous, via access into the vein.

In addition, anesthesiologists use gaseous anesthetics, which are inhaled through a breathing mask and can take effect quickly.

The anesthetic medications consist of sleep medication, painkillers and muscle relaxants, which cause deep relaxation of the muscles and the entire body.

While the anesthetics are administered, pure oxygen is given to breathe via a breathing mask. After the anesthesiologist has put the breathing mask on, the patient counts down from 10. Usually at 7 or 6 the patient closes their eyes and falls asleep.

During the entire treatment, the patient is artificially ventilated, preferably through the nose. All vital parameters such as blood pressure, pulse, oxygen saturation and body temperature are constantly monitored by the anesthesia team. The dentist and assistants are able to fully concentrate on the dental treatment.

Types of general anesthesia at the dentist

General anesthesia at the dentist

During treatment under general anesthesia, the patient is in a deep sleep. Intubation (ventilation) is always necessary, because the ability to breathe is temporarily discontinued due to the anesthetic medication. Accordingly, general anesthesia is a bit more complex. This method is recommended for people who are afraid of the dentist, as well as for large dental restorations.

Twilight sleep at the dentist

During twilight sleep (also known as analgosedation), the patient receives strong painkillers and sedatives. It is administered either in the form of tablets or intravenous, usually via a vein in the arm. The medication administered begin to take effect after 10-15 seconds. The patient becomes calm, sleepy and the memory stops from there. In contrast to general anesthesia, independent breathing is maintained and ventilation is not needed.

Laughing gas at the dentist

Laughing gas is a type of sedation in which oxygen and nitrous oxide (nitrogen-oxygen compound) are inhaled through a nasal mask. Laughing gas reduces the sensation of pain, has an anxiolytic and calming effect. Patients are in an alert and responsive state at all times.

However, nitrous oxide has one major disadvantage, which is why we do not use this form of anesthesia in our practice. It depletes the body’s storage of vitamin B12 and leads to vitamin B12 deficiency.

Difference between general anaesthesia and local anaesthesia at the dentist

Local anesthesia is given by injecting a local anesthetic into the oral mucosa (tissue). The patient is awake, responsive and aware during the entire treatment. Pain is no longer perceptible in that specific area of the mouth.

In most cases, we can also carry out major dental destorations in axious patients with the help of local anesthetics. General anesthesia is not absolutely necessary, but can be a great relief for many patients.

Procedure of general anesthesia

Before the planned procedure, there is a detailed discussion and examinationwith the dentist and the anesthesiologist. Important health issues are clarified and, if necessary, various blood tests are carried out. The body is prepared for the planned general anesthesia by optimizing the level of antioxidants, important vitamins and building blocks.

On the day of the dental treatment, the patient should not eat anything 6 hours prior and should not drink anything 2 hours prior.

Before the dental treatment, there is another meeting between the dentist and the anesthesia team.

The venous access is placed in the arm vein on the dental chair. With the help of a numbing cream, pain can be reduced directly at the puncture site, so that the needle puncture is less painful

The anesthetic medications are administered via the venous access and at the same time, the patient breathes pure oxygen through the breathing mask. Now it only takes a few seconds for the patient to fall into a deep sleep. A complete relaxation of the muscles takes place.

Since the anesthetics also relax the respiratory muscles, independent breathing is no longer possible – the patient is therefore artificially ventilated. The artificial respiration takes place via intubation, through the nose, into the throat and supplies the patient with oxygen. In addition, gaseous anesthetic medication can also be added to the respiratory air supplied. In this way, the anesthetic can be controlled mildly and effectively at the same time.

The anesthesia team, which consists of at least 2 specialists, monitors all of the patient’s vital functions and can make adjustments quickly. In addition to checking pulse and blood pressure, it ensures that the oxygen saturation of the blood is always 98-100% and the body temperature is 37°C. This enables ideal blood clotting so that uncontrolled wound bleeding does not occur.

In the area of the wound, the dentist also uses a local anesthetic so that bleeding is reduced and the patient does not feel any pain after waking up from the general anesthesia. By monotoring the vital functions precicely, the dose can be adjusted to a minimum. Since the patient is asleep, the dental treatment takes place in ideal conditions and can be completed more quickly and efficiently. During the time of the treatment, the dentist and anesthesiologist will consult to keep the duration of the anesthesia and operation as short as possible.

Once the treatment is complete, the anesthesiologist administers a medication that wakes up the patient from the general anesthesia. After this, it seems to the patient that the treatment never took place.

In general, every dental treatment and operation can be performed under general anesthesia. This includes grinding teeth or dental crowns, removing wisdom teeth, removing jaw infections or inserting/placing ceramic implants.

Dental restorations with ceramic implants under general anaesthesia

Many patients want fixed teeth made of a material that does not have any disadvantages on health. Ceramic crowns on ceramic implants is the treatment of choice and is clearly superior to other methods.

After this, in the second session, high-quality, laboratory-made ceramic crowns are produced and cemented onto the ceramic implants. These form the definitive and long-lasting dental prosthetics, which are made for the patient to keep for a lifetime. The second session, in most cases, is done without general anesthesia.

The procedure with a complete tooth restoration in two sessions, is particularly popular for patients who are afraid of dentists as well as self-employed patients. Unnecessary intermediate steps, such as bone grafting/augmentation, can be avoided and the patient can quickly and effectively achieve the desired set of teeth.

Professional team and equipment

With general anesthesia, it is very important that the anesthesia team and the dental team have a lot of experience. This means that the duration of anesthesia can be kept short and complications are reduced to a minimum.

It is also important that the maschines and equipment used are up-to-date and of the best quality.

Dental treatment under general anesthesia takes place in appropriately equipped, spacious rooms so that the teams, the patients and, if necessary, relatives have enough space.

Continuous support and monitoring

The health and safety of our patients is our top priority. For this, no compromises are made and all factors are taken into account accordingly.

Before treatment under general anesthesia, important parameters are checked and adjusted. The health condition is optimized with antioxidants, vitamins and minerals which can significantly improve the tolerance of general anesthesia.

During general anesthesia, the patient is continuously monitored. All important vital parameters are constantly maintained at ideal levels. This is very important, as any deviation can pose a risk to the operation and anesthesia. For example, a body temperature that is too high or too low can impair blood clotting and wound healing. Due to the lack of muscle activity, hypothermia is possible and should be avoided.

Advantages of general anesthesia in dentistry

Patients with dental anxiety worry a lot, weeks or months before the procedure, about how they will get through the upcoming procedure. This inner stress is exhausting and affects quality of life. However, if the decision has been made to carry out the treatment under general anesthesia, it can be a huge relief and the constant worrying stops. Therefore, the first advantage of general anesthesia begins long before the actual operation.

During dental treatments, the benefits are very clear. The patient feels nothing, hears no drilling noises and does not have to keep their mouth open. For the patient, the surgery is over before it even begins.

After the surgery, the patient has no memory of the process. This is an important point, especially for and very sensitive and anxious patients. This is because these patients tend to experience dental procedures as more loud and unpleasant.

Patients who are planning major dental restorations can complete the entire treatment in one or two sessions. Many, often unnecessary, intermediate steps can be avoided. Also, the time until the restoration is complete is shortened.

Another advantage is the calm and quiet working environment for the dentist. These ideal working and operating conditions make it easier and shortens the treatment time.

Risks and complications of general anaesthesia at the dentist

For patients without serious medical conditions, general anesthesia is generally very safe.

However, there are certain risks that come with all types of anesthesia. On one hand, they are due to the anesthetics used and on the other hand to the intubation for ventilation.

Although nausea, vomiting, hoarseness or sore throat are rare, they are still possible after any anesthesia. Tiredness and exhaustion can also occur the following days. These symptoms are similar jet lag after long flights and usually subside quickly. Plenty of sleep and relaxation on the days after help with rapid relief.

Immediately after waking up, a feeling of coldness and muscle tremors may be felt in the body. These symptoms are only short-term and are easily remedied by warming up the body.

We only use anesthetic medications that are highly tolerable and are quickly excreted by the body. Risks, side effects and complications are therefore very rare.

Statistically, driving to the dentist’s office is more dangerous than general anesthesia.

All possibilities, alternatives, risks and complications are explained and discussed in detail beforehand. Our patients can contact the doctors before and after the operation.

Who can benefit from general anesthesia at the dentist?

For various patients, it is of great advantage to have dental restorations carried out under general anesthesia. Usually patients already decide themselves and know they want general anesthesia for their dental treatment/surgery.

Patients who have had traumatic experiences at the dentist in the past tend to develop a fear of visiting the dentist, so-called dentophobia. This fear can be so strong that even the thought of the dental chair, the drilling noise or the smell of the practice can trigger stress and panic.

Dental fear is the most common reason for having dental treatment/surgery done under general anesthesia.

Since we specialize in dealing with dental fear, we can even carry out major procedures without general anesthesia. However, sometimes dental fear can be so strong that general anesthesia is the only possibility.

People with a high perception of pain or who do not respond to local anesthetia (very rare) also benefit from general anesthesia.

In some cases, a gag reflex can be so pronounced that all strategies are unsuccessful and dental treatment is impossible. A general anesthesia is the only option in these cases.

For people with severe mental disabilities, dental treatments can often only be performed under general anesthesia.

General anesthsia is beneficial for large dental treatments and surgeries. , that can take up to many hours or the whole day. This includes surgical procedures with tooth extractions and immediate implantations, but also prosthetic restorations with many crowns, bridges or ceramic fillings.

Surgical-prosthetic complete restorations of the entire oral cavity can also be performed under general anesthesia without complications.

For whom is general anesthesia not suitable?

To determine whether a treatment under general anesthesia is suitable or not, each case needs to be analysed individually. It is important that the patien decides themselves.

In general, the contraindications include taking certain drugs and psychotropic medication, various serious pre-existing illnesses and pregnancy.

All contraindications are discussed with the patient in advance in order to avoid complications and to be able to make necessary changes.

What to consider before general anasthesia at the dentist

The patient should be informed well about the topic of anesthesia before having treatment. All possible questions and uncertainties should be clarified with the dentist and anesthesiologist. This makes it easier to decide whether the operation should be performed under general or local anesthesia.

All guidelines regarding eating and drinking before the operation should be observed – do not eat for 6 hours before prior to the operation and do not drink for 2 hours before.

The bladder should be emptied before going under anesthesia.

What to consider after the general anesthesia at the dentist

After the patient has woken up from deep sleep, all vital functions and the general condition are further checked for a short time after the procedure. At this point, the planned dental treatment is complete and if planned, provisionals are placed on the ceramic implants. Patients can immediately drink something and eat something soft.

Patients can leave the practice about an hour after waking up. This is possible because the anesthetics used have the best tolerability.

During the next 24 hours after, patients should not drive. If the patient cannot be picked up, our dental office can arrange for the patient to be brought home safely.

In the following days a lot of rest and sleep is highly recommended. This shortens possible side-effects of general anesthesia, e.g. jet lag symptoms, and also improves wound healing.

The adjustment of the diet and the further intake of selected supplements strengthen the body and should continue to be observed.

FAQ about general anesthesia at the dentist

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