For some patients, a general anesthetic at the dentist is just the right thing.

In particular, people who are afraid of the dentist and who are about to undergo major dental treatment benefit from general anesthesia. Before making such a decision, it is important to learn and be informed 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?


General anesthesia is an artificially generated deep sleep that serves to completely switch off the conscious perception of the dental surgery and the pain.

The patient is completely unaware of the procedure and has no memory of it afterwards.

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

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

The anesthetic drugs used are sleep medication, painkillers and muscle relaxants, which enable a state of deep relaxation.

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 his team are able to fully concentrate on the dental treatment.

Types of general anesthesia at the dentist

General Anesthesia

During treatment under general anesthesia, the patient is in a deep sleep. Intubation (ventilation) is always necessary because natural breathing is temporarily discontinued because of the anesthetic drugs. 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

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 drugs 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

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 destroys the stores of vitamin B12 in the body and can lead to a vitamin B12 deficiency.

Difference between General Anesthesia and Local Anesthesia


With general anesthesia, the patient is put into a deep sleep. An experienced anesthesia team is absolutely necessary for this.

With local anesthesia, on the other hand, the dentist applies a local anesthetic via injection in the gums to numb the teeth in an area of the mouth. Therefore it is referred to as local anesthesia. This method is well known by many patients as it is used in most dental treatments to eliminate pain.

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With local anesthesia, on the other hand, the dentist applies a local anesthetic via injection in the gums to numb the teeth in an area of the mouth. Therefore it is referred to as local anesthesia. This method is well known by many patients as it is used in most dental treatments to eliminate pain.

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

With the help of local anesthetics, we can, in most cases, also carry out major dental restorations in anxious patients. General anesthesia is not absolutely necessary, but can bring/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 puncture will not be felt.

The anesthetic drugs 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. All the muscles relax.

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 an intubation, through the nose, into the throat and supplies the patient with oxygen. In addition, gaseous anesthetic drugs 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 anesthesia. By precisely adjusting the vital functions, 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 entire period 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 drug that wakes up the patient from the 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 Anesthesia


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 clearly superior to other methods.

In our practice we are able to carry out large dental restorations, e.g. placing 16 ceramic implants, in one session. Usually, general anesthesia is not necessary for this. However, general anesthesia offers patients with fear of the dentist an uncomplicated solution for mastering a major dental treatment. The entire treatment is performed as an all-in-one procedure, so an edentulous patient falls asleep without teeth and wakes up with fixed teeth. Aesthetic provisionals are placed on the freshly inserted ceramic implants, which remain in the mouth for about 3 months. Within these three months, the ceramic implants can heal firmly into the jawbone and integrate into the oral system.

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

This procedure, 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 anesthesia machines used are up-to-date and of the best quality.

The 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, but all factors are taken into account accordingly.

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

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

Advantages of General Anesthesia in Dentistry


Weeks or months before the procedure, patients with a fear of dentists worry a lot about how they will handle the upcoming procedure. This inner stress uses a lot of energy and affects quality of life. However, if the decision has been made to carry out the treatment under general anesthesia, a huge weight falls from the patient’s heart and the constant brooding stops. Consequently, the first benefit of general anesthesia begins long before the actual surgery.

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 anxious patients and very sensitive patients. This is because such patients experience a dental procedure more intensively, louder and unpleasantly.

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

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

Risks and Complications


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

However, there are certain risks that come with all forms of anesthesia. On one hand, there 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 in the following days. These symptoms are similar to the well-known jet lag after long flights and subside quickly. Plenty of sleep and relaxation in the days that follow bring rapid relief.

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

We only use anesthetic drugs 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 before the anesthesia. Our patients can contact the doctors telephone at any time, before and after the operation.

For whom is general anesthesia useful?


For various patients, it is of great advantage to have dental restorations under general anesthesia. Generally, the patients already know themselves and have decided that a general anesthesia is suitable for their surgery.

Patients who have had traumatic experiences at the dentist in the past tend to develop a fear of visiting the dentist, the so-called dental phobia. Such fear goes so that just the thought of the dentist’s chair, the noise of drilling or the smell of the practice can trigger panic.

Fear of the dentist is the most common reason for dental treatment under general anesthesia.

Since we specialize in dealing with dental fear, we can even carry out major procedures without general anesthesia. Occasionally, however, the fear of the dentist is so pronounced that an anesthetic cannot be avoided.

People with an increased perception of pain or who do not respond to the local anesthetic (very rarely) 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. General anesthesia is the last resort for those affected.

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

General anesthesia is particularly recommended for larger treatments that can last several hours. This includes surgical interventions with tooth removal and immediate implantations, as well as prosthetic care with many crowns and bridges.

Surgical-prosthetic complete restorations of the entire oral cavity can also be carried out in an uncomplicated manner under anesthesia.

Who is General Anesthesia not suitable for?

Whether a treatment under general anesthesia is suitable or not should always be considered on a very individual basis. It is important that the patient makes the decision themself and fully supports it.

In general, the contraindications include taking certain drugs and psychotropic drugs, various serious previous illnesses and pregnancy.

All contraindications are discussed with the patient in advance in order to rule out complications or to be able to make necessary changes.

What to consider before General Anesthesia


The patient should be informed well about the topic of anesthesia before the treatment. All possible questions and ambiguities 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 the operation and do not drink 2 hours before.

The bladder should be emptied before the start of anesthesia.

What to do after General Anesthesia


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 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 we only use anesthetics with the best tolerability.

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

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

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

FAQ


Who covers the cost of general anesthesia?

In Switzerland, the cost of general anesthesia must almost always be financed by the patient themself. In individual cases, dental insurance, IV or accident insurance cover a certain part of the costs.

What costs can be expected?

The cost of the anesthetic depends on the duration. For large dental treatments that last more than 5 hours, costs of around CHF 3,500 can be expected. If you have detailed questions, our anesthesiologist will be glad to advise you.

Are medical examinations necessary before general anesthesia?

Depending on the health of the patient, different examinations are necessary. This is determined individually and discussed with the patient.

How quickly does the general anesthetic work?

Very fast. Patients fall asleep immediately after administration of the anesthetic drugs. Usually it takes no more than 30 seconds.

Can I drive after waking up from general anesthesia?

Patients should not drive after general anesthesia. We recommend that you are picked up afterwards. We can organize a trip home for you.

Can I eat something beforehand?

You should not eat anything for at least 6 hours before the start of the operation.

Can I have a drink beforehand?

You should not drink any liquid for at least 2 hours beforehand.

Can I smoke before and after general anesthesia?

Smoking has a negative impact on anesthesia and wound healing. You should therefore not smoke before and after the operation.

Can I drink alcohol before and after general anesthesia?

Alcohol also has a negative effect on anesthesia and wound healing. Therefore, you should avoid it before and after.

What happens after waking up?

After waking up, all vital parameters continue to be checked.

The dentist will explain to you how the treatment went and you can see the result in the mirror. Depending on the dental treatment carried out, you may have fixed provisional or permanent ceramic restorations at this point in time. Due to the additional application of a local anesthetic, you will not feel any pain after waking up.

You are allowed to leave the practice, accompanied, about an hour after the end of the operation.

Can I expect nausea after general anesthesia?

Nausea after general anesthesia is very rare.

How long do after-effects of general anesthesia last?

This is different for each patient. Fatigue and a feeling of jet lag may last for a day or two after the general anesthetic.

Is there a risk of suddenly waking up during anesthesia?

Suddenly waking up during general anesthesia is extremely rare.

Are there allergic reactions to general anesthesia?

Allergic reactions to the anesthetics used are very rare. Based on the controlled vital parameters, the anesthetist can quickly determine whether an allergy is present and make appropriate adjustments.

When can I eat and drink again?

You are allowed to eat and drink immediately after the operation is completed. As the surgical area is locally anesthetized, please be careful not to burn yourself and bite your lip.

We recommend consuming rather soft food in the first week after the operation.

Can I speak to the dentist or anesthetist in person?

Both before and after the anesthesia, the dentist and anesthesiologist are available to contact by telephone. This is especially important for people who are afraid of dental work. We place great importance on our patients being well informed and therefore value having close communication and contact with our patients.

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