The Safety of Anesthesia for Oral Surgery

Oral Surgery Anesthesia

If you have to have your wisdom teeth removed or your child has a large number of cavities that need to be filled, you may be anxious and question the safety of oral anesthesia. Studies show that oral anesthesia administered by dentists and oral surgeons in office settings is safe and it helps ease patients' anxieties about pain during dental procedures.

This is important because more than a third of adults fear going to the dentist. This can prevent them from getting regular checkups and cleanings which can impact their oral and overall health.

The anesthesia method dentists use may depend on factors such as a person's age, overall health, history of allergies, level of anxiety, a patient's preference, and the length and complexity of the dental procedure required.

Local Anesthesia

Local anesthesia, which is used for routine dental procedures like cavities, can take about seven to work depending on the location of the tooth. Lower back teeth generally take longer to numb. Your dentist may apply a topical numbing agent, to ease the sting of an injection, so you don't feel pain.

Local anesthesia is considered very safe. The biggest risk is allergies. A patient may be unusually sensitive to a drug and have an adverse reaction such as itching, swelling, or hives. In a worst-case scenario, she may suffer breathing problems and require emergency care. This is extremely rare and happens in fewer than one percent of all cases.

Sometimes epinephrine is used to help the anesthesia work. Epinephrine can make your heart feel like it is racing and cause anxiety, headache, and tremors, but this is not considered an allergic reaction.

Anesthetist administering gas to patient
Science Photo Library - IAN HOOTON. / Getty Images

Laughing Gas and IV Sedation


For patients who have both dental anxiety and a fear of injections, dentists can anesthetize them by having them breathe in a mixture of oxygen and nitrous oxide, or "laughing gas," The mixture takes effect within two to three minutes.

Patients often feel a tingling or floating sensation but are awake, calm and they feel no pain. Adverse effects are extremely rare. Dentists will advise you not to eat before your procedure to reduce the risk of vomiting.

The mixture wears off three to five minutes after the mask is removed. Dentists advise patients to wait at least five minutes before getting up to avoid the risk of falling.

With other, deep, or IV forms of sedation, patients might be given pills to swallow, inhale the anesthesia through a face mask, given an injection, or have the anesthesia administered intravenously.

If you're having deep or IV sedation, your dental team will monitor your vital signs such as your breathing, heart rate, temperature, and blood pressure throughout the procedure.

Review studies show that while IV sedation is slightly riskier, sedation is safe for outpatient oral surgery.

General Anesthesia

General Anesthesia is used for longer, more complicated procedures, patients who have a lot of anxiety, and special needs patients and children who can't sit still. It's either inhaled or administered through an IV by a dentist, an oral and maxillofacial surgeon, or an anesthesiologist.

Patients are unconscious and like with deep and IV sedation, their heart rate, blood pressure, and breathing are monitored. General anesthesia is riskier than local anesthesia and sedation but still considered very safe.

Side Effects- IV Sedation and General Anesthesia

Although studies show that IV sedation and general anesthesia are safe there are several known side effects. That's why you should always plan on having someone accompany you who can either drive or help get you home after your procedure. These side effects include;

-Headache, nausea, vomiting

-Confusion, delirium, amnesia

-Slurred speech

-Sore or parched throat

-Numbness a

-Fatigue

Risks of General Anesthesia

The risk factors of oral anesthesia include;

-Allergic reaction to a substance, flavoring, or dye

-Nerve problem, usually temporary, "pins and needles" sensation

-seizure

-coma

-breathing difficulties

-heart failure

-stroke

Precautions and Interactions

When adverse effects or deaths occur due to oral anesthesia, it's often because a patient had an underlying medical condition, such as heart or kidney disease or high blood pressure. Certain diseases can also increase the risk of an adverse reaction to anesthesia.

For example, one study found that children with cerebral palsy had an increased risk of suffering from adverse effects such as a drop in temperature, blood pressure, or difficulty breathing while undergoing general oral anesthesia.

This is why going over your medical history with your dentist or oral surgeon, telling them about any allergies you have, especially to flavoring and dyes, and listing all of the medications you're currently taking is important.

In recent years, there has been a trend to use general anesthesia for young children with large numbers of cavities. Dosing for young children is based on weight and needs to be considered carefully to prevent overdose.

The American Academy of Pediatrics and the American Academy of Pediatric Dentistry recommend that two people trained in advanced life support need to be present in case of an emergency involving a child. The recommendations suggest that besides an oral surgeon, an anesthesiologist or a registered nurse be present.

Redheads and Oral Anesthesia

If you're a natural redhead, who colors her hair, you may want to tell your dentist or oral surgeon. Studies have found that due to a mutation in a gene, redheads are more sensitive to pain and are more resistant to pain-blocking medications. One study found that redheads may require as much as 20 percent more anesthesia than blonde and dark-haired people.

A Word From Verywell Health

Many people hate going to the dentist. The sound of the drill and fear of pain can cause people to avoid going to the dentist. Studies show that local, sedation, and general anesthesia methods for oral surgery are safe and help put patients at ease.

However, to avoid an allergic reaction or outcome due to an underlying health condition, it's important to provide your dentist or oral surgeon with a detailed medical history that includes whether you've ever had a reaction to anesthesia, allergies you have, and any medications you're currently taking.

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Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Beaton L, Freeman R, Humphris G. Why are people afraid of the dentist? Observations and explanations. Med Princ Pract. 2014;23(4):295-301.

  2. Mortazavi H, Baharvand M, Safi Y. Death rate of dental anaesthesia. J Clin Diagn Res. 2017;11(6):ZE07-ZE09.

  3. Lee J, Lee J-Y, Kim HJ, Seo K-S. Dental anesthesia for patients with allergic reactions to lidocaine: two case reports. J Dent Anesth Pain Med. 2016;16(3):209-212.

  4. Chi SI. Complications caused by nitrous oxide in dental sedation. J Dent Anesth Pain Med. 2018;18(2):71-78.

  5. nverso G, Dodson TB, Gonzalez ML, Chuang S-K. Complications of moderate sedation versus deep sedation/general anesthesia for adolescent patients undergoing third molar extraction. J Oral Maxillofac Surg. 2016;74(3):474-479

  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5535496/

  7. Wass CT, Warner ME, Worrell GA, et al. Effect of general anesthesia in patients with cerebral palsy at the turn of the new millennium: a population-based study evaluating perioperative outcome and brief overview of anesthetic implications of this coexisting disease. J Child Neurol. 2012;27(7):859-866.

  8. https://www.healthychildren.org/English/healthy-living/oral-health/Pages/Anesthesia-or-Sedation-for-Your-Childs-Dental-Work.aspx

  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1362956/

Additional Reading
  • Beaton L, Freeman R, Humphris G. Why are people afraid of the dentist? Observations and explanations. Med Princ Pract. 2014;23(4):295-301.


  • Chi SI. Complications caused by nitrous oxide in dental sedation. J Dent Anesth Pain Med. 2018;18(2):71-78.


  • Facco E, Zanette G. The odyssey of dental anxiety: from prehistory to the present. A narrative review. Front Psychol. 2017;8:1155.


  • https://pubmed.ncbi.nlm.nih.gov/21724314/

  • https://www.healthychildren.org/English/healthy-living/oral-health/Pages/Anesthesia-or-Sedation-for-Your-Childs-Dental-Work.aspx

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1362956/

  • https://www.researchgate.net/publication/334433551_Complications_Associated_with_Local_Anesthesia_in_Oral_and_Maxillofacial_Surgery

  • Inverso G, Dodson TB, Gonzalez ML, Chuang S-K. Complications of moderate sedation versus deep sedation/general anesthesia for adolescent patients undergoing third molar extraction. J Oral Maxillofac Surg. 2016;74(3):474-479.


  • Lee J, Lee J-Y, Kim HJ, Seo K-S. Dental anesthesia for patients with allergic reactions to lidocaine: two case reports. J Dent Anesth Pain Med. 2016;16(3):209-212.


  • Mortazavi H, Baharvand M, Safi Y. Death rate of dental anaesthesia. J Clin Diagn Res. 2017;11(6):ZE07-ZE09.


  • Wass CT, Warner ME, Worrell GA, et al. Effect of general anesthesia in patients with cerebral palsy at the turn of the new millennium: a population-based study evaluating perioperative outcome and brief overview of anesthetic implications of this coexisting disease. J Child Neurol. 2012;27(7):859-866.


  • Wiemer SJ, Nathan JM, Heggestad BT, et al. Safety of outpatient procedural sedation administered by oral and maxillofacial surgeons: the mayo clinic experience in 17,634 sedations(2004 to 2019). J Oral Maxillofac Surg. 2021;79(5):990-999.