The Main Differences Between Sedation and Anesthesia
Going in for oral surgery can be frightening or overwhelming, especially if you’re young or you’ve never had a surgical procedure done before. Often, it is just more comfortable to be sedated or asleep when you are having an oral surgery procedure such as wisdom teeth extractions. In addition, many complex surgeries performed by oral and maxillofacial surgeons require the patient to have deep sedation or general anesthesia.
But what is the difference between sedation and anesthesia? Many people do not understand the difference and many also do not understand that there are many different levels of sedation. When you hear people talking about going to “sleep” for your dental extraction, it does not necessarily mean the same thing for everyone as well as not every dental provider can provide the same level of “sleep” for the procedure.
How are sedation and general anesthesia different?
First, anesthesia may refer to either local anesthesia or general anesthesia. Local anesthesia is basically the numbing medication we inject directly into the area that is about to have the surgery done. This freezes the area so that you do not feel pain. Every oral surgery procedure will require local anesthesia.
General anesthesia refers to “being put to sleep” for your surgery. You will be completely unconscious during the procedure.
When we are talking about sedation and general anesthesia, it is helpful to think it about levels of consciousness on a spectrum. At one end of the spectrum, you have a scenario where the patient is completely awake with no sedation and fully lucid. Whereas, at the other end, the patient is under general anesthesia and is fully unconscious and will not respond to any stimulation. Sedation falls somewhere in between.
Sedation is commonly referred to as monitored anesthesia care. It is recommended by your dentist when they think your procedure requires an additional agent to make you more comfortable, in addition to local anesthesia. It will help you to be more comfortable and relaxed for your oral surgery.
Sedation is most commonly done at an oral and maxillofacial surgeon’s office. We perform them every day. There are different types of sedation. Unlike most general dentists, specialists in oral surgery can provide all types of sedation. Deeper forms of sedation are beneficial if you are anxious, or uncomfortable in keeping your mouth open for an extended period, or have a sensitive gag reflex, or you require an invasive surgical procedure such as wisdom teeth extractions.
The level of sedation you require will depend on many factors, including the type of procedure, how your body responds to anesthesia, your age and medical conditions and your health habits.
There are three basic levels of sedation – minimal, moderate and deep. Minimal sedation helps you relax but you will likely be awake. You will be able to respond easily to verbal and physical stimulation. Minimal sedation is often achieved using oral medication or laughing gas. Most general dentists can provide minimal sedation. It may not be adequate if you require invasive dental procedures such as wisdom teeth extractions.
Moderate sedation is when you feel even more drowsy and you may even fall asleep during the procedure. You may or may not remember much of the procedure. It might be more difficult to arouse you. This is typically achieved using intravenous medications (either one or two drugs). Your dentist requires special training to perform this type of sedation.
Deep sedation is like twilight sedation where you feel very dreamy and will fall asleep. You are not totally unconscious, but it would be harder to arouse you. You do not respond to verbal and physical stimulation as readily as moderate sedation. You will sleep through the procedure and you will have little memory of the procedure. This is usually recommended for more complex oral surgery procedures such as wisdom teeth extractions or other difficult extractions, or if you have a significant dental phobia or are very anxious.
Deep sedation requires even more specialized training in residency and the facility needs to undergo rigorous accreditation to be allowed to perform deep sedation. Most deep sedation are only done by oral and maxillofacial surgeons in the dental community.
There are scenarios where your oral surgeon may recommend the administration of general anesthesia. This will be performed by an anesthesiologist. The agents involved may be through gas inhalation or intravenous medications or a combination of both. When under general anesthesia, patients are unaware of stimulation and their surroundings and are unable to respond. Patients have a complete loss of consciousness. As with sedation, patients are monitored closely throughout the surgery to ensure proper and safe administration of the anesthetic.
Facilities must be specially inspected to meet the strict guidelines for general anesthesia accreditation. Our facility is one of the few dental facilities in the lower mainland that is accredited for all forms of sedation as well as general anesthesia.
Sedation and anesthesia of various types are very beneficial in all kinds of oral surgery settings. Their goal is so that patients can receive invasive treatment comfortably and so that the oral surgeon can perform the necessary treatment without obstruction and difficulty.
In British Columbia, the College of Dental Surgeons of BC have created guidelines and standards that allow the safe practice of sedation and anesthesia. These regulations are to ensure patient safety. Not all dentists can provide the same level of sedation. Every dentist must apply for the level of sedation they intend to administer. If you are receiving sedation for your dental procedure, you should always ask your dentist what level of sedation will be given.
If you have any questions or require more information, please contact Pacific Coast Oral and Maxillofacial Solutions!