Local vs. General Anesthesia for Oral Surgery

If you are preparing to receive oral surgery, there are a few factors to consider when it comes to anesthesia and which type an oral surgeon may recommend. There are two main types to choose from: local anesthesia and general anesthesia. An oral surgeon will consider various factors, including comfort level, pain tolerance, and budget.

Local anesthesia

Local anesthesia numbs the surgical site and surrounding areas. At the start of the procedure, the oral surgeon may inject local anesthesia into the gum tissue near the tooth. With local anesthesia, the patient will stay conscious throughout the procedure. They may feel slight pulling sensations or pressure on the area as the oral surgeon works, but these sensations will be minimally painful.

While local anesthesia is most common for minimally invasive procedures, such as simple tooth extractions that do not require incisions, it is also an option for more intensive procedures. This is where the patient’s comfort level comes into play.

Nitrous oxide

Nitrous oxide, also known as laughing gas, is an effective alternative type of local anesthesia for oral surgery that provides more support. Nitrous oxide minimizes pain and relaxes the patient without putting them to sleep. The patient will receive a mixture of oxygen and nitrous oxide to breathe in throughout the appointment.

Since nitrous oxide is not potent, it is almost always in combination with local anesthetics. This approach is best for simple procedures performed on children or patients who feel nervous about having dental work done.

General anesthesia

General anesthesia sedates a patient to the point that they are unconscious and cannot feel pain during oral surgery. The patient is unlikely to even remember the procedure. It will feel like they went to sleep and woke up groggy once the anesthesia wore off. For this reason, this approach is often referred to as being “put to sleep” for surgery.

This type of anesthesia is administered intravenously (through an IV line). It is only recommended for highly invasive procedures, such as impacted wisdom teeth extractions. This is because general anesthesia gives the oral surgeon more time and a steadier surgical site on which to operate, in addition to enhancing patient comfort.

The bottom line

Local anesthesia only affects the surgical site and the gum tissue around it, while general anesthesia effectively puts the patient to sleep for the entire procedure. An oral surgeon will discuss each of these options in greater detail to help patients decide which is right for them. However, as mentioned, the decision will come down to the following factors:

• Pain tolerance: How much pain the patient can tolerate should be considered. Some patients have such a low pain tolerance that they cannot stand the pulling and prodding sensations of oral surgery under local anesthesia. The area may be numb, but anxiety can elevate these sensations to an uncomfortable level.
• Comfort: Some patients would prefer to remain asleep during the procedure. Others are nowhere near comfortable being unconscious, even in a medical setting. Depending on the procedure, an oral surgeon can work to accommodate either of these preferences.
• Budget: General anesthesia can be more costly than local anesthesia since it uses powerful substances and must be administered through an IV line. Patients may save money by opting for local anesthesia and nitrous oxide.