DD needs to have her wisdom teeth removed at some point and I have an anesthesia question. I recall many years ago, DD’s pediatrician told me should DD need any teeth removed, never to allow the oral surgeon to administer anesthesia to her, no matter how well-trained in anesthesia the oral surgeon is. The pediatrician made the point that only an anesthesiologist should administer anesthesia, etc. Is it typical for oral surgeons to administer anesthesia themselves? I am sure I would feel more comfortable if an anesthesiologist administered it, but I have no idea if this is common in the dental setting? From what I understand, an oral surgeon can be specially trained to administer it. Is my understanding correct?
I do not think DD will be able to handle it if she were awake and just numbed during the procedure. I was just wondering what experiences you guys had and whether or not your kids received anesthesia for wisdom teeth removal?
Our oral surgeon used a combination of nitrous oxide and versed. He and the staff had speciality training in administering anesthesia and special certifications to do so.
Not sure if there are differences state to state.
Not a chance that my D could have stayed awake during the extraction of 4 teeth.
I wonder if your pediatrician meant to not have the regular dentist do the extraction? Our pediatrician gave us the same advice because many of our local dentists would extract non impacted wisdom teeth and they don’t have the special training.
That said, our D didn’t do well with the versed and it took hours before we could go home because she was violently ill.
My son was just numbed and was just fine with that. Worked well and simplified the recovery. It was a good option for him. As a side note: we were paying for it out of pocket and a nice benefit of his option was that it was cheaper.
If EMTs can give nitrous oxide, then I would think a surgeon would be fully qualified to as well. Only an anesthesiologist should perform general anesthesia, but that is rarely done for wisdom teeth unless the patient insists.
DD is 18. Not sure how she would do if she could hear what is going on with the extraction.
The pediatrician was of the belief that anesthesia needs to be administered only by a regular anesthesiologist–he felt very strongly about this to the point that he said he’d never let his child receive it in an oral surgeon’s office. I am guessing he felt that the oral surgeon’s staff would not have the expertise in monitoring the patient and if something were to go wrong, he/she may not have the same ability to handle emergencies that may arise. He told me this probably five or ten years ago and it has always stuck with me.
There are various types of anesthesia. I wouldn’t have general anesthesia, which is in essence, a medically induced coma, outside a hospital with a board certified anesthesiologist. I would trust an oral surgeon with local anesthesia or procedural sedation.
Years ago when my D was quite young, I read an article about the problem with children being given anesthesia in dentist’s offices, with inadequate monitoring of vitals; some children died when no one noticed they had stopped breathing.
Your daughter is 18 now so it’s not a case of pediatric anesthesia-- more like adult anesthesia, I would think. You should discuss with the oral surgeon what meds they plan to use and what sort of monitoring there would be.
Some doctors will do dental surgery in a hospital, but you usually have to pay more (a lot more). When my daughter was little she needed a lot of work done (adopted when all 20 teeth were in, and all crumbling with decay) and it was going to cost $400 just for the dentist to go to the hospital, then the cost of the operation at the hospital (on medical deductible/co-pays) then the cost of the dental work (insured or not). We ended up just doing the work one or two teeth at a time and it was fine.
My kids have both had theirs out in the surgeons offices. One was the Ritz and all very organized with a lot of highly trained help. The other was a more a Holiday Inn level, and it was fine too. Both got a fist full of prescriptions, including percoset. Be careful with those.
I think most of the time they use an anesthesiologist is when give general anesthesia. My sons oral surgeon refused to remove his wisdom teeth until he had his tonsils removed or we would have to pay for an anesthesiologist. With the propofol they use an anesthisist (nurse specializing in anesthesia)…there may be an anesthesiologist on the floor somewhere but he wasn’t administering the propofol.
I just had an extensive gum graft two months ago. I had versed at the periodontist’s office and I don’t remember a thing. He was chatting about sports with me before the procedure and the next thing I remember is waking up an hour later after the procedure was done. No memory at all about what had happened and no feeling sick - I woke up hungry and went home shortly afterwards. No issues at all.
There are two issues here:
1 - who is administering the anesthesia, and monitoring the patient
2 - where is the surgery being performed
If general anesthesia is to be used, I would do that in a hospital setting (and I don’t know of any local offices that would do that outside of such a setting - they do it in an outpatient surgi-center within the local hospital, so if there are any complications, they have full hospital support.
If Nitrous Oxide is being used, that is often done in an outpatient setting. I know our dentist doesn’t do nitrous oxide - if you need it for fillings due to anxiety, he refers out. When my daughters had their wisdom teeth out (and one had an extraction and “exposure” of another tooth as part of her orthodontic work, that was done in the Oral Surgeon’s office, where he had an anesthesiologist on staff. So, certified expert to administer and monitor, but not in a hospital setting. He could handle minor complications, but if there was a major complication, they would have to transport via ambulance.
If DD has anxiety, and doesn’t handle fillings well, you might want to go with the general anesthesia, particularly if it’s all 4 teeth, and if they are impacted or haven’t ruptured and they will have to “dig” for them. But keep in mind it could be significantly more expensive.
My kids went to an oral surgeon who had s nurse anesthetist. This is a similar situation to the nurse anesthetist in a hospital that often work with patients coming in for colonoscopies. Our dentist does not do oral surgery and refers…endodontist for root canals and the oral surgeon for wisdom teeth removal.
My daughter had all 4 out last year and she has bad TMJ (at 24 years old which is considered old for wisdom tooth removal). The oral surgeon had a trained anesthetist (a nurse) and my daughter was given IV sedation. The oral surgeon was a wisdom tooth removal machine and was done with the entire procedure in under 20 minutes. She was fine post-sedation and healed very quickly. We went with somebody who does dozens of wisdom teeth removals every week and counted on his experience, and it worked out well. I have only heard of one person getting their wisdom teeth out in a hospital and it was because of some other complication/medical condition.
I do think I am confusing anesthesia with conscious sedation. Though I can see by the various experiences that people have had that I need to ask the oral surgeon a few questions about how the sedation part is handled. Thank you for your replies everyone–they have all been very helpful!
@CTmom2018 – the article you linked reflects DD’s pediatrician’s concerns very accurately–though of course the article’s author articulated the issues much more eloquently than I did!
It’s good to know that some oral surgeons use a trained nurse anesthetist. I did not know that. I also had no idea that some oral surgeons do the extractions in a hospital setting.