Anesthesia is used for so many other surgeries, why not at the dentist? Friend of mine just had oral surgery for a broken tooth and obviously got novocaine, but he asked if he could be unconscious and they said they didn’t provide that service at their clinic. While drilling or grinding they hit a nerve, which was incredibly painful. Seems like if he flinched at the wrong moment it could make something go horribly wrong.
I understand there is liability in using anesthesia and they don’t use it on every single other type of surgery, but wouldn’t there also be liability if the patient flinches and you drill into the wrong part of their mouth? Even just nitrous seems like it would make the surgery so much easier, safer, and less traumatic for the patient.
Edit: thanks for the responses, I guess I was conflating anesthesia with sedation. My question should have been “why is sedation not required for oral surgery?” Regardless, I learned a lot!
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It all comes down to risk vs benefit; Anesthesia falls under the umbrella of sedation which is light (anxiety medicine, nitrous), moderate (anxiety meds + opiates, maybe Ketamine or Propofol), deep (high doses of the above), and anesthesia (general anesthetics). Outside of deep sedation and anesthesia, sedation is more art than science. There is no magic dose of medications to achieve those, we only have guidelines to go by that assume ideal physiology. There is a risk of you stopping breathing during any level of sedation, in addition to risks of heart attack or stroke of your blood pressure bottoms out. It takes years of training in medication management PLUS airway management to become confident with sedation, and the standard of care mandates that the person performing sedation has to be a different person than the one performing the procedure, because if something goes wrong we have to act quickly.
So overall for procedures like dental extractions or cavity filling, 95% of the time a properly placed local anesthetic completely knocks out any sense of pain through the procedure. So why put you at risk of dying *and* make you pay for two professionals to be in the room when one person injecting Bupivocaine will do the trick?
Dentistry also isn’t the only type of surgery where we don’t use general anesthesia (in most cases). I’m not a surgeon myself but I do minor surgical procedures such as toenail removal, abscess I&D, laceration repairs, chest tubes, etc.
Other surgeries and procedures off the top of my head that we might not sedate you for unless your anxiety gets so bad that you can’t cooperate include bone and joint reduction, cesarean sections, some amputations, some vascular surgeries and imaging procedures. Some surgeons will even put hardware into you without knocking you out because regional blocks exist, which is where a properly placed injection knocks out a whole limb.
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