“Do doctors use general anesthesia for all oral surgeries?”

No, it all depends upon the invasiveness of the procedure and patient tolerance and anxiety.

Some minor oral surgeries can be done under sedation alone.

Not all oral surgeries need general anesthesia. Some can be done with local anesthetic “local” depending on what is being done. There is also surgeon and patient preference.

No.

Not all cases, it depends on what is being done. Some are even done at the surgeons office with local anesthesia. However most of the time when oral surgeons bring cases to the OR is because they do required General.

I suspect that depends on the nature of your surgical procedure. You should definitely ask your oral surgeon.

Christopher Creighton

You may be unclear about the definition of “general anesthesia.” When we anesthesiologists refer to general anesthesia, we understand that term to mean a state in which the patient has lost consciousness as well as protective reflexes (for example, eye-blinking, coughing), and seems to be insensible to painful stimuli in that the patient has no observable movements when one applies a painful stimulus (pinch, needle poke, or surgical incision). Patients in this state often – though not always – require airway and breathing support to maintain adequate ventilation and blood levels of oxygen.

For dental work by oral surgeons, for example extraction of “wisdom teeth,” general anesthesia is not necessary unless there are patient considerations (for example cognitive impairment causing inability to remain still voluntarily, extreme anxiety, or difficulty with sedation because of co-administration of opioid medications, like methadone or suboxone, to patients undergoing opioid withdrawal treatment, which often results in tolerance to opioid and sedative medications).

For most office procedures in an oral surgery practice, sedation with injection of local anesthesia to numb the sensory nerves of the teeth, is adequate. The American Society of Anesthesiologists (https://www.asahq.org/standards-and-guidelines/continuum-of-depth-of-sedation-definition-of-general-anesthesia-and-levels-of-sedationanalgesia) defines sedation and general anesthesia as a continuum ranging from mild sedation, or anxiolysis, to moderate sedation, deep sedation, and then general anesthesia. The usual goal in oral surgery procedures is mild to moderate sedation. This goal, in which the patient may be unresponsive to voice, but continues to display intact airway reflexes and adequate spontaneous breathing, can be achieved using either intravenous medications or inhaled nitrous oxide (laughing gas) in a 50% mixture with oxygen. The choice of how to achieve adequate sedation is left to the patient and the oral surgeon.

Jay R Shayevitz, MD, MS

Hi,

It depends on the type of surgery. For example, wisdom teeth extraction is usually done with moderate sedation. Most of the other oral surgeries will require general anesthesia.