Dear Dr. Hall,
My daughter is 23. She has two impacted wisdom teeth that need extraction one of which is under the bone. The question is what type of anaesthesia is required to remove them considering some bone needs to be removed. Will it have to be general anesthesia or will sedation be enough? I am very concerned about the general anesthesia. Thank you.
Thanuja from Pennsylvania
(See Dr. Hall’s answer below.)
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I don’t know the complete circumstances about your daughter’s case, but it is hard for me to imagine that there could be serious complications enough to warrant general anesthesia. I extracted many hundreds of impacted wisdom teeth, and never used anything more than conscious sedation, and can’t remember a patient who was uncomfortable.
Especially for a 23-year-old. At that age, the bone is relatively pliable, and there hasn’t been time for cementum accumulation on the roots of the teeth, so the extractions should be relatively uneventful. It’s a rare case of a 23-year-old that has truly difficult wisdom teeth. Yes, there are added risks with general anesthesia, and I think it’s a good rule to not use any more anesthesia/sedation than is necessary. If you have a dentist who is telling you that she needs general anesthesia, I would seek a second opinion.
– Dr. Hall
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.
CONAN TENG DDS says
I think doctors tell patients general anesthesia is sedation just like doctors tell patients deep cleaning equates to scaling root planning. Patient would not understand what sedation or scaling root planning means, but they will understand what general anesthesia and deep cleaning means.
There are 4 levels of sedation, minimal, moderate, deep sedation and General Anesthesia. What differentiate each are responsiveness, airway impairment and also sedation medication/agents given. An example of minimal sedation is the effect of nitrous oxide (laughing gas). Moderate and Deep sedation is what Dr Hall refers to “conscious sedation” where patients can still respond to stimulus and maintaining their own airway. General Sedation means no response to stimulus and airway have to be protected which is the usual method of sedation and a breathing tube (intubation) placed for children under going dental procedures.
I am sure your 23 year old daughter will receive Moderate to Deep Sedation where an IV is placed in her arm and medication given through the IV to allow her to forget about the procedure, which is the common level of sedation for adults with dental anxiety undergoing dental treatment. Usually four wisdom teeth extractions should not take more than 15-20 mins not counting waiting for local anesthetic to take effect, even when all 4 are impacted (under the bone). It is a relatively fast procedure. Receiving sedation or not all depends on patients anxiety/comfort level and financial situation. If your daughter has very high anxiety and do not want to have any recollection of the surgery then perhaps sedation would be the most comfortable way to remove her wisdom teeth. If your daughter does not have dental phobia and relatively comfortable undergoing dental procedures, then perhaps your daughter’s wisdom teeth can be removed with just local anesthetic (numbing of teeth only). Conscious sedation using IV medications/agents is the most common level or mode of sedating a patient for wisdom teeth extractions.