June 2, 2021

Dental Surgery And Anaesthesia: What Are Your Options?

Are you scheduled for a dental procedure like the All-on-4® with dental implants and are concerned about experiencing pain or discomfort during your treatment? Dental anxiety and increased stress levels leading up to a dentist visit are very common. Luckily, modern dentistry offers different types of dental anaesthesia to make you comfortable during and after your All-on-4® or dental implant treatment. 

To help you feel more confident about your dental surgery and take your worries away, we’ve created a short guide on dental anaesthesia and types of sedation. We’ll discuss what anaesthesia is and when they are used, but also what benefits and side effects you may experience. 

What Are The Types of Anaesthesia Used in Dental Surgeries?

Anaesthesia refers to a state of unconsciousness, induced for the purpose of medical procedures. Stemming from Greek "without sensation", anaesthesia is used to keep you from feeling pain or discomfort during dental surgery. It may be used in minor procedures, like filling a tooth or during more significant dental surgeries, such as receiving All-on-4® and dental implants. 

There are three main types of anaesthesia: 

  • Local anaesthesia
  • Sedation - intravenous or inhalation
  • General anaesthesia

Anaesthetics work in different ways, they may eliminate discomfort in a specific area or cause a total lack of sensation, putting you in a controlled, almost sleep-like state. Each type of anaesthesia has its specific uses and applications. 

Your dentist determines which one is best suited in your individual case, based on:

  • The planned procedure
  • The area being anaesthetised
  • Your personal preferences 
  • Your medical history

Local Anaesthesia

Generally applied by the operating dentist, local anaesthesia is used for smaller procedures, numbing only the area of the body that is undergoing surgery. This means you remain conscious throughout the procedure and able to communicate with your dentist.

The American Academy of Pediatric Dentistry (AAPD) defines local anaesthesia as "the temporary loss of sensation including pain in one part of the body produced by a topically-applied or injected agent without depressing the level of consciousness." Topical anaesthetics come in the form of gel, creams or sprays and are applied on the injection site before the local anaesthetic is injected so that less discomfort is experienced.  

Local anaesthetics are the preferred choice for most dental procedures: They require less preparation, are cost-effective and allow for a faster recovery time with rare and minor side effects. 

Where appropriate, they should be given preference to intravenous sedation and general anaesthesia, both of which are associated with greater risks and side effects.

Sedation - intravenous and inhalation 

Intravenous sedation is a form of anaesthesia that suppresses the central nervous system. This relieves the anxiety and discomfort experienced during dental work. It is used for minor surgeries or less complex procedures. A popular form of inhalation used in dentistry is nitrous oxide, better known as laughing gas, often used for children and mildly anxious patients requiring minor dental procedures e.g. fillings.

As the name suggests, intravenous sedation/anaesthesia is given to you through an IV drip. A few minutes later, you will begin to feel relaxed and drowsy. A stronger dose might even make you fall asleep. In some cases, intravenous sedation is given in addition to local anaesthetics. Either way, when given any type of sedation, your breathing, heart rate and blood pressure must be carefully monitored.

Intravenous sedation has been found to cause procedure amnesia, by inhibiting the creation of long-term memories. Whilst you might be able to talk and respond to instructions during the procedure, you will most likely not remember it afterwards. 

Intravenous sedation does however come with more risks and side effects than local anaesthetics. These may include nausea, drowsiness, and headaches. 

general anaesthesia


General Anaesthesia

General anaesthesia is used for major dental surgeries and isn’t without risks. It should therefore not be the immediate choice for pain and anxiety relief. Unlike local anaesthesia or sedation, general anaesthesia leaves you completely unconscious. It is applied through an IV or inhaled via a mask and requires the presence of a registered anaesthetist who will monitor your vital signs throughout the procedure. 

Being unconscious, you won’t feel any pain during your dental surgery. However, it may take a day or two for the effects of the medication to wear off. That means you will need to arrange for someone to pick you up from your appointment, as you won’t be able to drive after having general anaesthesia. 

The risks and side effects of general anaesthetics are more severe than those of local anaesthetics or intravenous sedation, especially for older adults and people with health complications, such as heart conditions and seizure disorders.

The risks associated with general anaesthesia include:

  • Mild or severe allergic reactions, which may include rashes, swelling of the face and throat and difficulty breathing
  • Malignant hyperthermia, an increase in body temperature that leads to breathing problems and an increased heart rate
  • Nerve damage, known as paresthesia
  • Seizures
  • Coma
  • Heart failure
  • Strokes

Whilst the associated risks are significant, general anaesthesia is a very common treatment. Under the care of an experienced and highly educated dental team, and given that you follow all pre and post-treatment instructions, the likelihood of complications is greatly reduced. 

In fact, general anaesthesia is often the only solution to treating young children, individuals with learning difficulties, or those who are highly anxious. Without the proper anaesthesia, treatments can’t be completed without pain, which may induce or worsen dental phobias.

General anaesthesia should only be applied in cases of invasive oral surgeries, such as:

  • General tooth extractions
  • Cleft lip/palate Surgery
  • Oral cancer surgery
  • All-on-4® and dental implants
  • Bone grafts
  • Corrective jaw surgery
  • Sleep apnoea surgery
  • Cosmetic dental procedures

At Next Smile™ All-on-4® Centre, the dental implant and All-on-4® Pioneers in Australia, we can offer the option of local anaesthesia and/or general anaesthesia. Each case is assessed for the appropriate type of anaesthesia however if you are typically anxious when it comes to procedures, a general anaesthetic may be the best for a more invasive dental procedure like dental implants and the  All-on-4® treatment. In Australia, your dentist is obligated to provide you with comprehensive information on the side effects and complications involved in receiving any type of anaesthetic. 

all on 4 procedure


What Anaesthesia is used during the All-on-4® procedure? 

All-on-4® with dental implants is a method of full arch rehabilitation, a technique often used to restore smiles in people who have lost their natural teeth due to trauma, gum disease or the effects of aging. 

Which anaesthetic is used in All-on-4® procedures will vary from patient to patient. Whilst it is possible to perform the All-on-4® surgery with a local anaesthetic, this is something you will have to discuss with your trusted oral professionals, local Next Smile™ dentist, and anaesthetist.

Can You Choose Which Anaesthetic is Used During Dental Surgery?

Whilst your dentist will be the one to make the final decision, we encourage you to state what type of anaesthetic you would prefer. There may be limitations to this choice depending on the nature of the procedure and your patient history. However, your dental surgeon will want you to feel as comfortable as possible during the procedure and respect your wishes.

At Next Smile™, we have great partnerships with many anaesthetists across Australia who can work with us in any surgical environment, whether in a hospital or one of our purpose-built surgical theatres. All our partners work to the highest clinical level and adhere to our Next Smile™ practice and clinical protocols, so you are in the best hands!

For your questions and concerns about dental anaesthesia and All-on-4® dental procedures here at Next Smile™, schedule an appointment at your local clinic today. Our qualified team will help you choose what anesthesia is right for your procedure.