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I Need Oral Surgery...I Want To Go To SLEEP!

By D. Omar Watson DDS, MD

To the laymen, sedation for removal of wisdom teeth or other oral surgical procedures may seem routine. Even though some label "going to sleep" as a routine procedure, it is a facade that sedation is humdrum. In fact, the stellar track record of Oral Maxillofacial Surgeons (OMFS) providing sedation is a reflection of our extensive training. Our training enables us to provide different anesthetic techniques and agents to facilitate safe treatment and patient comfort. Moreover, education in complex anesthesia, pharmacology, and advanced cardiac life support (ACLS) underscores the ability to deliver sound care.
There are a variety of effects certain medications may induce, such as: amnesia, pain relief, suppression of stress response, sedation, immobilization, and hemodynamic stability. A comprehensive inquiry for medical conditions, medications, substance use, obstetrical, and pertinent social histories are required. This information dictates if sedation would likely be safe. IV sedation may not be the most prudent method to facilitate treatment for some cardiac, medically compromised, or considerably morbid patients. However, for the vast majority of patients, sedation happens to be a proven method to facilitate safe care.

A pre-anesthetic plan is developed from medical history and physical exam. Many times an OMFS may consult the patient's primary physician or medical specialist for more information to determine if adjustment is necessary in administration of anesthesia. Pre-operative preparation is important for the patient, also. It is important not eat or drink anything at least 6 hrs prior to surgery. This will lower the risk of aspiration, nausea, or respiratory predicaments. Though, most routine medications can and should be taken as scheduled with a sip of water without any problematic consequence. The sedation patient must also bring a responsible escort who is adult age to serve as their driver/caregiver after surgery. Smoking, alcohol, or recreational drugs within 24 hours of surgery can cause dismal complications. During sedation, all patients are monitored with electrocardiogram, blood pressure, pulse oximeter, and other methods according to the standard of care. Emergency medications and armamentarium are available at all times in accordance to ACLS guidelines, but seldom used.

When all is said and done, 'going to sleep' for oral surgical procedures is safe and effective and has long been a hallmark of our practice. As an OMFS with a medical degree, this uniqueness further expands my ability to continue this tradition of care.