5 Types of Dental Anesthesia & Risks 

5 Types of Dental Anesthesia & Risks 

 Whitney DiFoggio MA, RDH
Written by Whitney DiFoggio MA, RDH🔬 Evidence Based
5 Types of Dental Anesthesia & Risks 

If you’re about to plan a pretty big dental procedure or you’re generally nervous about seeing a dentist, dental anesthesia options can really help. Understanding how each one works and any dental anesthesia side effects to be aware of will help you select the best type of sedative for your specific circumstances. Not only that but understanding how long dental anesthesia last compared to your planned treatment will impact the medication you and your dentist settle on when planning your procedure.

When & Why We Use It

The reason we use dental anesthesia and sedation medications is to help patients relax and feel more comfortable during their appointment. Maybe it’s because they have a long or complex dental procedure planned, and they need to be able to sit there for an hour or more at a time. Or perhaps it’s somebody who has had not-so-great interactions with dentists in the past, causing them to develop anxiety or total dental phobia (which then gets in the way of them accessing the dental care they need.)

The drowsy, relaxing dental anesthesia side effects complement local numbing medication to ensure a calm experience from start to finish. It can also help to manage hyperactive gag reflexes for people who tend to be uncomfortable having someone’s hands in their mouth.

Types Of Dental Anesthesia 

There is more than just one type of dental anesthesia or sedation, and they all work differently. Some dental anesthesia side effects wear off in a matter of minutes, while others last all day. Understanding the various types of dental anesthesia before you plan your treatment will ensure the best experience.

Depending on the type of dental procedure that you have planned and which dentist you’re seeing (not all dentists offer the same types of sedation or anesthesia options), you’ll generally be able to choose between one or more of the following:

1.  Local Anesthesia

Local anesthetics are the “numbing” medication injections that your dentist uses to desensitize the teeth or gums being treated during specific dental procedures. The medication deadens the nerve endings, preventing you from feeling any pain or discomfort for at least a couple of hours. Most likely, the only thing you’ll notice is a bit of pressure. A local anesthetic is injected at the nerve serving the tooth being treated; there is a different injection site for different teeth.

The most common side effects of local anesthesia are soreness, swelling, or rarely, temporary facial paralysis in the area the medication was injected. Some people also experience rapid heart rates, depending on their medical condition.

2. Nitrous Oxide (AKA Laughing Gas)

If you want a moderate analgesic to help you relax without “knocking you out,” then nitrous oxide is your best bet. Often called “laughing gas” because of the lighthearted tendencies it encourages, this lighter sedative is fast-acting and quickly reversible.

Nitrous oxide is breathed in through your nose, with a soft nosepiece and tube delivering the gas during your dental procedure.

During your appointment, you’ll remain fully alert but probably feel as if you’ve had a couple of glasses of wine to drink. That way, you can still answer any questions or follow instructions but won’t care as much about what’s going on around you. 

Laughing gas is perfect for patients of all ages.

3. Oral Sedation

Oral sedation is frequently used for squirmy kids or adults who just want to “take the edge off” and not remember anything about their appointment. It’s a mid-level sedation option that’s stronger than laughing gas but doesn’t involve IV sedation.

Oral sedation works by taking a medication by mouth—either a pill or liquid if you’re a child—about an hour before your planned procedure. It gradually makes you feel sleepy or daydreamy, and it also doubles as an amnesic medication (so you’re less likely to remember anything about your visit.) The sedative lasts for a few hours before it starts to wear off.

Dentists might use oral sedation for longer treatments like root canals, crowns, dental implant placement, or on children who have a hard time sitting still.

4. IV Sedation (Twilight Sedation)

A step up from oral sedation is IV sedation. Or, as a lot of people call it, “Twilight Sedation.” This type of dental anesthesia uses medication delivered through an intravenous (IV) line in your arm, allowing it to work quickly and predictably for the desired length of time. How long does IV dental anesthesia last? As long as you need it to, whereas oral sedation only lasts one specific length of time.

IV sedation is extremely common for oral surgeries like a wisdom tooth removal or placing multiple dental implants. A dentist might also use IV sedation on a child with extensive treatment needs or who has special needs that prevent them from receiving routine dental care.

5. General Anesthesia

Alright, so in most cases, you’re probably not going to have general anesthesia in a dentist’s office. With the exception of oral surgery practices, offices that have a visiting anesthesiologist (for large cases like full mouth rehab or multiple implants installed) OR if you’re taking a child to the hospital to meet their pediatric dentist for a complex treatment case.

General anesthesia uses a combination of medications that make you feel completely asleep for the duration of your appointment. This is the one where you’re “put under” and won’t feel any type of anything because your body and mind are both completely unaware to what’s going on.

Side Effects Of Dental Anesthesia?

Are there side effects of dental anesthesia that you need to be aware of? Yes. Which is another reason why you should be really open with your dental provider as they’re planning your procedure.

 The most common side-effects of local anesthetic (injected anesthesia) are:

  • Hematomas at the injection site
  • Elevated heart rate because of the epinephrine
  • Damage to the nerve in that area of your mouth (rare)
  • Prolonged facial paralysis (rare)

Other types of sedatives will have side effects that vary from one to the other but typically include:

  • Nausea and/or vomiting
  • Confusion
  • Headaches
  • Drowsiness, dizziness
  • Muscle aches
  • Sore throat

Precautions With Dental Anesthesia

Although dental anesthesia/sedation can be used in most situations, there are some risk factors that may contraindicate which type of medication is used. Hence, it is extremely important to disclose your medical condition to your dental health provider. Here are just a few examples:

Pregnancy. The American Dental Association says that local anesthetics with epinephrine (e.g., bupivacaine, lidocaine, mepivacaine) may be used during pregnancy. There are some types of anesthetic medications that are safe to use during pregnancy, while there are others that should be avoided. If you think you are possibly pregnant, let your dentist know.

Special needs. Some individuals do better with specific sedatives or anesthetic drugs and not others, especially if there are underlying medications or heart issues at play.

Heart problems. The vasoconstrictors used in local anesthesia may set off your heart rate and make it difficult to control. Similarly, other sedatives will need to be cleared with your doctor.

Sensitivity in the past with anesthesia. Some individuals do not do well with specific types of sedatives or anesthetic drugs. If you have a history of the medication not wearing off or needing more than normal, let your dentist know. 

Elderly patients. Older patients who have had recent hospitalizations, surgeries, are taking medications, or are at risk for complications during an oral surgery will need their dentist to collaborate with their primary care physician.

Medications you’re taking. Always disclose any and all drugs you’re taking, whether they’re prescription or not.

Risks Of Dental Anesthesia?

According to most dental experts, the biggest “risks” or side effects of having sedation or anesthesia during your appointment include:

  • Pain at the injection site
  • Hematoma (bruising) in the face
  • Nerve damage or prolonged facial paralysis
  • Difficulty passing urine
  • Prolonged headache
  • Nausea
  • Sore through
  • Allergic reaction, causing itchy skin or anaphylaxis
  • Confusion or hallucinations
  • Irregular heart rate
  • Chills

It is extremely rare to ever see or hear about someone dying because of sedation or anesthesia medications. When you work with an experienced, licensed provider and are upfront about all of your medical conditions, the risk of life-threatening situations is almost unheard of.

Is It Possible To Wake Up During Oral Surgery?

Not all sedatives “put you under.” Some of them keep you in a semi-conscious state, even if you don’t realize it or remember anything about it. Whereas general anesthesia is so carefully monitored by a licensed anesthesiologist that there is little to no risk of you “waking up” in the middle of the treatment. Plus, your providers are also watching things like your pulse and respiratory rates, so they’ll be able to tell if your medication needs to be adjusted during the procedure.

Can I Drive After Dental Anesthesia?

Type of Dental Anesthesia Can You Drive After?
Local anesthesiaYes
Nitrous OxideYes
Oral SedationNo
IV SedationNo
General AnesthesiaNo

Unless you’re only getting local anesthetic and/or nitrous oxide, then no, you cannot drive yourself home afterward. It would be the equivalent of driving under the influence. You need to have someone with you to drive you home after your dental treatment. On the plus side, laughing gas wears off so quickly that YES, you can drive right after your appointment.

How Long Does It Take To Wear Off?

Type of Dental Anesthesia How long does it last?
Local anesthesia4 to 5 hours 
Nitrous Oxide2 to 5 minutes 
Oral Sedation3 to 4 hours 
IV Sedationactively controlled 
General Anesthesiaactively controlled 

Light sedatives like nitrous oxide wear off within just a few minutes of your dentist turning them off. There are no lengthy side effects. 

On the other hand, local anesthesia lasts for 4-5 hours at a time; it’s different for everyone. There are some things you can do to help get the numbing medication to wear off more quickly if you need it to.

Oral sedation typically lasts for a set period of time, like 3-4 hours. That window gives your dentist enough time to get you comfortable, treat your teeth, and send you back home before everything wears off.

IV and general anesthesia are controlled by steady delivery of medication, allowing the anesthesiologist or dentist to set exactly how long they work and when they stop working. But once the medication is turned off, you’ll still feel groggy for several hours after.

Recovery Tips With Dental Anesthesia 

If you’re only having local anesthetic injected or getting laughing gas, all you need is a little time. Nitrous oxide wears off quickly, but local anesthetic can take several hours. In the meantime, try not to eat anything so that you don’t accidentally bite down on your lip, tongue, or cheek. A common side-effect, especially in younger patients, is sores from sucking or chewing on their lip while it’s numb.

Other anesthetics/sedatives will need several hours to wear off. You’ll need to have someone drive you home from your appointment and sit with you until you start to “come around” and feel yourself, especially if you’re nauseous.

Plan to take the rest of the day off and stay at home. Go ahead and have some soft, bland foods and water ready so that you can rest in a chair and keep your head elevated and eat whenever you’re ready.

If, for any reason, you experience anesthesia side effects lasting more than one day, contact your dentist’s office.

Talk With Your Dentist 

Your dentist is your best resource when it comes to choosing the right dental anesthesia/sedation for your situation. But one extremely important thing to keep in mind is to always be truthful about your medical and health history. Are you taking any recreational or prescription drugs? Have you recently been treated by a doctor or hospitalized? If you fail to disclose important health information, the dental anesthesia side effects could be detrimental.

If you want to be “completely knocked out” during your treatment, you’ll probably want a dental office that offers twilight sedation/IV anesthesia or an oral surgery clinic with general anesthesia personnel on staff.

Dental Anesthesia and Sedation 

The different types of dental anesthesia, side effects, efficacy, and who can offer them will vary from office to office. Not all dentists offer or are trained to provide the same types of dental sedation. Lighter options like local anesthetic and nitrous oxide are in most offices, whereas IV sedation or general anesthesia are typically used in oral surgery clinics and outpatient facilities. Your dentist can help you identify the best sedative/anesthesia for your situation. No two are alike! Always be sure to review your medical history and talk to your dental provider about the risks involved in the type of sedative you choose.

 Whitney DiFoggio MA, RDH
Written by Whitney DiFoggio MA, RDH"Teeth Talk Girl," is a registered dental hygienist. She started her dental health journey on YouTube, educating the public through videos.
Last updated onNovember 19, 2022Here is our process

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