Local anesthetic ( LA) or general anesthetic (GA)?
Let’s be honest, lots of people find trips to the dentist uncomfortable, unpleasant and sometimes painful. There are also people who suffer moderate to severe anxiety towards dentistry that stops them coming until they are forced due to severe problems.
As such, modern dentists are equipped with the skills, equipment, pharmaceuticals, and most importantly, the compassionate attitude required to deliver our services to the people attached to the mouths we work on.
Pain and anxiety is a very personal thing
However in most cases, fillings and other restorative works are dental procedures that require anesthesia. This is typically in the form of a local anesthetic injection which stops the pain signal from ever reaching the brain. This “numbing” of the area being worked on removes almost all sensations of what is happening. This is also commonly associated with the “fat lip” feeling that passes within a few hours of the injection.
Some patients are harder to numb than others, but additional anesthetic, waiting longer or utilising different techniques means the vast majority of dental procedures can be done painlessly. Dentists also appreciate that having your teeth cleaned (depending on the difficulty) can require local anesthetic to make it comfortable and tolerable.
When having an injection, a numbing gel is often placed at the site where the needle will be inserted to reduce the feeling of the injection itself. Extractions and root canal treatments are most definitely dental procedures that require anesthesia.
It is important to understand that dentists prefer to have comfortable and relaxed patients as it reduces our stress and improves the thoroughness and quality of the outcome. We want our patients to like us, so being a gentle and caring dentist is a top priority.
From time to time we encounter patients who choose to have challenging work done without anesthetic. These typically fall into 3 groups. Those who are needle – phobic, those that dislike the numb feeling and those who have a high pain threshold, or genuinely feel very little.
Central to all of this is to have an open discussion with your dentist about your preferences and concerns. There are no badges for being a hero, or toughing it out, and we are experienced to read the signs if someone is in distress.
In addition to local anesthetic, there is also conscious sedation and nitrous oxide happy gas that can provide a relaxing and calmative effect.
So what about General anesthesia?
General anesthesia or GA is where you are put to sleep for dental procedures. This is almost always done in a hospital under the care of a qualified medical anesthetist, as you would for other surgery performed by a doctor.
General anesthetic is used when the dental procedure is particularly challenging or the patient is highly anxious, and being asleep is the only option.
The most common dental procedure performed under general anesthetic is the removal of wisdom teeth. In many cases they are in difficult to access locations and would be distressing to experience if awake.
Extensive children’s dentistry is also performed by specialists under GA. As you can appreciate, this is critical to successful outcomes. Children are not as able to be compliant, sit through lengthy procedures and are at higher risk of developing dental phobia if subjected to very challenging work.
So what if you are an adult and you want a general anesthetic for dental work? This is possible, but quite often limited in its scope. Beyond extractions, it is more difficult, and in many cases impossible to perform the complex and highly demanding procedures such as root canal treatments, crowns, or even complex fillings. The nature of the work, and the facilities in most hospitals do not make this possible.
This makes the management of any dental anxiety and the development of a great rapport with your dentist crucial to having your dental work performed with the minimum of stress.