IV Sedation & Anesthesia

Intravenous anesthesia is an option under certain situations for some patients. The patient should discuss with Dr. Cuomo if they are a candidate for this procedure.

Please call our Carmel, NY Office at The Barns Office Center Phone Number 845-278-2101 or call our Danbury, CT Office at Edgewood Professional Center Phone Number 203-797-0008 with any question or to make an appointment to discuss your anesthesia options.

Several methods of anesthesia are available. The method of anesthesia that is chosen for or by a patient depends upon the nature of the surgical procedure and the patient’s level of apprehension. The following table illustrates the choices of anesthesia, a description of the anesthetic technique, and the usual indications for that technique.

Method of Anesthesia Description of Technique Usual Indications
Local Anesthetic The patient remains totally conscious throughout the procedure. A local anesthetic (e.g. lidocaine) is administered in the area where the surgery is to be performed. Local anesthetic is used in conjunction with the other methods of anesthesia in all oral surgery procedures. Simple oral surgery procedures such as minor soft tissue procedures and simple tooth extractions.
Nitrous Oxide Sedation with Local Anesthetic A mixture of nitrous oxide (laughing gas) and oxygen is administered through a nasal breathing apparatus. The patient remains conscious in a relaxed condition. Nitrous oxide has a sedative and analgesic (pain- controlling) effect. Simple oral surgery procedures to more involved procedures such as removal of wisdom teeth and placement of dental implants.
Office Based General Anesthesia with Local Anesthetic* Medications are administered through an intravenous line (I.V.). The patient falls asleep and is completely unaware of the procedure being performed. Medications most commonly used are Fentanyl (opiate), Versed (benzodiazepine), Ketamine, and Diprivan. Supplemental oxygen is delivered through a nasal breathing apparatus and the patient’s vital signs are closely monitored. General anesthesia is available for all types of oral surgery. A patient may choose general anesthesia for simple procedures depending on their level of anxiety. Most people having their wisdom teeth removed or having a dental implant placed will choose general anesthesia. General anesthesia may be necessary if local anesthesia fails to anesthetize the surgical site which often occurs in the presence of infection.
Hospital or Surgery Center Based General Anesthesia A patient is admitted to a hospital or surgery center where anesthesia is administered by an anesthesiologist. Indicated for patients undergoing extensive procedures such as face and jaw reconstruction and TMJ surgery. Also indicated for patients with medical conditions such as heart disease or lung disease who require general anesthesia.

To administer general anesthesia in the office, an oral surgeon must have completed at least three months of hospital based anesthesia training. Qualified applicants will then undergo an in office evaluation by a state dental board appointed examiner. The examiner observes an actual surgical procedure during which general anesthesia is administered to the patient. The examiner also inspects all monitoring devices and emergency equipment and tests the doctor and the surgical staff on anesthesia related emergencies. If the examiner reports successful completion of the evaluation process, the state dental board will issue the doctor a license to perform general anesthesia. The license is renewable every two years if the doctor maintains the required amount of continuing education units related to anesthesia.

Again, when it comes to anesthesia, our first priority is the patient’s comfort and safety. If you have any concerns regarding the type of anesthesia that will be administered during your oral surgery procedure, please do not hesitate to discuss your concerns with your doctor at the time of your consultation.

Intravenous Sedation (“Twilight Sedation”)

Our office offers our patients the option of Intravenous Sedation or Dental Intravenous Anesthesia or to some it is referred to as “Twilight Sedation” for their dental treatment. Intravenous Sedation or “twilight sleep” helps you to be comfortable and calm when undergoing dental procedures. Your treatment can be completed under intravenous sedation. Intravenous sedation or “IV sedation” (twilight sedation) is designed to better enable you to undergo your dental procedures while you are very relaxed; it will enable you to tolerate as well as not remember those procedures that may be very uncomfortable for you. IV sedation will essentially help alleviate the anxiety associated with your treatment. You may not always be asleep but you will be comfortable, calm and relaxed, drifting in and out of sleep – a “twilight sleep”.

If you choose the option of intravenous sedation your IV sedation/anesthesia is administered and monitored by the doctor therefore eliminating the costly expense of having your treatment carried out in an operating room or same day surgical facility.

How is the IV Sedation Administered?

A thin needle will be introduced into a vein in your arm or hand. The needle will be attached to an intravenous tube through which medication will be given to help you relax and feel comfortable. At times a patient’s vein may not be maintainable, in these situations the medications will be administered and the needle retrieved – both scenarios will achieve the same desired level of conscious sedation. Once again some patients may be asleep while others will slip in and out of sleep. Some patients with medical conditions and/or on specific drug regimens may only be lightly sedated and may not sleep at all.

The goal of IV sedation is to use as little medication as possible to get the treatment completed. It is very safe, much safer than oral sedation. With IV sedation a constant “drip” is maintained via the intravenous tube. At any time an antidote can be administered to reverse the effects of the medications if necessary. Along with IV sedation there are also other different “levels” of sedation available to you in our office. There is nitrous oxide analgesia.

Nitrous Oxide (Laughing Gas)

Nitrous Oxide is a sweet smelling, non irritating, colorless gas which you can breathe. Nitrous Oxide has been the primary means of sedation in dentistry for many years. Nitrous oxide is safe; the patient receives 50-70% oxygen with no less than 30% nitrous oxide. Patients are able to breathe on their own and remain in control of all bodily functions. The patient may experience mild amnesia and may fall asleep not remembering all of what happened during their appointment.

There are many advantages to using Nitrous Oxide

  • The depth of sedation can be altered at any time to increase or decrease sedation.
  • There is no after effect such as a “hangover”.
  • Inhalation sedation is safe with no side effects on your heart and lungs, etc.
  • Inhalation sedation is very effective in minimizing gagging.
  • It works rapidly as it reaches the brain within 20 seconds. In as few as 2-3 minutes its relaxation and pain killing properties develop.

Reasons to not use Nitrous Oxide

Though there are no major contraindications to using nitrous oxide, you may not want to use it if you have emphysema, exotic chest problems, M.S., a cold or other difficulties with breathing. You may want to ask your dentist for a “5 minute trial” to see how you feel with this type of sedation method before proceeding.

Northeast Implant & Oral Surgery

5 out of 5 stars based on 3 reviews.

Our Latest Patient Testimonials

Dr. Salas was one of the best doctors of dentistry we have met. He was completely professional and went through the entire procedure from beginning to end. He talked directly to us and my son who is autistic and full of angst to put all of us at ease. He told us if any problems came up he would stop the procedure and schedule a later date at the local hospital with our son under complete sedation and safety. On day of the removal they took our son in and the nurse stayed to tell us exactly what was going on and then kept us up to date on his progress. The procedure was very quick and when it was over we were taken to our son who was all smiles. He said he had no pain. But his smile was all we had to see. We thank Dr. Salas and the entire staff at Northeast for a wonderful experience for our son. We highly recommend Dr. Salas to any one with a child or adult with challenges.

- Frank F

5 out of 5 stars on

Our Latest Patient Testimonials

I had my wisdom teeth extracted by Dr. Chris Cuomo and had an extremely positive experience with not only the doctor but the office as well. Typically I dread the dentist but Dr. Chris’ bedside manner made me feel at ease. He advised me on what was best for my situation and informed me of all of my options. Even after my surgery, I was nervous that there was something wrong with the healing process and the office took me in that night to assure me that everything was healing well. If I ever have to have my other two wisdom teeth removed I would without a question go back to Dr. Chris!

- Jaclyn S

5 out of 5 stars on

Our Latest Patient Testimonials

Great practice, friendly staff, and Dr. Chris was awesome. Absolutely no pain and great overall experience.

- Milt H

5 out of 5 stars on