Nitrous oxide and narcosis

Types of pain elimination:

At a glance:

  • At a glance:
  • Nitrous oxide: best method, effort and costs low
  • Narcosis: with complicated wisdom teeth

For pain elimination during the wisdom tooth surgery – also known as pulling wisdom teeth – different methods are available

Wisdom teeth pull only with syringe

At a glance:

The syringe ensures freedom from pain, it should be drawn a maximum of 2 wisdom teeth at a time, noises are heard The local anesthesia is absolutely sufficient for the absence of pain during wisdom teeth pulling.

However, the patient hears the working sounds during the procedure (drilling, knocking, cracking, etc.). Many patients are irritated and they find it very uncomfortable. Listening to music via headphones (bring along!) During the procedure suppresses the noise, but the vibrations on the bone and a discreet feeling of pressure remain.

Wisdom teeth pull with nitrous oxide

At a glance:

Nitrous oxide is a harmless gas, it makes you euphoric and tolerant of pain. Together with a tranquilizer it is ideal for wisdom tooth removal. Nitrous oxide (N2O / nitrous oxide) sedation is currently the best course of action. The nitrous oxide is inhaled through a mask that is loosely placed on the nose. As soon as the mask is removed, the effect of the laughing gas stops within 5 to 10 minutes.

Nitrous oxide was first used in 1844 by the American dentist Horace Wells in Connecticut / USA, after he had accidentally discovered its analgesic effect on a funfair. The inhalation of the safe gas was at that time a common attraction at folk festivals. It has a relaxing effect and puts you in a smoke of satisfaction. In the US, UK and Scandinavia, the use of nitrous oxide in the dentist is widespread – in Germany, however, it is rarely used. The effect of the nitrous oxide may be enhanced by the prior ingestion of a sedative. We ask our patients to be in our practice half an hour before the procedure. We then give them the appropriate tablet in the correct dosage. This unfolds its strongest effect punctually to the intervention. The combination of calming tablet and nitrous oxide now leads to a greatly reduced perception of the patient. There is also a certain amount of positive euphoria, whereby even negative events are hardly perceived as such. Since the analgesic effect of the laughing gas is not sufficient for wisdom tooth surgery, a local anesthetic (syringe) is still used. However, you can no longer feel their “pricks” already. Further syringes are not required in the treatment with nitrous oxide, in contrast to treatment under general anesthesia.

Anesthetic wisdom teeth pull in sedation or general anesthesia

At a glance:

General anesthesia ensures complete freedom from pain even when removing complicated wisdom teeth

Anesthesia may be required to remove very complicated wisdom teeth, especially if they enclose the lower jaw nerve (see explanation under “Difficulty”). Both methods are initiated by placing a venous access in the elbow or the back of the hand (“pricks” in the arm or the back of the hand). Both sedation and anesthesia require the presence of an anesthetist (specialist in anesthetics) in our practice. This also increases the cost of the procedure. Both methods provide a precisely controlled, artificial sleep of the patient. The difference between sedation and general anesthesia is that the patient still breathes during the sedation (consciousness is partially preserved) while being artificially ventilated under general anesthesia. For this purpose, a breathing tube (tube) is advanced through the mouth or nose into the trachea and connected to the ventilator. Both methods are very safe and have been used thousands of times in our practice without incident. The awakening from anesthesia occurs after the supply of anesthetic has been stopped. As a result, the patient awakens “at the touch of a button” and can leave the practice after a one-hour observation period. A very important factor for the safety of anesthesia and sedation is the strict observance of the sobriety requirement: six hours before the procedure must not be eaten or drunk!

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Christina Cherry
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