Professional Guide to Anesthesia Options for All-on-X Surgery

For some people, every visit to the dentist is fraught with anxiety that leads to stress, sleepless nights, and, in some cases, downright fear. As the best dental surgeons in Temecula and beyond, we always try to introduce clarity and familiarity to everything we do. We believe this helps our patients enjoy a smooth treatment process and shed their dental fear, which is mostly caused by the unknown.

A few months ago, we discussed the three most commonly available anesthesia options for All-on-X surgery and full-arch type of procedures. We discussed Local Anesthesia, IV sedation, and General Anesthesia options and went over each one in some detail. 

Today, we would like to focus on IV Sedation and General Anesthesia in particular, as these two are the only available options for patients who don’t want to undergo local anesthesia (i.e., go through surgery while awake).

What are my options for All-on-X surgery if I don’t want local anesthesia?

Local anesthesia is commonly used in dental offices, mostly for minor procedures and safety reasons due to certain medical conditions. However, more demanding treatments like All-on-X surgery, ‘something stronger’ is the best option to ensure patient comfort and safety throughout. So what other options are available?

IV Sedation

With this option, a patient is given intravenous medications, but is not intubated (no breathing tube is inserted). Also known as twilight anesthesia, this is the option most commonly used for quick, straightforward procedures such as wisdom teeth removal and single dental implant placement. The key to this is that the procedure is quick, usually taking under 30 minutes of surgery time. The doctor doing the surgery is usually the one doing the anesthesia as well (surgeon/anesthetist model).

This model works very well for quick cases when the surgery is not very challenging, and the procedure doesn’t take long. The surgeon has enough time and medical know-how to attend to both the surgery and the patient’s anesthesia needs at once. In case certain complications arise, such as breathing problems or blood pressure issues, it’s fairly straightforward to address them. 

The difficulties start when a straightforward procedure takes longer than expected due to surgical complications (broken off root tips, unexpected bleeding, excessive salivation, or airway concerns). Then the one doctor doing anesthesia and surgery is tasked with taking care of two things at once—accomplishing the surgery and handling the anesthesia complications.

The situation can get progressively more challenging, as increased bleeding due to the patient waking up and feeling the procedure being performed can lead to increased blood pressure, and hence more bleeding, followed by more secretions that lead to airway compromise, coughing, loss of airway, and all sorts of bad things happening. In these cases, the surgeon/anesthetist is now being pulled two ways—do I finish the surgery or try to address the anesthesia issues?  The latter is, of course, more important than anything else.

General anesthesia

This procedure involves a dedicated anesthesiologist who is responsible for monitoring the patient’s well-being while the All-on-X surgery is being performed. There are two doctors in the room during the surgery—the surgeon and the anesthesiologist. This option is typically reserved for patients who are medically compromised (have a couple of major health problems, such as blood pressure and diabetes) as well as for those surgeries that are likely to take some time (typically between 45 minutes and a few hours).

In case of general anesthesia, the patient is intubated (given a breathing tube) right from the start. This is extremely helpful because the airway issues are virtually minimized since the patient is given a very secure way to breathe during the surgery. Even in the case of excessive bleeding or excessive secretions/salivation, the airway is protected by the breathing tube, and the patient is not in danger. 

A dedicated anesthesiologist watches the patient closely throughout the whole surgery—all concerns related to blood pressure, diabetes, and the state of anesthesia can be addressed by a single doctor monitoring the patient while the surgeon fully focuses on the surgery and getting the best outcome for the patient.

When it comes to All-on-X surgery, there is not an ounce of doubt in our mind that General Anesthesia with intubation is the best way to get things done. Some offices will steer patients away from general anesthesia because “it’s not necessary” or “it’s expensive”, but the truth is that General Anesthesia with two dedicated providers is the safest, most effective way to get the procedure done.

Let’s face it, would you rather go for the safest, most effective approach if given a choice, or would you settle for the riskier, cheaper anesthesia approach with a higher chance of potential complications and a single doctor putting you to sleep and doing the surgery? 

General Anesthesia for All-on-X surgery is an undeniable winner and the best way to get it done. If some offices are trying to push you into doing IV sedation for this procedure, just understand that it’s not the best service for you, and it’s definitely not worth the potential money you might or might not be saving. 

Who performs safe All-on-4 surgery near me in Temecula, CA & the surrounding area?

At Temecula Dental Implants & Oral Surgery, we’ve made a name among patients and peers for our absolute dedication to making our patients every moment in our clinic feel comfortable and as pain-free as possible. Our compassionate team will never advise you to do something that we don’t feel is in the best long-term interest of your overall wellbeing. 

When you come to a free initial consultation at our clinic, we’ll look into your medical and dental condition in great detail to match your condition with the best treatment possible. Entrust your oral health to the leading dental surgeons in Riverside County—book your appointment without delay!