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Continuing Education in Anaesthesia, Critical Care & Pain 2005 5(3):71-75; doi:10.1093/bjaceaccp/mki020
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Continuing Education in Anaesthesia, Critical Care & Pain | Volume 5 Number 3 2005 © The Board of Management and Trustees of the British Journal of Anaesthesia [2005]. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

Anaesthesia for dentistry

Kaye Cantlay, BA MB ChB MRCP FRCA, Specialist Registrar in Anaesthesia and Intensive Care
Intensive Care Unit, Royal Victoria Infirmary, Queen Victoria Road, Newcastle-upon-Tyne, NE1 4LP

Sean Williamson, MB ChB FRCA, Consultant Anaesthetist
The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW

Julian Hawkings, BSc BDS DGDP(UK) FDSRCPS, Senior Dental Officer and Specialist in Surgical Dentistry
Eston Community Clinic, Fabian Road, Middlesbrough, TS6 9RQ
Tel: 01642 854600, Fax: 01642 282818, E-mail: sean.williamson@stees.nhs.uk (for correspondence)

The first 150 words of the full text of this article appear below.


Key points

The first general anaesthetics administered were for dental extractions.

General anaesthesia for dentistry is not without risk and should not be undertaken as a first-line means of anxiety control.

Consideration should always be given to the possibility of local anaesthetic techniques with or without conscious sedation.

Patients requiring general anaesthesia for dental work are frequently children or individuals with learning difficulties.

The standards of general anaesthesia for dentistry should be the same as those in any other setting.

 


   History of dental anaesthesia
 
The first general anaesthetic administered for a dental extraction is credited to Connecticut dentist Horace Wells. Having observed at a travelling show that laughing gas induced anaesthesia, Wells began experimenting with the gas himself. On the 11th December, 1844, he underwent extraction of one of his own wisdom teeth by a colleague whilst under the influence of nitrous oxide. The following year he attempted to demonstrate this technique in Harvard. . . . [Full Text of this Article]


   Problems of dental anaesthesia
 
Patient factors

Surgical factors


   Local anaesthesia
 
Lidocaine 2% plain

Prilocaine 3% with felypressin 0.03 IU ml–1

Articaine 4% with epinephrine (1:100 000)

Bupivacaine 0.25–0.5% plain


   Conscious sedation
 
Inhalation sedation

I.V. sedation

Oral sedation


   General anaesthesia
 
Conduct of general anaesthesia

Assessment

Premedication

Monitoring

Induction

Airway

Maintenance

Patient positioning

Recovery

Analgesia


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