Baton Rouge Dentist

How Do Dental Sedation and General Anesthesia Compare?

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A patient lying back, relaxed in a dental chair, as the dentist uses a tool in the patient's mouthA December 2025 news story about an Arizona patient who died after dental implant surgery raised understandable concerns about dental sedation. However, several important details help put this case into perspective.

What Type of Anesthesia Did the Oral Surgery Practice Use?

The oral surgeon’s practice offered local anesthesia, nitrous oxide, IV or “twilight” sedation, office-based general anesthesia, and hospital-based general anesthesia.

Based on the available information, the patient appears to have received office-based general anesthesia, which carries more risk than conscious sedation. Referring to all these options as “anesthesia” can give patients the wrong impression about their relative risks.

Conscious sedation, including nitrous oxide, oral sedation, and IV sedation, allows a patient to remain responsive. For an anxious patient, controlling fear and stress can also be an important part of providing safe dental care.

What Risk Factors Were Involved?

Further reporting indicated that investigators found several patient risk factors. Cannabis use before the procedure was specifically identified.

Cannabis can affect the airway and may increase the risk of complications such as a throat spasm during anesthesia. The Arizona Dental Board determined that the oral surgeon had not adequately considered the patient’s risk factors, including cannabis use. The Board required 12 hours of continuing education before restoring the surgeon’s anesthesia permit.

Why Does Medical Disclosure Matter?

We don’t have enough information to know everything that occurred before the procedure, including exactly what the patient disclosed or what instructions he received. For that reason, it would be unfair to place the entire responsibility for this outcome on either the patient or the dental team.

However, patients should disclose all prescription medications, recreational drugs, supplements, and other substances before receiving sedation or general anesthesia. The practice’s medical history forms instructed patients to report drug use, although cannabis was not specifically listed.

This case involved general anesthesia, not routine dental conscious sedation. Conscious sedation has a solid safety record when the dental team properly screens the patient, selects an appropriate level of sedation, monitors the patient, and has complete information about medications and drug use.

Baton Rouge dentist Dr. Ryan Perry sponsors this post. Read why many patients say he is one of the best dentists in Baton Rouge.

Am I immune to anesthesia or do I need a new dentist?

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I don’t know what is wrong with me, but every time I have to get a cavity filled at the dentist, they can never get me numb. I really don’t like going to the dentist anyway, so when I have to get a filling, it is terrible. They do one shot and wait. They do another shot and wait. It’s not fun. Is it me? Am I just immune to the anesthesia? Is it my dentist? Does he not know what he’s doing?

Cal

Dear Cal,

You didn’t mention much about your past experience at the dentist, except that you don’t like to go. If your past includes some kind of traumatic experience at the dentist, that experience could be playing a part in why you have a hard time getting numb when you have dental procedures.

There are cases when anxiety and stress prevent novocain from working correctly. Why still isn’t completely understood. It may be muscle tensity, the body’s chemistry, or some other factor, but the numbing action of the novocain doesn’t complete or it wears off very quickly.

Sedation dentistry to the rescue

If you feel that anxiety and stress describes you, sedation dentistry may be a good avenue for you. Sometimes starting with nitrous oxide, or laughing gas, can help you relax enough for the novocain to work properly. Nitrous oxide alone is enough for some patients to be able to get their dental work done comfortably. If you still aren’t comfortable, you can try conscious sedation dentistry. You would take some medicine to help you relax before your appointment, but you don’t sleep. You are just very comfortable, so much so that you may not even remember the appointment.

If you haven’t had a bad experience in the past that would lead you to feel anxiety and struggle for novocain to work, it may not be a bad idea to try a different dentist. There are dentists who are especially good at gentle dentistry.

This post is sponsored by Dr. Ryan Perry in Baton Rouge, LA.