General Questions1. How is Office-Based Anesthesia (OBA) Different Than Hospital Anesthesia?
Beyond the obvious difference of location, patients find many aspects of Office-Based Anesthesia preferable to hospital anesthesia:
- Services provided in the office are typically significantly cheaper and faster than the hospital. -Patients enjoy the comfort and familiarity of going to a place they know and being treated by staff they are comfortable with.
-Treatment is generally significantly faster than the hospital.
-There are no cumbersome parking fees.
Although the location is different, the equipment and medications used for anesthesia are in most cases exactly the same as those used in the hospital setting. The main difference in OBA and Hospital anesthesia lies in patient selection. Because we do not have specialized or non-standard equipment for significantly ill patients, patients treated in the office setting must typically be healthy enough to undergo anesthesia without that equipment.
2. Is Office-Based Anesthesia Safe?
All patients treated in the office setting are treated based on current American Society of Anesthesiology (ASA) and American Society of Dental Anesthesiology (ASDA) guidelines and recommendations as well as meeting or exceeding pertinent state or local legal regulations for monitoring standards and equipement. While we can never guarantee 100% that something unexpected may not occur, we are trained and equipped to handle a significant number of possible anesthesia emergencies.
3. What If There IS An Emergency Or Complication?
In the event of an unforseen complication or emergency related to the surgery or anesthesia, we have strict emergency protocols in place and will escalate care as indicated to provide the treatment you or your loved one requires. In extremely rare circumstances, this may include transfer to a higher acuity center or hospital if the determination is made that the equipement or staff availability in the office is insufficient to adequately treat the current situation. Rest assured, however, that tens of thousands of cases are performed in office each year with absolutely no significant events.
4. Why Do I/My Child Need Anesthesia?
There are many reasons someone may need anesthesia for a dental procedure. For adults, the determination is usually made by the patient that they would prefer the comfort afforded by sedation/general anesthesia during their treatment. For children, the determination is usually made by the treating dentist. Many children are too young or cognitively unable to cooperate for treatment safely, or may have significant treatment needs which they would be unable to tolerate treatment due to length or number of appointments required for said treatment.
5. What Risks Are There?
By far the most common risks for anesthesia on healthy, suitable patients are mild. They typically include things like post-operative pain, bruising, or nausea. More rare complications are things like unexpected drug reactions/interactions, injury to tissues, or headaches.
In extremely rare cases, the possibility exists for things as significant as nerve damage/weakness, heart or lung injury, brain injury, or death.
6. How Much Does Anesthesia Cost?
Please see our fees and cancellation page for information regarding costs.
1. How Do I Get An Appointment For Anesthesia?
You won't schedule your appointment directly with our office. Instead, once the determination is made that you or your loved one is suitable for OBA, your dentist will schedule a time and date for you based on existing availability of the anesthesia provider. For any questions regarding arrival time, or to reschedule your appointment, please contact your primary dentist to see what future availability they may have available.
Please be aware that appointment availability may be extremely limited, and the next appointment at your dental provider or the hospital may not be for several months. Due to the significant need for treatment in the state of Alabama, failure to show up to your appointment without appropriate notice may disqualify you from future appointments.
2. What Forms Do I Need For Anesthesia?
Although your primary dentist should have given you forms or directed you to our site on the day you scheduled your appointment, please see our Forms page for any required paperwork.
3. What Rules Are There For Eating/Drinking Before Anesthesia?
ASA Guidelines for eating and drinking prior to aneshesia are VERY important to follow. Although it is uncommon, food or drink in the stomach may be aspirated into the airway/lungs should you/your child vomit during the anesthesia process; especially during a time where the airway reflexes are not present. This can lead to a significant pneumonia which may be very difficult or impossible to treat, and could become fatal.
Based on Current ASA Guidelines We Require the Following:
- Absolutely NO food for at least 8 (Eight) hours prior to the scheduled arrival time.
- Cow's milk/infant formula must be stopped 6 (Six) hours prior to the scheduled arrival time.
- Breast milk must be stopped 4 (Four) hours prior to the scheduled arrival time.
- Clear liquids (water, gatorade, pedialyte, apple juice) must be stopped 2 (Two) hours prior to the scheduled arrival time.
These times are non-negotiable, and failure to maintain this may cause lengthy delays or cancellation of the appointment.
4. What Should I/My Child Wear For The Procedure
Wear comfortable, loose-fitting clothing on the day of the procedure. Try to avoid things like tightly-fitted jeans, childrens' clothes without access to legs or feet (onesies), or layers of clothing which make reaching the skin difficult.
5. Should I/My Child Take Their Medication Prior To Their Anesthesia?
Unless specifically indicated by your doctor or anesthesia provider, please continue taking any currently prescribed medications at their routine time and dosage. It is very important that you list ALL medications or supplements that you are currently taking on your registration forms, even if you believe the condition you are taking them for has been well-controlled.
6. Who Should Come With Me/My Child?
For adult patients we require a second, competent adult escort to be present throughout the procedure. Patient transportation options are at their discretion, but please be aware that some modes of transportation (taxi, Uber, Lyft, etc.) may refuse to transport a patient post-operatively if they show signs of impairment.
For pediatric patients we require at least ONE biological parent or legal guardian to be present throughout the duration of the entire procedure. For any legal guardian who is NOT the biological parent, we require appropriate and valid legal documentation which clearly denotes the guardian's ability to make medical/dental decisions. In certain cases, we may at the provider's discretion allow or attempt a phone consent if the direct biological parent or guardian cannot be physically present. In those instances the patient escort MUST be a competent legal adult who must also stay throughout the entire duration of the procedure.
Day Of Surgery Expectations
1. Can I Stay With My Child During The Procedure?
Although we understand and appreciate the significant anxiety you may experience, and will make our best effort to alleviate those concerns prior, we are unable to allow parents to stay in the room or procedure area during the treatment.
2. How Will I/My Child Go To Sleep?
For adults, anesthesia will typically be induced after we apply all monitors and start an IV line through which all medications will be given. In most cases you will have no memory of falling asleep.
For children, anesthesia is typically induced by having the patient breath a special gas through a mask which will cause them to fall asleep. After they are asleep an IV will be placed in order to give additional/emergency medications as indicated. The portion of the procedure your child will remember is generally very brief, and they will normally not realize they fell asleep. Although every effort is made to for this process to be completely seamless, many children are too young or traumatized to cooperate for things as simple as coming to the room or lying in the chair. In these instances, your help may be required to reassure and direct them so the procedure may begin.
3. Will You Stay With Me/My Child During The Procedure?
Your anesthesiologist will be by you/your child's side from pre-op throughout the entire procedure as well as post-operatively. Our job is to monitor vital signs and administer medication as needed, and we can't do that without being there.
4. How Long Will The Procedure Be?
While we would love to give you an exact time, the duration of the procedure will vary based on a number of factors including treatment complexity and provider speed. The anesthesia time begins when the patient enters the operating room and the anesthesiologist begins treatment and ends when the anesthesiogist is comfortable that their presence is no longer required for the patient to maintain themselves without assistance. Your dental provider should be able to give you a rough estimate of the total time expectation prior to the appointment for an estimate of cost and scheduling available escorts.
Some typical procedure times are below, though the exact time may vary considerably even for the same procedure:
Wisdom Tooth Removal: 30-45 Minutes
Implant Placement: 30 minutes to >1 hour
Pediatric Dental Rehabilitation: 1->1.5 hours
5. What Time Should I Arrive For The Procedure?
Your dental provider should give you all scheduling and appointment related times prior to the appointment. If you within 24 hours of the procedure and still don't have an appointment time please contact the treating dentist or anesthesiologist so we can get that information to you as soon as possible.
Please be aware that due to the nature of the treatments, wide variability exists in the treatment times and it is not uncommon to have a procedure be either longer OR shorter than expected. Especially in pediatric settings, patients are frequently sick and therefore you may be contacted to come in earlier than expected for the procedure.
6. Can My Child Go To School Before/After the Procedure?
Children should not go to school on the day of the procedure. Children who attend school prior to their appointment will be considered to have violated the food and drink guidelines as we cannot assure they or their teachers were able to watch or limit them appropriately. Children will likely be tired and may have pain after the procedure, and should not go to school or attend practice for sports/activities until the following day.
1. How Long Will I/My Child Be Asleep After the Procedure?
Although every patient's recovery experience varies based on a number of factors, typical initial recovery from anesthesia happens within 15-20 minutes of the procedure being finished. Patients should expect to be tired or sleepy for several hours following anesthesia, and may have difficulty with memory in the post-operative period.
2. Will I Be With My Child When They Wake Up?
We make every effort to have you there with your child as they awake from anesthesia. Your presence in the recovery room is one of the MOST comfortable and reassuring treatments we have. As such, it is very important for you to remain close by throughout the procedure in order to ensure we can facilitate this.
3. Will I/My Child Have Pain Afterwards?
While every effort is made to make you/your child as comfortable as possible after anesthesia, we can never guarantee a complete absence of pain or discomfort; especially for significantly complex treatment plans. In many cases you or your child will wake up with local anesthesia in the mouth, and there may be a several hour period before full sensation returns. For very young children, their concept of pain is limited and they will often confuse the sensation of lingering anesthesia medications or local anesthesia as unpleasant, which may cause them to cry or be fussy. This is typically a brief period.
4. Will I/My Child Be Able to Eat/Drink Afterwards?
We aim for you/your child to be able to resume fluid intake immediately after the procedure unless specifically contraindicated. Diet advancement should be slow and considered, starting with soft, mild foods and working up to a routine diet across the course of the day (several days depending on procedure specific requirements)
5. What Are The Common Side Effects of Anesthesia?
While we cannot cover every possible side effect here, by far the most common side effects of anesthesia are:
- Nausea, vomiting, upset stomach
- Itchy, scratchy, sore throat
- Redness/bruising at the site of the IV
For any other side effect concerns please contact your provider for a more personalized investigation.
6. How Soon Can I/My Child Resume Normal Activity/Go to Schoool/Go to Work?
For adult patients undergoing minor surgical procedures, they may resume work activities the same day as long as they feel adequately recovered. Weight lifting should be limited. Skip the gym for at least 24 hours. Don't make any significant legal/financial decisions for at least 24 hours. Work or school absences may be obtained from your primary dental provider's office.
Pediatric patients are typically able to resume school by the next day unless they have continued requirements for post-operative pain medication. In those cases we advise to keep them out for at least one more day until their soreness is adequately controlled without medication.
7. What Should I Watch Out For After Anesthesia?
While most patients recover completely without significant issues, rarely complications post-operatively occur. You should watch your child for the first several hours after anesthesia. Pain, nausea, vomiting, lethargy, and transient memory issues are all expected after anesthesia. Contact emergency services immediately for significant events such as: new onset seizures, significant chest pain, respiratory distress or trouble breathing, signs of a stroke, or cardiac arrest.
8. What If I Need More Medication For Pain Afterwards?
Although we will routinely check on you/your child in the hours following anesthesia, and are happy to advise to appropriate post-operative best practices, we do not prescribe medications for post-surgical pain. Significant pain which does not resolve taking recommended OTC drugs, or pain which does not resolve in the expected length of time, should be followed-up with your primary dental provider. He/she may decide as appropriate to prescribe further medication.
1. Do You Accept My Insurance?
Please see our insurance page.2. Do You Accept Payment Plans?
While we do not directly accept payment plans, please speak with us to determine if a payment service such as CareCredit or similar may be appropriate for you/your child's treatment needs.
3. How Much Does Anesthesia Cost?
Please see our fees and cancellations page.
4. Will I Get A Receipt?
Expect to receive a receipt within 24 hours of any payments received by SCDA. Please understand that a receipt only verifies payment from your provider. It is NOT in itself an indication of full payment/zero balance since charges may vary based on the required pre-operative fee if the procedure takes longer than estimated. You should expect an invoice for the full charges (minus prior payments) within 24 business hours of the procedure. You agree to pay in full all remaining balances in agreement with the financial agreement forms within 48 business hours of the procedure unless special arrangements have been made.
For any questions not covered here or elsewhere on our page, please reach out to us at the contact options below. We would be glad to answer them for you.