Do I Need Sedation for Wisdom Teeth Removal?

Seen in Midtown Houston, Saturday hours: Book an appointment  ·  (713) 322-7474  ·  Sedation Dentistry in Houston

At Omega, Dr. Jonathan Rosenstein, board-certified oral & maxillofacial surgeon (ABOMS), and Dr. Edmund Watkins, oral & maxillofacial surgeon, handle sedation dentistry.

The Four Options

• Local anesthetic alone. You are awake and the area is fully numbed. Most patients feel pressure and movement, not pain. No fasting and no driver, and it's included in the treatment fee. It suits straightforward extractions in patients who are not anxious.

• Nitrous oxide, laughing gas. Inhaled through a small nose mask alongside local anesthetic. You stay awake and aware but noticeably calmer, and it wears off within minutes of the mask coming off, so most people drive themselves home. It suits mild anxiety. Nitrous oxide is a separate charge; ask for today's fee.

• Oral sedation. A tablet taken before the appointment, on top of local anesthetic. You will be drowsy, may remember little, and you need someone to drive you both ways. The depth is harder to control than with IV, because once the tablet is swallowed it cannot be adjusted. It is quoted at your consultation.

• IV sedation. Medication delivered through a vein and adjusted as we go. Fasting and a driver are required.

General anesthesia, where you are fully unconscious with airway support, is kept for specific cases. Our visiting physician anesthesiologist gives it, and it is quoted at your consultation.

Which One Your Case Actually Needs

We look at how hard the surgery is, how anxious you are and your medical history.

Local alone is reasonable when you have one or two teeth, fully erupted, with straightforward roots, and you're comfortable in a dental chair.

Nitrous is a good middle when you get nervous but not panicked, the surgery isn't complex, and you'd rather not organize a driver.

IV sedation is worth discussing when:

• All four are coming out in one appointment.

• A tooth is impacted in bone and has to be sectioned, with bone removed.

• A root sits close to the inferior alveolar nerve in the lower jaw, where the surgeon needs you completely still.

• You have real dental anxiety, a strong gag reflex, or trouble keeping your mouth open for a long time.

• You've had a bad experience before.

After your exam we tell you which level we recommend. If a straightforward extraction doesn't need sedation, we'll say so rather than adding it to your bill.

Questions to Bring to Your Consultation

Bring these to your consultation, along with a list of every medication and supplement you take. Only the surgeon can answer them for your mouth.

• Which level of sedation do you recommend for my teeth, and why?

• Would a lighter option work for me, and what would change if I chose it?

• Who gives the sedation, and who watches me while I have it?

• What should I do with each of my medications and supplements before the appointment?

• How long should I fast, and who needs to drive me and stay with me?

• What happens if I eat, get sick or catch a cold before the appointment?

• What will it cost, and will I get the exact fee in writing before treatment?

If you are nervous, say so at the consultation; that is part of how we choose the level.

What IV Sedation Is Like on the Day

Most people describe IV sedation as a warm heaviness, and the next thing they know is being told it's finished. A small cannula goes into the back of your hand or your arm, and the medication goes in over a minute or two.

A dedicated team member monitors your breathing, heart rate and oxygen level throughout, and the sedation is adjusted as needed. Most patients remember little or nothing of it.

How Sedation Is Charged

IV sedation is charged once per appointment, so several teeth in one appointment carry one sedation fee. Wisdom tooth removal itself is priced per tooth.

For the rest, read what IV sedation costs and our wisdom teeth removal cost guide.

Is It Safe

It can be, when the right people give it and watch you. Who gives the sedation and who watches you matter as much as the level you choose.

Risks of the surgery include dry socket and, for lower teeth, numbness of the lip or chin if the nerve near the roots is affected.

The deeper levels are given by clinicians trained and permitted to give them. At our office IV sedation is given by our oral and maxillofacial surgeons, by Dr. Shirin Farhadian under her Texas Level 3 sedation permit, and in some cases by a visiting physician anesthesiologist. Board-certified oral & maxillofacial surgeon Dr. Jonathan Rosenstein (American Board of Oral and Maxillofacial Surgery) removes wisdom teeth at our office. So does oral & maxillofacial surgeon Dr. Edmund Watkins.

During sedation you are monitored continuously: oxygen saturation, heart rate and rhythm, blood pressure, and breathing.

What we need from you is complete honesty about your medical history: every medication including supplements, any heart or lung condition, sleep apnea, pregnancy, alcohol or recreational drug use, and any previous reaction to anesthesia. Nothing on that list is judged. All of it changes the plan.

How to Prepare

We give you instructions for your case, and they come before anything on this page. This is what usually applies to IV or oral sedation:

• Fasting. Usually nothing to eat or drink from midnight before a morning appointment; we give you the exact window. A full stomach under sedation is the risk that anesthesia protocols exist to prevent, so if you slipped and ate, tell us and we will reschedule rather than proceed.

• Arrange a driver who can stay through the appointment and take you home. A rideshare alone does not satisfy this.

• Wear short sleeves and flat shoes. Leave jewelry at home.

• Medications. Tell us every medication and supplement you take, and bring the list. Before your appointment we tell you what to do with each one.

• Take out contact lenses, and remove nail polish from at least one finger, because the oxygen monitor clips there.

• Fill your prescriptions before the appointment. You won't want to wait in a pharmacy line afterward.

• Smoking. Stop for as long as you can beforehand, and for 72 hours after, because smoking raises the risk of a dry socket.

With local anesthetic or nitrous only: unless we tell you otherwise, eat a normal light meal beforehand. You don't need a driver for nitrous once we've observed you for a few minutes.

The Rest of That Day

Sedation wears off within hours; the sockets heal over days. After IV or oral sedation you'll be groggy for a few hours, so someone drives you home and you rest. No driving, work or signing anything important for 24 hours.

For the 72-hour rules, dry socket and the day-by-day picture, read recovering after wisdom teeth removal. Call us if numbness is not going away, and call the same day for the symptoms in the box below.

Booking in Midtown Houston

To decide, book a consultation. The 3D CBCT scan is taken at your consultation, and we go through your sedation options with you. We give you the exact fee in writing after your exam, before any treatment. The same surgeon plans your case, performs it and follows you afterward.

Send us your insurance and we'll check your benefits before your visit.

We're at 106 W Gray St in Midtown, Houston. No referral needed. Website booking requests are answered within one business day. For the whole visit, see wisdom teeth removal in Houston.

Book a consultation or call (713) 322-7474.