Anesthesia Options

The majority of oral and maxillofacial surgery procedures are performed in the safety and comfort of our office providing personalized care, and minimizing waiting periods. This treatment approach is more convenient and cost-effective for patients.

At the consultation appointment, Dr. Tillery will review your medical history, discuss your surgery and what to expect during and after the operation, and offer you the anesthesia treatment options best suited and safest for you. This is also the best time to ask any questions and discuss any concerns you may have about your operation.

THE ABILITY TO OFFER A SAFE, COMFORTABLE AND PLEASANT EXPERIENCE

Dr. Tillery has years of extensive hospital residency training in all forms of anesthesia delivery and pain control methods. He served a resident on the medical anesthesia service, evaluating pre-operative patients, delivering the anesthesia, and monitoring post-anesthetic patients. He is experienced in airway management, endotracheal intubation, establishing and maintaining intravenous lines, and managing complications and emergencies. 

This advanced training in anesthesia is what has distinguished the specialty of oral and maxillofacial surgery since it’s earliest days.  In fact, after anesthesiologists, oral & maxillofacial surgeons receive more formal anesthesia training than any other medical specialty.  

Dr. Tillery is licensed by the State of Florida to provide IV Sedation and General Anesthesia. 

Our surgical assistants are accredited through the Dental Anesthesia Assistant National Certification Examination program to assist the doctors in the TEAM Approach to safe administration and monitoring of patients.  The doctors and staff consistently attend continuous education and anesthesia safety programs throughout the state and at national conferences to ensure their competency in the safe administration of anesthesia.  The doctor and assistants maintain certification in Basic Life Support/CPR (BLS) and Advanced Cardiac Life Support (ACLS).  Dr. Tillery is currently serving as the President of the Florida Dental Society of Anesthesiology.  

WHAT FORMS OF ANESTHESIA ARE AVAILABLE?

Dr. Tillery is able to use various anesthetic techniques to help patients relax and feel comfortable during oral surgery based on the patient’s medical history, level of anxiety, and the type of procedure being performed.

Local Anesthesia: A local anesthetic is administered via injection at the surgical site to completely numb the treatment area. These injections can be administered alone or used in conjunction with nitrous oxide or IV sedation. Some patients actually fear losing control of their senses and would rather be awake and aware of their procedure. This technique will allow patients to drive themselves to and from the office without the need for a driver to accompany them.

IV Sedation: Performed by administering anti-anxiety medications and painkillers through an IV, this method places patients in a dream-like state in which they feel no pain and often do not remember the procedure when it is over.  The sedation is accompanied by local anesthesia that is administered once the patient is sedated or asleep, so the patient does not experience the pain of the local anesthesia administration. Once the procedure is completed and the IV sedation is discontinued, the patient is still numb and experiences no pain from the surgery for at least one hour—allowing the patient to take their pain medicine well in advance.  The pain medicine can have time to start working before any discomfort begins.

• General Anesthesia: Used for extensive procedures such as jaw surgery or facial reconstruction, general anesthesia induces a state of unconsciousness and renders the patient unable to feel any pain. This is a deeper level of anesthesia than what is offered with IV sedation.  This form of anesthesia is administered through an IV route and/or through a breathing tube. General Anesthesia is still accompanied by local anesthesia, which is administered once the patient is asleep, so the patient does not experience the pain of the local anesthesia administration. Once the procedure is completed and the General Anesthesia is discontinued, the patient remains numb and experiences no pain from the surgery for at least one hour—allowing the patient to take their pain medicine well in advance.  This gives the pain medicine time to start working before the pain begins.  For patients requiring this level of anesthesia, Dr. Tillery can arrange to perform the surgical procedures at an Ambulatory Surgery/Outpatient Surgical Facility or at the Hospital.

Nitrous Oxide: Usually combined with a local anesthetic, nitrous oxide is a gas administered through a breathing mask to help reduce anxiety.  Patients will experience some relaxation from nitrous oxide, but the gas is not potent enough to put patients to sleep—even at maximum dosages. Unlike its use for general dental procedures (like fillings, crowns, bridges), patients typically prefer IV Sedation for oral surgery procedures. 

• Oral Sedation (using pills or liquids):  Medications taken orally are rarely effective for relief of surgical anxiety.  Medications taken by mouth are unpredictably absorbed in the gut for a number of reasons (dilution with food, slow GI mobility due to anxiety, etc.) resulting in either inadequate sedation, higher potential for overdosing, and prolonged recovery. Oral sedation techniques are rarely used in an oral surgeon’s office as IV Sedation and General Anesthesia techniques are more predictable, more versatile, reversible, and considered safer.

WHAT PRECAUTIONS SHOULD YOU TAKE BEFORE AND AFTER ANESTHESIA?

If your oral surgery requires IV Sedation or General Anesthesia remember to not eat or drink anything for at least 8 hours prior to the procedure. Avoid smoking for at least 12 hours before the procedure. Someone will need to drive you to and from your appointment.  They will need to remain in the office the entire time that you are there. You should wear loose clothing that gives the oral surgery team easy access to your arms past your elbows, and you should discuss your routine medications with your oral surgeon to determine if you should continue to take them on the day of the procedure.  Most prescription medications including blood-pressure medications are ok to take in the 8 hour window prior to your procedure provided you take them only with a small sip of water.

Procedures that are performed strictly under local anesthesia do not require you to refrain from eating or drinking prior to the procedure.