Anesthesia Options

Anesthesia Options at COFS

The doctors at Commonwealth Oral & Facial Surgery are committed to making your experience during surgery as comfortable as possible. We realize that having any surgery can be stressful. We offer several different options for anesthesia. You and your doctor will decide which option is best for you.

All of our providers at Commonwealth Oral &Facial Surgery have completed extensive anesthesia training. As residents, they trained with an anesthesiologist and underwent a rigorous credentialing process.   Once in private practice, they are required to have anesthesia reviews as well as facility and equipment inspections every five years.

No other dental or medical specialty requires this degree of training. Because of this training and continued credentialing requirements, board certified oral and maxillofacial surgeons are the only healthcare specialist (aside from anesthesiologist) permitted to administer all levels of sedation and general anesthesia. All of our doctors at Commonwealth Oral & Facial Surgery are board certified.

Local Anesthetic

Examples of common local anesthetics are: Lidocaine, Carbocaine, Septocaine, and Marcaine. These are all types of numbing medications that are administered in the area where the surgery is to be performed. Local anesthesia is also used with other methods of anesthesia in our practice.

On the day of the procedure, there are no strict dietary limitations. Feel free to enjoy a light meal before the appointment.


Exparel is a new local anesthetic. It is long-acting and is injected into the surgical site(s). It is designed to gradually release into your body over a longer period of time for lasting pain relief. It helps to reduce the need for taking opioid pain medication.

Local with Nitrous Oxide

Nitrous oxide (laughing gas) is a colorless gas with a slightly sweet odor that you breathe through a mask. The mask covers only your nose. When nitrous oxide is used with local anesthetic, it helps to relieve anxiety and reduces pain during the procedure. It is safe and effective. Once the nitrous oxide is stopped the effects wear off quickly.

On the day of the procedure, there are no dietary limitations. Although avoidance of dairy products may be advisable when having nitrous oxide, feel free to enjoy a light meal before the appointment.

Non-intravenous Sedation

Non-intravenous sedation is used to relax adult patients or your child. For children it can increase his or her cooperation. The most common medication we use for this type of sedation in children is Oral Versed (Midazolam). It will be used in conjunction with local anesthetic and nitrous oxide.

For children, at the time of your child’s evaluation you will be given the prescription. This prescription should be filled and brought with you on the day of the surgery. We normally ask that you and your child arrive at the office an hour before your appointment. When your child is brought into the treatment area, the doctor will verify the medication. After the medication and dosage are verified, we will have your child take the medication.

He or she will then stay in a treatment room for monitoring while the medication takes affect. This usually takes approximately 30-60 minutes. The duration of the sedation varies from child to child, but it can last approximately 45 minutes to 1 hour for the actual dental treatment, followed by another 4 to 6 hours during which your child will be sleepy/drowsy.

IV Anesthesia/Sedation

IV anesthesia/sedation is a moderate type of anesthesia. It’s administered through an intravenous line (IV) that directly enters the bloodstream. The effects are usually immediate. The patient falls asleep and is unaware of the procedure being performed. Supplemental oxygen is delivered through nasal breathing apparatus and the patient’s vital signs are closely monitored. When the IV medications are stopped, patients wake up quickly and may feel groggy and sleepy.

A reliable adult must accompany the patient to the appointment and remain in our office during the procedure. After escorting the patient home, it is suggested that an adult remains with them throughout the day.

There are strict dietary restrictions associated with this type of anesthesia. You must not have anything to eat or drink anything including water, for six hours before the appointment. If you are prescribed medications to be taken an hour before the appointment then you will take them with a sip of water.

We recommend you wear comfortable and loose fitting clothing on the day of surgery so that we can easily place monitoring devices (short sleeve shirts are helpful).