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Office-Based Anesthesia in Texarkana & Paris TX

The safety and comfort of our patients during surgery are central to our success and our patient’s satisfaction. We provide anesthesia services to make the surgical procedure as smooth, pleasant, and safe as possible. We can customize the anesthesia to the patient’s level of anxiety.

Local Anesthetic

Local anesthetics numb the area for simple procedures such as easy, non-surgical tooth extractions or minor gum procedures. The patient is fully conscious throughout the procedure. A local anesthetic such as lidocaine is always used for oral surgery, usually in conjunction with some form of sedation. Local anesthetics prevent pain but do not sedate the patient, relieve anxiety, or dampen the unpleasant sounds sometimes associated with oral surgery. Local anesthesia alone (without additional anesthetics) is usually reserved for a patient who cannot safely tolerate IV anesthesia due to poor health, advanced age, or morbid obesity.

Nitrous Oxide (Laughing Gas)

Nitrous oxide is both a sedative and a pain reliever. For minor oral surgeries, nitrous oxide can take the edge off patient anxiety. The patient is relaxed but conscious during the procedure. If you have mild dental anxiety, nitrous oxide can relax you before starting an IV or a very minor procedure. The effectiveness of nitrous oxide can vary widely among patients and, therefore, can be unreliable.

Office-Based General Anesthesia

This is often referred to as IV sedation. The medications are given through an intravenous line (IV) directly into the bloodstream. Patients are semi-conscious or unconscious throughout their procedure and unaware of their surroundings. Most patients for wisdom teeth removal or dental implants, surgical extractions, or bone grafts prefer IV sedation.

Anesthesia Safety Backed by Training and Expertise

To administer general anesthesia in the office, an oral surgeon must have completed at least three months of hospital-based anesthesia training during the oral and maxillofacial surgery residency program. This training is in addition to the four years of outpatient anesthesia experience obtained during the training program. General dentists do not have this level of training. They are not as experienced with the various forms of anesthesia needed for patient comfort and safety, nor do they have the necessary skill set to handle an unexpected complication or emergency.


The American Association of Oral and Maxillofacial Surgery (AAOMS) and the Texas Society of Oral and Maxillofacial Surgeons (TSOMS) require an office anesthesia evaluation every five years. All team members must be CPR-certified and have advanced emergency training led by the oral surgeon. In addition, Dr. BunelDr. DukeDr. LeganDr. Hastings and Dr. Burks must maintain Advanced Cardiac Life Support certification and obtain 12 hours of anesthesia continuing education every two years as required by the Texas State Board of Dental Examiners. Further, our anesthesia assistant personnel have completed the Dental Anesthesia Assistant National Certifying Examination (DAANCE).

Dental Anxiety and Sedation

Between 10% and 20% of people in the U.S. avoid trips to the dentist or oral surgeon because of dental anxiety. For some patients, anxiety escalates into a dental phobia, which is more serious and can leave a patient paralyzed with fear. We treat patients with various levels of dental anxiety or phobia.

At Oral and Maxillofacial Surgeons of Northeast Texas, our goal is to provide our patients with stellar results without anxiety. As oral surgeons, we utilize various forms of sedation to relieve our patients’ stress and relax them so surgery and recovery go smoothly. If you suffer from dental anxiety or phobia or find oral surgery unpleasant, discuss this with us at your first appointment so we can develop an appropriate treatment plan, including sedation.

Wisdom Teeth and Anesthesia

Most patients having their wisdom teeth removed prefer IV sedation. Patients undergoing IV sedation need to be accompanied by a responsible adult on the day of surgery, as it takes a while for the sedation to wear off. You should rest at home and not drive or operate machinery in the first 24 hours after receiving general intravenous sedation.

Other procedures commonly performed under IV anesthesia or nitrous oxide include:

What is the best type of dental sedation?

The best sedation is the one that works for you. It depends on the nature of the surgical procedure, the level of your anxiety, and your health. Drs. Bunel, Duke, Legan, Hastings and Burks regularly administer IV sedation to their patients. IV sedation provides a deeper level of sedation. Your oral surgeon will review your options with you in detail before scheduling any procedures.

Can I request IV Sedation or General Anesthesia?

Yes, please let us know during your consultation appointment. We want you to be as comfortable and stress-free as possible during oral surgery.

How soon does the sedation wear off after oral surgery?

Nitrous oxide wears off within a few minutes after we stop administering it. You can usually drive yourself home after a procedure performed using laughing gas only.

IV sedation can take up to 24 hours to leave your bloodstream. After surgery, you are sleepy and may have difficulty with certain activities. You will need someone trusted to drive you home and ensure you are in bed or resting on the couch after IV sedation and oral surgery.

Are there any complications from IV Anesthesia?

Most patients do not experience lasting side effects from sedation. Our staff and surgeons monitor you at all times while under sedation and are trained and experienced in administering IV sedation. There are rare instances when you may temporarily experience side effects, including:

  • Persistent drowsiness
  • Dry mouth
  • Nausea or vomiting – we routinely give medication in the IV to prevent this.
  • Headaches
  • Bruising from the IV needle

Oral surgeons are fully trained in the administration of all forms of anesthesia. Their expertise ensures your safety and comfort under anesthesia. If you have questions regarding anesthesia for your upcoming surgical procedure, please discuss them with your surgeon at your first appointment. To schedule a consultation, call us:

Texarkana: 903-794-3331
Monday – Friday: 8:15 AM – 5:00 PM

Paris: 903-794-3331
Monday – Friday: 8:30 AM – 4:30 PM

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