When fear becomes overwhelming: safe sleep with general anesthesia

For most patients, local anesthesia is completely sufficient. However, there are situations in which the thought of the sounds, smells, and sensations of treatment becomes an insurmountable hurdle—whether due to severe dental phobia, an extreme gag reflex, or because a very extensive surgical procedure is required.

In such cases, anesthesia (intubation anesthesia) is often the “reset button”: you fall asleep, and when you wake up, everything is finished. But what actually happens in the body during this process? And is it safe?

More than just “deep sleep”: the medical principle

Unlike twilight sedation, where you can still breathe independently and respond, general anesthesia completely switches off consciousness and pain perception. It is a controlled medical state managed by a specialist in anesthesiology. While we focus on your dental treatment, the anesthesiologist is exclusively responsible for your safety.

The medication cocktail usually consists of three components:

1. Hypnotics: induce deep sleep (loss of consciousness).
2. Analgesics: eliminate pain throughout the body.
3. Muscle relaxants: relax the muscles to prevent defensive reflexes.

The procedure: safely through three phases

General anesthesia follows a strict protocol to ensure maximum safety.

Phase 1: Induction

You receive intravenous access (usually in the arm or on the back of the hand). The anesthetic takes effect within seconds. The often-described “drifting into sleep” is generally perceived by patients as very pleasant and relieving.

Phase 2: Maintenance (airway protection)

Since your breathing drive and swallowing reflex are switched off, your lungs must be protected. This is especially crucial during dental procedures, where water and blood are present in the mouth. The anesthesiologist inserts a breathing tube (endotracheal tube) or a laryngeal mask. You do not feel this, as you are already deeply asleep. Through this airway device, you are ventilated, and the depth of anesthesia is precisely controlled. Vital signs such as heart rate, oxygen saturation, and blood pressure are continuously monitored.

Phase 3: Recovery

As soon as the dental procedure is completed, the anesthesiologist stops administering the medication. You usually wake up within a few minutes. For you, it feels as if only a moment has passed—even if the surgery lasted for hours (amnesia effect).

The 24-hour rule: behavior after the procedure

ven if you feel fit quickly in the recovery room, your body has undergone significant strain and the medication continues to take effect. For your safety, strict rules apply for 24 hours: strenge Regeln:

• Escort required: You may not leave the practice alone. You must arrange for someone to take you home safely and ideally stay with you afterward.
• No driving: You are not fit to drive. This applies to cars, bicycles, and e-scooters. Even active participation in traffic as a pedestrian can be risky.
• No legal decisions: For 24 hours, you are legally considered not fully capableof making binding decisions. Do not sign contracts or make important financial decisions.
• Eating & drinking: Avoid alcohol. Do not eat until full sensation has returned to your mouth to prevent accidental biting.

Who is general anesthesia suitable for?

General anesthesia places strain on the cardiovascular system and is therefore carefully evaluated from a medical standpoint. It is the method of choice in cases of:

• Diagnosed odontophobia (severe dental phobia).
• Extreme gag reflexthat makes treatment while awake impossible.
• Complex surgical procedures (e.g., removal of all four wisdom teeth at once or major implant surgeries).
• Physical or cognitive disabilitiesthat limit cooperation while awake.

A word about costs: If there is a medical indication (e.g., certified phobia, children under 12 years of age, disability), statutory health insurance often covers the costs. If anesthesia is requested purely for comfort reasons, it is usually considered a private additional service.

Are you afraid of treatment? Speak to us openly. Together with our anesthesia team, we will find the safest and most stress-free solution for you.

Information about anesthesia options in our practice.