For most patients, local anesthesia is completely sufficient. However, there are situations in which the thought of noises, smells, and the sensation of treatment represents an insurmountable hurdle. This may be due to a pronounced dental phobia, an extreme gag reflex, or because a very extensive operation is pending.
In these cases, general anesthesia (intubation anesthesia) is often the “reset button”: you fall asleep, and when you wake up, it is all over. But what actually happens in the body during this process? And is it safe?
More than just “deep sleep”: The medical principle
In contrast to twilight sleep (sedation), where you can still breathe and react, general anesthesia completely switches off your consciousness and sensation of pain. It is a controlled state managed by a specialist in anesthesiology. While we take care of your teeth, the anesthesiologist is exclusively responsible for your safety.
The medication cocktail usually consists of three components:
- Hypnotics: Induce deep sleep (loss of consciousness).
- Analgesics: Switch off pain throughout the entire body.
- Muscle relaxants: Relax the muscles so that no defensive reflexes occur.
The procedure: Safely through the three phases
General anesthesia follows a strict protocol that guarantees the highest level of safety.
Phase 1: Induction
You will receive intravenous access (usually on the arm or back of the hand). The anesthetic takes effect within seconds. The often-described “drifting into sleep” is usually perceived by patients as very pleasant and relieving.
Phase 2: Maintenance (Protection of the airways)
Since your respiratory drive and swallowing reflexes are switched off, we must protect your lungs. This is crucial, especially during work in the mouth where water and blood are present. The anesthesiologist inserts a breathing tube (endotracheal tube) or a laryngeal mask. You will not feel this, as you are already fast asleep. You are ventilated through this route, and the depth of anesthesia is controlled with millimeter precision. Vital signs such as heart rate, oxygen saturation, and blood pressure are monitored every second.
Phase 3: Emergence
As soon as the dental procedure is finished, the anesthesiologist stops the supply of 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
Even if you feel fit quickly in the recovery room: your body has performed heavy work and the medication continues to have an effect. For your safety, strict rules apply for 24 hours:
- Requirement for an escort: You may not leave the practice alone. It is mandatory to organize a person to pick you up, bring you home safely, and ideally look after you at home.
- Driving ban: You are unfit to drive. This applies to cars, but also to bicycles or e-scooters. Active participation in road traffic as a pedestrian can also be dangerous.
- No contracts: Legally, you are considered incapacitated for 24 hours. Do not sign any contracts or make any important financial decisions.
- Eating & drinking: Refrain from alcohol. Do not eat until the sensation in your mouth has completely returned to avoid biting yourself.
For whom is general anesthesia appropriate?
General anesthesia is a strain on the circulatory system and is therefore medically weighed. It is the method of choice for:
- Diagnosed odontophobia (pathological fear of the dentist).
- Extreme gag reflex, which makes treatment while awake impossible.
- Complex surgical procedures (e.g., removal of all four wisdom teeth at once or major implant surgeries).
- Physical or mental disabilities, where cooperation while awake is limited.
A word on costs: In cases of medical necessity (e.g., certified phobia, children under 12 years, disability), statutory health insurance often covers the costs. If the anesthesia is performed purely as a “comfort request,” it is usually a private additional service.
Are you afraid of treatment? Please speak to us openly. Together with our anesthesia team, we will find the path that is safe and stress-free for you.