Dental treatment under general anaesthetic

This leaflet provides detailed information for patients having their dental treatment under general anaesthesia (GA).

Having a general anaesthetic means that you are asleep during your dental treatment.

This information helps you to prepare for your dental surgery and understand what happens before, during and afterwards.

Where will I be seen?

You will be seen in the Day Case Unit at the Horton Hospital in Banbury.

You will have your general anaesthetic and leave hospital on the same day; you do not need to stay in hospital overnight.

How do I get there?

The Day Case Unit at the Horton General Hospital can be reached from the Oxford Road entrance.

Postcode: OX16 9AL

If you arrive by car, you will have to pay to park your car.

There is disabled parking in the main car parks.

Important information

You will need someone responsible to come with you to your appointment and take you home after your treatment.

They must be able to stay with you for at least 24 hours after you leave the hospital. You must not travel home by public transport.

If you do not have someone with you, your dental surgery might be cancelled.

Do not bring children, or anyone you need to look after, with you to the hospital.

Eating and drinking before your surgery

Please follow these instructions before your surgery. If you do not, your surgery might be cancelled.

• You must not eat any food, chew or suck sweets or have any drink with milk in it for 6 hours before your arrival time.
• You may drink clear fluids (such as water or squash) up to 2 hours before your arrival time.

If there is food or liquid in your stomach during your anaesthetic, it could cause choking or serious damage to your lungs.

The morning of your surgery

Please do:

• Wear loose and comfortable clothing and flat shoes. Bring spare clothes with you
• Bring any mobility aids, such as a walking stick or walking frame
• Take your medicines as normal, unless the dentist has told you otherwise. Bring your medicines with you.
• Remove any make-up or nail varnish / false nails.
• Make sure you have a supply of paracetamol and ibuprofen at home, if you can take these.
• Bring something to keep you occupied whilst waiting (book, magazine, phone, ipad).

Please don’t:

• Do not come to the hospital if you feel unwell. Please contact the Hospital first.
• Do not bring valuables or jewellery. If you have jewellery that cannot be removed, tell us so that we can cover it with tape before surgery.
• Do not smoke for at least 24 hours before your dental surgery.

At the hospital

Meeting the team

When you arrive at the Day Case Unit, a receptionist will take you to a room or bay on the ward.

A nurse may take your blood pressure and check your pulse.

We may ask you to wear a hospital gown and wear a name badge on your wrist / leg.

The doctor will talk to you about the general anaesthetic and confirm the plan for going to sleep.

The dentist will talk to you and confirm the plan for your dental treatment.

The team will try to keep waiting times to a minimum, but it is not always possible to know how long your wait will be.

During dental day surgery

The nurse may give you a drink, this should help you to feel more sleepy / relaxed.

The nurse will take you to the anaesthetic room, a family member or carer can come with you.

You will either walk, sit in a wheelchair or be transferred on the trolley.

If you wear glasses, hearing aids or dentures, you can wear them into the anaesthetic room.

The nurse will look after them during your surgery and return them to you afterwards.

In the anaesthetic room, we will check your name and attach some equipment to you to monitor your heart, blood pressure and breathing.

The anaesthetist gives you the anaesthetic medicine through a canula in your hand or arm or through a mask over your nose and mouth. You will go to sleep quickly.

The adult that came with you can then go back to the waiting room.

A team of doctors, dentists and dental nurses will take care of you and complete your dental treatment.

Your dental treatment

Dental examination

Once you are asleep, we will complete a thorough examination of your mouth including your teeth and soft tissues.

We will assess your oral health and identify any issues such as dental decay, gum disease or other dental problems.

We may take X-rays to aid our examination.

Dental x-rays

Dental x-rays are essential for diagnosing problems not visible and can help to show the following:

• Decay between teeth
• Bone loss associated with gum disease
• The position of teeth and roots.
• Presence of an abscess / infection

Advantages of dental x-rays

Identifying issues at an early stage, allowing for prompt treatment

Providing a complete view of teeth, roots and bone, aiding in thorough diagnosis and treatment planning

Disadvantages of dental x-rays

Though dental x-rays use radiation, the radiation levels used are exceptionally low. They are designed to minimize exposure while providing the necessary diagnostic information.

Scaling and polishing

Scaling involves removing plaque and tartar from the surfaces of the teeth to maintain gum health. Polishing involves removing superficial / surface staining.

Advantages of scaling and polishing

• Scaling removes tarter that brushing alone cannot eliminate
• Regular scaling helps to maintain healthy gums and prevent gum disease
• Polishing removes superficial / surface stains and can improve the appearance of your teeth

Disadvantages of scaling and polishing

• Temporary sensitivity of the gums, which may be tender and bleed slightly
• Teeth may be more sensitive to cold foods or drinks
• Gum recession: As the gums heal and are less inflamed the gums can retract away from the tooth over time

Fillings

When a tooth has dental decay or accidental damage / trauma, a filling can be used to restore its shape and function.

Not all teeth can be filled; sometimes removal of the tooth is necessary.

The process for a filling involves:

• Removing the decayed portion of the tooth or smoothing the part that has been damaged
• Cleaning the affected area
• Filling the cleaned cavity with the chosen filling material

Different materials can be used for fillings, including:

Amalgam (silver)

Composite (tooth coloured)

Glass ionomer (tooth coloured)

Each has its advantages and specific uses. Not every filling material is appropriate for every cavity and your dentist will choose the most suitable one for each cavity.

Advantages of fillings

• Fillings restore the structure and function of decayed teeth
• Fillings prevent further decay by sealing off cavities
• Amalgam fillings (silver) are durable, long lasting and can withstand significant chewing forces. They are used commonly for fillings in back teeth.
• Composite / glass ionomer fillings can try and match the tooth colour, providing a more natural appearance. They are mostly used for fillings on front teeth

Disadvantages of fillings

• It can be challenging to check the way your teeth bite together under general anaesthesia and this might feel different when you wake up. Fillings can be adjusted at a future visit if needed.
• The texture of filling materials can feel different to your natural teeth.
• Newly filled teeth can be sensitive to pressure, air, sweet foods or temperature.
• Over time fillings can crack or wear out, requiring repair or replacement.
• Some patients may have allergic reactions to the materials used.
• Large or deep fillings can irriate the nerve inside the tooth, leading to toothache.

Removal of teeth

Tooth removal is required when a tooth has deep decay or infection and cannot be saved.

If left untreated, the tooth may cause problems including pain or infection, which may lead to a repeat general anaesthetic.

Under general anaesthesia we will numb the tooth and surrounding area with local anaesthetic. Advantages of tooth removal

• Prevention or relief of pain or infection

Disadvantages and risks of tooth removal

Pain and discomfort: It is common to feel discomfort and swelling after tooth removal. This is usually worse for the first three days and it may take up to two weeks before all the soreness goes.

Bleeding: Minor bleeding from the extraction site is common. The risk of prolonged is increased for patients with bleeding disorders, high blood pressure or taking blood thinning medication.

Infection: This may develop after an extraction, causing pain, swelling, bad breath or fever.

Lip soreness and bruising: While the tooth is being removed there may be some pressure or stretching of the lip by the surgical instruments, which may cause temporary bruising.

Damage to nearby tooth or filling: Occasionally when a tooth is removed, the tooth or filling next to it may become chipped or loosened.

Dry socket: This occurs when the blood clot at the extraction site dislodges or dissolves, exposing the underlying bone. This most commonly occurs two to five days following extraction.

Delayed healing: Smoking, certain medications and poor oral hygiene can slow the healing process and lead to delayed healing or bone exposure.

Difficulty chewing: If multiple teeth have been removed, chewing may be harder until the mouth adjusts.

Changes in appearance: Teeth provide support for the soft tissues of the lips and cheeks so losing them can affect your smile and change your facial appearance.

Damage to surrounding teeth: There is a possibility of accidental damage to adjacent teeth/fillings during the extraction process.

Nerve injury: Nerves close to the lower back teeth can be bruised / injured, leading to temporary or (rarely) permanent numbness or tingling in the lips, tongue, or chin.

Sinus complications: Upper back teeth can be located close to or in contact with the sinus. Extractions may occasionally result in a small opening, which can lead to discomfort or infection and might require an additional procedure for repair.

Fractured jaw: This is very rare and usually only occurs when removing deeply impacted teeth in patients with weakened bones.

Recovery in hospital

When you wake up in the recovery room, you may have an oxygen mask over your mouth and nose.

This is normal after an anaesthetic; the oxygen helps to clear the anaesthetic from your body while you recover.

If you had teeth removed (extractions), you may have a fabric dressing in your mouth. There might be some blood.

We check your blood pressure, pulse and oxygen levels regularly while you are in the recovery room.

If you have any pain, discomfort or feel unwell, please tell your nurse. They can give you medicine to help.

Leaving the hospital

You can leave the hospital when your nurse thinks that you are well enough to go home. We will offer you squash or water when you feel ready.

The dental team will explain the treatment that you have had to you and the adult with you.

A nurse will explain how to look after your mouth and take any medicines that you need at home.

Please ask the dental or nursing team if you have any questions.

After you leave hospital

• Although you might feel fine, your reasoning, reflexes, judgement, coordination and skill can be affected for 48 hours after surgery.
• When you have left the hospital, you should not be left on your own. A responsible adult must stay with you for 24 hours.
• Please rest until the next day. Do not go to work or school on the day after your surgery.

For 48 hrs after surgery, do not:

• Drive any vehicle or ride a bicycle. This is a legal requirement.
• Operate any machinery, including domestic appliances.
• Cook, use sharp utensils (kitchen tools), pour hot or boiling liquids.
• Smoke or drink alcohol.
• Take sleeping tablets.
• Make any important decisions / sign any contracts / use the internet.
• Be responsible for children or other dependants.

Follow-up appointment

We will send a discharge letter explaining what dental treatment you have had to your local dentist or doctor.

We will send you an appointment letter for a review at your local community dental clinic three months after your general anaesthetic.

Getting in touch

If you have a cold or are unwell, please do not come to hospital but let us know as soon as possible so that we can rearrange your surgery.

If you need to contact us before your operation, please phone the Banbury Dental Clinic on 01865 904080.

If you need to contact us on the day of your operation, please phone the Horton Day Care Unit on 01295 229767 / 229239.