Anesthesia at OMSAMI

Your Comfort and Safety Are Our First Priority

At Oral & Maxillofacial Surgery Associates of Michigan, our surgeons — Dr. Vejayan Krishnan, Dr. Aaron Ruskin, and Dr. Zaid Abu-Seir — are among the most comprehensively trained specialists available when it comes to anesthesia. Unlike most dental providers, oral and maxillofacial surgeons are specifically educated and clinically trained to administer every level of anesthesia, from simple numbing to full general anesthesia, right here in our offices in Farmington Hills, Brighton, and Canton.

Whether you are coming in for wisdom teeth removal, dental implants, or a more complex surgical procedure, we want you to feel informed, confident, and at ease. This page covers everything you need to know about anesthesia at OMSAMI.

Why Our Surgeons Are Uniquely Qualified

Following dental school, oral and maxillofacial surgeons (OMS) complete a minimum of four years of training in a hospital-based surgical residency program alongside medical residents in general surgery, anesthesia, and other medical specialties. During this time, OMS residents evaluate patients for anesthesia, deliver the anesthetic, and monitor post-anesthetic patients during their medical anesthesiology rotation. In addition, OMS residents evaluate their own patients and perform procedures alongside administering the anesthesia.

As a result of this extensive training, every oral and maxillofacial surgeon is well-prepared to appropriately administer local anesthesia and all forms of sedation, including general anesthesia. Your OMS is experienced in airway management, endotracheal intubation, and establishing and maintaining intravenous lines, as well as managing complications and emergencies that may arise during the administration of anesthesia.

In addition to their residency training, our surgeons hold the required state anesthesia permits to administer sedation and general anesthesia in an office setting — a separate credentialing process above and beyond a surgical license that involves formal office inspections, equipment requirements, and staff training standards. This is not a credential that general dentists automatically hold.

Understanding Anesthesia: The Different Levels

Different procedures require individual levels of anesthesia. Our surgeons will discuss all anesthesia options with you before your surgery so you understand exactly what to expect.

Local Anesthesia

Local anesthetics affect only a small portion of the body, working to numb the area so the patient does not feel pain. Lidocaine is a common numbing medication that is injected directly into the affected area and takes effect quickly. Patients are fully conscious and aware during local anesthesia but should not feel any discomfort. It is typically used for simple tooth extractions.

Minimal Sedation — Nitrous Oxide

This method combines local anesthesia with the calming effects of nitrous oxide, also known as “laughing gas.” A mixture of nitrous oxide and oxygen is breathed through a mask or nosepiece, allowing a patient to remain aware during the procedure while staying relaxed. Patients with anxiety about dental care often prefer this option for simple procedures, and it is also available for more involved procedures such as dental implant placement or wisdom teeth removal.

Moderate Sedation — “Twilight Sedation”

Sometimes referred to as “twilight sedation,” intravenous (IV) moderate sedation places a patient in a state between awake and asleep, drifting in and out of consciousness. Although patients are partially conscious, few remember anything from the procedure other than feeling sleepy and relaxed. Moderate sedation is commonly used for procedures such as removal of impacted wisdom teeth and generally leads to a quick recovery with minimal anesthesia side effects.

Deep Sedation

Deep sedation is a drug-induced depression of consciousness during which a patient cannot be easily aroused but can respond to repeated stimulation. This level is appropriate for more involved procedures or for patients with significant dental anxiety, and is carefully monitored throughout by our clinical team.

General Anesthesia

The combination of medications used to put patients completely to sleep before surgery is called general anesthesia. Under general anesthesia, patients are completely unconscious — though they typically feel as though they are simply falling asleep. The key difference is that the patient does not respond to reflexes or pain signals. Our surgeons administer and manage general anesthesia in our office setting with the same rigorous monitoring used in a hospital or surgical center. myoms

Safety in Our Offices: Our Standard of Care

At its core, a culture of safety means patient safety is the number one priority, and the policies and actions of every doctor and staff member in the practice are focused on that objective. At OMSAMI, this commitment is built into every aspect of how we operate. myoms
Pre-surgical evaluation. Before every procedure, your surgeon reviews a complete medical history on the date of surgery, evaluates all significant findings, and documents a brief physical evaluation — especially of the heart and lungs — along with your airway assessment, baseline vital signs, and fitness for the planned level of anesthesia.

Dedicated Monitoring: During any procedure involving sedation, a trained clinical team member is assigned exclusively to monitoring your vital signs from start to finish — separate from the surgeon performing your procedure.

Emergency readiness: Our offices are fully equipped with emergency medications, reversal agents, oxygen, and advanced airway equipment. All clinical staff maintain current BLS certification, and our surgeons hold ACLS certification.

Permitted and inspected offices: Our offices have passed formal state inspections for anesthesia safety, equipment, and staffing — a requirement of Michigan’s anesthesia permitting process and a standard aligned with AAOMS guidelines. Patients also play a vital role in the culture of safety. Be forthcoming about your full medical history and all medications, supplements, and herbal remedies you take. Your safety depends on it — and our surgeons want to know everything relevant to make your experience as safe as possible.

Before Your Procedure: How to Prepare

Proper preparation helps ensure a smooth, safe experience. Depending on the type of anesthesia you are receiving, instructions will vary. If you are receiving moderate sedation, deep sedation, or general anesthesia, the following generally applies:

Do not eat or drink anything for at least 6–8 hours before your procedure (your surgeon will give you specific timing)

Inform us of all medications, supplements, vitamins, and herbal products you take
Disclose any personal or family history of reactions to anesthesia
Stop certain medications before surgery if instructed (such as blood thinners — your surgeon will advise)

Arrange for a responsible adult to drive you home and remain with you for the rest of the day — you will not be permitted to drive after sedation or general anesthesia. Wear comfortable, loose-fitting clothing to your appointment. Arrive on time so our team can complete your pre-operative evaluation before proceeding.

Before your surgery, your surgeon will review the type of anesthetic to be used and the way you are likely to feel during and after the procedure. This is the time to discuss any concerns you have. It is vitally important that you share your medical and anesthesia history, as well as any known family issues with anesthesia.

After Your Procedure: What to Expect

Recovery depends on the type of anesthesia used. Patients who receive local anesthesia or nitrous oxide typically feel close to normal within a short time. If you received IV sedation, deep sedation, or general anesthesia, expect the following for the rest of the day:

Drowsiness, grogginess, or light-headedness for several hours

Possible nausea, which usually resolves within a few hours. The need to rest at home — no driving, operating machinery, or making important decisions for at least 24 hours. A responsible adult should be available to stay with you.

After surgery, you may be prescribed medication to keep you comfortable at home. Most patients describe their experience during surgery as comfortable and surprisingly pleasant. Our team will provide written post-operative instructions before you leave, and we will follow up with you after your procedure. Please follow all instructions carefully — they are designed to support healing and minimize any risk of complications.

Risks and Benefits of Anesthesia

As with any medical procedure, anesthesia involves both meaningful benefits and potential risks. Our team takes every precaution to minimize risk, and serious complications are rare.

Benefits include:

• Complete elimination of pain and discomfort during surgery
• Significant reduction in anxiety, especially for patients with dental phobia or fear
• The ability to complete complex or lengthy procedures safely and efficiently in a single visit
• Better surgical outcomes when the patient is comfortable and still

Potential risks include:

• Nausea and vomiting (the most common side effect)
• Temporary dizziness, headache, or grogginess following the procedure
• Soreness or minor bruising at the IV site
• Allergic reactions to anesthetic agents (rare)
• Respiratory complications in patients with certain underlying conditions such as sleep apnea, obesity, or asthma (rare, and screened for in advance)
• Aspiration — prevented by strict fasting instructions before surgery

The overwhelming majority of patients receive anesthesia at OMSAMI without any significant complications. Before your procedure, your surgeon will conduct a thorough medical review and assess any individual risk factors to determine the safest approach for you specifically.

We Are Here to Answer Your Questions

An informed patient is a safe patient. If you have any questions or concerns about anesthesia before your appointment, please contact any of our three offices — in Farmington Hills, Brighton, or Canton. Our surgical team is happy to walk you through your options and make sure you feel fully prepared and confident going into your procedure.

Farmington Hills: 248-553-3280
Brighton: 810-229-9600
Canton: 734-656-2500
Or email us at info@omsami.com

The information on this page is intended for general educational purposes and does not constitute medical advice. Please consult with your OMSAMI surgeon regarding the specific anesthesia approach best suited to your individual health history and procedure.