Why general anesthesia or “dentistry while asleep”?
Many people are unable to receive dental care due to fear and anxiety. General anesthesia, also known as “dentistry while asleep” can help both adults, children and people with disabilities/special needs or conditions to have dental work completed while unconscious “asleep”.
Sleep dentistry can help a patient have dental treatment done so that treatment needed isn’t left and in turn resulting in teeth becoming worse and flaring up, breaking down or needing to be extracted. Sleep dentistry allows a person to have their dental treatment completed in one appointment, which can contribute to optimal oral health for themselves.
Sleep dentistry can be used for restorations (fillings), root canal treatment, cleanings, teeth extractions, and cosmetic procedures such as crowns, veneers.
Our anesthetist, Dr. Gizzarelli, BScPhm, DDS, MSc (Dental Anaesthesia)
Dr. Gino Gizzarelli, is very approachable and friendly. On the day of your appointment, before you go to sleep you will meet Dr. Gizzarelli. He will discuss your general anesthesia, and will answer any questions you have.
For nervous adults, Dr. Gizzarelli can provide you with an oral sedative to help relax prior to the general anesthesia. For younger patients, Dr. Gizzarelli can use gas inhalation with different flavours. In recovery, a nurse will assist Dr. Gizzarelli in monitoring the patient until it is ok for them to leave.
Dr. Gino Gizzarelli’s Biography
Dr. Gino Gizzabelli completed his first degree in 1995 at the University of Toronto in Pharmacy. He worked as a full-time clinical pharmacist at Toronto General Hospital for 2 years before returning back to the University of Toronto to study dentistry. Following his dental degree in 2001, he continued his studies in the same university and completed a 3-year Master’s degree in Dental Anesthesia. During these 3 years, Gino trained in the operating rooms of the Hospital for Sick Children and Toronto East General Hospital. Throughout his studies and until present, Gino has maintained a part-time clinical pharmacist position at Toronto General Hospital. Dr. Gizzarelli is a member in good standing with the Royal College of Dental Surgeons of Ontario, the American Society of Dentist Anesthesiologists, and the Canadian Academy of Dental Anaesthesia. Dr. Gizzarelli is a diplomat of the American Dental Board of Anesthesiology and the National Dental Board of Anesthesiology. He is a certified specialist in dental anesthesia (in Ontario). He is an itinerant dentist anesthesiologist and teaches occasionally at the University Of Toronto Faculty Of Dentistry and at various conferences and CE courses.
- People who have dental anxiety/fear
- People who have a fear of needles and/or the drill
- The younger patient
- The younger patient who may have a lot of dental work and being able to complete treatment in one comfortable visit
- People with disabilities or other conditions which could make it difficult to receive dental treatment
- People who have had a traumatic previous dental experience, “bad memory”
- People with very sensitive teeth
- People who have a strong gag reflex
- People who have a lot of work to be completed and what to have treatment completed in one easy visit (or fewer visits on work needed)
- People who have fear of noises, smell and taste
- Can help in surgical procedures such as wisdom teeth extractions
How does it work with my dental insurance?
Our office will help you in understanding your dental coverage:
- If you have insurance we will send in an estimate for you for your work needed along with general anesthesia that is required to get a preapproval prior to your appointment so that you are aware of your coverage. We accept insurance payments directly. Most insurance companies allow this. Having your dental fees paid directly to the dentist allows you to keep your own personal finances for other expenses like grocery bills, mortgage payments, or vacation plans. Although some insurance companies do cover 100% of all dental care, most insurance companies have plan limits. The limit can be in the form of percentage of fee covered, deductible, maximum allowance per year, fee guide limitations, or only covering select services. Simply contact our office (705) 707-2050 and speak to Jeannie, she will help you determine your insurance coverage once we receive the estimate back from your insurance company.
- If you have ODSP insurance if over 18 and Healthy Smiles Program if under 18 in our experience these programs cover general anesthesia.
- If you have no dental insurance we will provide you with a detailed written estimate of work needed and the associated costs.
What to expect before the sedation/anesthesia appointment?
- DO NOT EAT SOLID FOOD (including gum, candy) IN THE 8 HOURS PRECEDING THE SEDATION/ANAESTHETIC APPOINTMENT.
- DO NOT DRINK MILK, JUICES OR COFFEE IN THE 8 HOURS PRECEDING THE SEDATION/ANAESTHETIC APPOINTMENT.
Food in the stomach may result in vomiting and subsequent pneumonia during anesthesia. This is unsafe and can be fatal.
You may drink 1 -2 cups of water or apple juice up to 3 hours before the appointment. No other liquids are permitted.
A light meal is strongly recommended for the evening before the anaesthetic appointment.
- Take your medication as usual with a sip of water unless otherwise directed.
- If you are diabetic, please inform your dentist or myself ahead of time.
- Wear short sleeves, loose fitting clothing and flat shoes.
For appointment longer than 2-3 hours, please bring a complete change of clothing.
- Do not wear contact lenses; do not wear make-up, nail polish or hand/face creams/lotions.
- Please advise of any recent change in your health such as fever, vomiting, diarrhea, cold, or flu in the days before your appointment.
- Please confirm the person who will be taking your home that day. A taxi driver alone is NOT sufficient. If no arrangements are made, your appointment will be cancelled.
- Please call if you have any questions or concerns 1 (416) 839-4777.
What to expect during the sedation/anaesthesia appointment?
Before going to sleep, various monitors such as a blood pressure cuff will be placed on your arm and a sensor will be placed on your finger. A small intravenous catheter is placed usually in the back of the hand. Sedative medications are usually given intravenously and by inhalation on occasion. When you first wake up, it is normal to feel disoriented and dizzy. It usually takes 20-60 minutes to be alert enough to go home safely.
What to expect after the sedation/anaesthesia appointment?
- A responsible adult must accompany you home in a car or taxi.
- Rest of the reminder of the day. DO NOT WORK OR DRIVE OR MAKE IMPORTANT DECISIONS FOR 24 HOURS FOLLOWING ANAESTHESIA. Ideally a responsible adult should be with you until the next day.
- Drink plenty of fluids (water, juice) after anaesthesia but begin with frequent and small quantities. Do no drink alcoholic beverages for 24 hours after your visit. If you are not experiencing any nausea or vomiting, you may eat solid foods as tolerated (please begin with light or easily digested foods).
- The area where the IV catheter was placed may be bruised for a few days after your visit.
- If there is local anaesthetic (‘freezing”): be careful not to bite your lips, cheek or tongue.
- A sore throat is common after an anaesthetic.
- Resume prescribed medications after the anaesthetic.
- If there are questions or concerns after the appointment, please do not hesitate to call.
For children that need dental treatment, general anesthesia it can be a great option to help them in having work completed effectively, quickly and most often in one appointment. Dr. Gizzarelli will come and greet you and your child and see if there are further concerns or questions.
What to expect for your child before the sedation/anesthesia appointment?
- DO NOT ALLOW YOUR CHILD TO EAT SOLID FOOD (including gum, candy) IN THE 8 HOURS PRECEDING THE ANAESTHESIA APPOINTMENT.
- DO NOT ALLOW YOUR CHILD TO DRINK MILK OR JUICES IN THE 8 HOURS PRECEDING THE ANAESTHESIA APPOINTMENT. Food in the stomach may result in vomiting and subsequent pneumonia during anaesthesia. This is unsafe and can be fatal. Your child may drink up to 1 cup of water or apple juice up to 2 hours before the appointment. No other liquids are permitted.
- Medications can be taken as usual with a small sip of water unless otherwise directed.
- If your child is diabetics, please inform your dentist or myself ahead of time.
- Dress with loose fitting clothing & please bring a diaper or a change of clothes.
- Please advise us of any recent change in your child’s health such as fever, cold, or flu?
- Please call if you have any questions or concerns (416) 839-4777.
What to expect for your child during the sedation/anaesthesia appointment?
- Your child will be given oxygen and usually sleep medicine through the mask to breathe.
- Most children toss/turn, stretch out their arms, roll their eyes and their breathing patterns will change as they are going off to sleep.
- After they are asleep, an intravenous catheter will be placed in their hand or foot that allows fluids and medication to be given.
- A breathing tube may be placed in the nose.
- Your child will be completely asleep for the entire procedure and no one is allowed to remain in the treatment area after your child is asleep.
What to expect for your child after the sedation/anesthesia appointment?
- It usually takes approximately 30-60 minutes after the anaesthestic before your child can go home safely. It is not uncommon for your child to cry when they wake up as they are still dizzy and disoriented. The IV catheter will be in place until your child is awake.
- A responsible adult must accompany your child home in a car or taxi.
- Your child should be resting at home for the remainder of the day. They should not run or ride a bike until the next day.
- Give your child fluids (water, juice) after anaesthesia, begin with frequent & small quantities. If your child is not experiencing any nausea or vomiting, they may drink milk and eat solid food as tolerated (please begin with easily digested foods).
- A sore throat or sore nose is common after anaesthesia and will resolve on its own.
- If there is discomfort: Tylenol, Advil, Or Motrin may be given based on their age & weight. If nausea or vomiting: Gravol may be given based on your child’s age & weight.
- Please do not hesitate to call: if your child vomits beyond 12 hours, if there is fever longer than 24 hours, if there is any difficulty breathing or if there any other concerns.