Patient Intake

Eating and drinking

It is extremely important that patients have nothing to eat or drink before the scheduled appointment. Failure to strictly follow these instructions could result in aspiration and may be fatal.

• No food or drink after 10 pm the day before surgery.
• Medications should be taken with sips of water.

Clothing

• Wear a short-sleeve loose shirt and comfortable pants.
• Children should wear a T-shirt and pajama pants.
• Do not wear makeup, nail polish, or fake eyelashes.
• Contact lenses must be removed before anesthesia.
• Do not bring anything valuable or wear any jewelry.

Change in health or medications

A change in health, especially a cold, cough, or fever, is EXTREMELY important. Please notify our office of any change in health. Your appointment may need to be rescheduled.

Transportation

If you are the patient receiving sedation, you MUST have a separate person take you home after the procedure. You cannot transport yourself home, so please arrange transportation ahead of time.

Activity

The patient may feel sleepy for several hours and may nap throughout the day. The patient should not drive, ride a bike, swim, jump on trampolines, sign contracts, or do anything requiring full coordination for at least the rest of the day. Normal activities can usually resume the day after surgery.

Fever

The patient may become flushed with a slight fever after anesthesia. Keep the patient indoors in a cool place for the rest of the day.

Diet

Begin slowly with mild, clear liquids (water, Gatorade, soda). Slowly introduce more solid foods through the day. Avoid meat or dairy for 2 to 3 hours. The dentist may have additional dietary restrictions depending on the dental work done.

IV site

A small percentage of patients have tenderness or redness at the IV site after surgery. Bruising is common and expected, but swelling or increasing redness is not normal.

Sore throat or nose

A breathing tube is normally placed through the right or left side of the nose. Redness or small amounts of blood when the patient blows their nose is normal. The patient may also have a sore throat or nose for up to 3 days after surgery.

Pain or discomfort

Some discomfort or pain after dental treatment is common. IV pain medications given during surgery generally wear off within a few hours. The dentist may have given local anesthesia, so parts of the mouth may be numb. If pain persists despite the recommended pain medications, contact the dentist.

Nausea or vomiting

Nausea and vomiting occasionally occur after anesthesia. If this happens after discharge, restrict to clear liquids until nausea passes. If vomiting persists beyond 4 hours, contact the anesthesiologist.

Bleeding

Follow the dentist's instructions on bleeding after the procedure. If bleeding lasts longer than expected or seems excessive, contact the dentist.

1. Drowsiness, poor coordination, impaired judgment. Usually self-resolving, but take precautions to avoid injury during this period.
2. Nausea and vomiting. Some studies indicate 15 to 30% of patients experience this. Notify the office if vomiting persists beyond 6 hours.
3. Confusion. Pediatric patients may wake up confused, kicking, and screaming. This is usually self-resolving.
4. Sore throat and nose. A breathing tube may cause soreness for a few days.
5. Nose bleed. A breathing tube through the nostril may cause minor bleeding that usually resolves within 1 to 2 days.
6. Markings on the face. Tape is used to secure the breathing tube, protect the eyes, and secure IV sites. Minor skin reactions to adhesive may occur.
7. Lip swelling. Common after full-mouth dental treatment and usually resolves within a couple of days.

Complications and risks

Any medication can cause an allergic reaction. Even severe reactions can usually be treated early enough to keep you safe. Rare but severe problems from general anesthesia include kidney injury, heart attack, pneumonia, nerve damage, and stroke, and could lead to death.

Aspiration of stomach contents

Stomach contents can drain into the lungs during anesthesia and cause serious complications. You (or the patient) MUST not eat or drink for the time set by the anesthesiologist, generally AT LEAST 8 hours before anesthesia. Pediatric patients must be watched closely during this period so they do not eat or drink anything unattended.

After anesthesia

Confusion, impaired judgment, poor coordination, and sedation may last several hours. You (or the patient) must stay near and under the supervision of a responsible adult for at least 24 hours, and must not drive, operate dangerous devices, exercise, play sports, ride a bicycle, or do similar activities.

This information is provided to the patient (or the parent or guardian of a patient under 18) about the choices and risks of dental treatment under anesthesia in an office setting (Office-Based Dental Anesthesia), so you can make an informed decision. You have the right to accept, refuse, or request information about the proposed anesthesia and any alternatives.

1. No treatment. You may refuse any and all treatment or anesthesia. This has no risk of treatment or anesthesia complications, but withholding or delaying treatment of dental decay or other problems may have adverse oral or systemic health consequences.
2. Awake dental treatment. Dental care fully awake, without sedation or general anesthesia. No sedation or anesthesia risk. Numbing injections may still be used. An anesthesiologist is not needed.
3. Office-based dental anesthesia. Dental treatment under anesthesia provided by an anesthesiologist in your dentist's office, which allows deeper levels such as deep sedation or general anesthesia. Risks are described below.

Authorization and request to provide anesthesia

I hereby authorize and request Dr. Ji Yoon Choi and Dr. Vy Le to perform the anesthesia and any other procedure deemed necessary or advisable as a corollary to the planned anesthesia. I consent to, authorize, and request the administration of such anesthetic or anesthetics (local to general) by any route or technique deemed suitable by the anesthesiologist. I understand the anesthesiologist will have full charge of the administration and maintenance of the anesthesia, and that this is independent of the surgery/dentistry. The anesthesiologist may refuse to provide anesthesia for any risks or perceived risks to the patient which, in his or her sole discretion, may outweigh the benefits.

I understand that the most frequent side effects of any anesthesia are drowsiness, nausea, vomiting, and phlebitis. Most patients remain drowsy for the rest of the day, and coordination and judgment will be impaired for as long as 24 hours. Children should remain with a responsible adult during this period. Phlebitis is a raised, tender, hardened, inflammatory response at the IV site. It usually resolves with warm moist heat, though tenderness and a hard lump may be present for up to a year.

I have been informed that on rare occasions anesthesia-related complications include, but are not limited to: pain, hematoma, numbness, infection, swelling, bleeding, discoloration, nausea, vomiting, allergic reaction, and pneumonia. I further acknowledge, understand, and accept the extremely remote possibility that complications may require hospitalization and/or result in brain damage, heart attack, or death. I understand the risks of local anesthesia, conscious sedation, and general anesthesia vary, with local anesthesia usually considered the least risky and general anesthesia the most.

I understand that anesthetics, medications, and drugs may be harmful to an unborn child and may cause birth defects or spontaneous abortion. I accept full responsibility for informing the anesthesiologist of a possible or confirmed pregnancy, which will require postponing the anesthesia. For the same reason, I must inform the anesthesiologist if I am a nursing mother.

Since medications, drugs, anesthetics, and prescriptions may cause drowsiness and incoordination, I have been advised not to use alcohol or other drugs for 24 hours, and not to make any major life decisions or operate any vehicle or hazardous device for at least 24 hours until fully recovered. I have been advised of the necessity of direct one-on-one parental supervision of my child for 24 hours following anesthesia.

I have read and understood the risks, benefits, and alternatives of anesthesia in a dental office setting. I understand I have the right to ask questions, request information, consider any risks, request alternative treatment options (including no anesthesia), request more time to consider, and make an informed decision. I acknowledge receipt of and understand both the pre-operative and post-operative anesthesia instructions. I am satisfied with the information given to me and I consent to the anesthesia.

I understand that there is no warranty or guarantee as to any result or cure. Anesthesia services are completely independent from the operating dentist's procedure. The anesthesiologist assumes no liability for the surgery/dental treatment performed under anesthesia, and the dentist assumes no liability for the anesthesia.

I request that my physicians release to the anesthesiologist any information they desire regarding my diagnosis, treatment, prognosis, and recommendations, and other data pertinent to my surgery and anesthetic management. I authorize the anesthesiologist to speak with my spouse, parents, or children regarding any phase of my treatment. I have received a copy of the instructions and this consent.

Patient, parent, or legal guardian: I have read and understood the possible risks, benefits, and alternatives to in-office dental anesthesia for my (or my child's) procedure. I have had ample opportunity to review this consent, ask questions, and make an informed decision. I am satisfied with the information given, and I consent to receiving all levels of anesthesia.