Can I drive after a tooth extraction?

Why can a tooth extraction affect driving ability?

There is a variety of ways that a dental procedure like an extraction can affect someone’s ability to drive.  

Dentists and oral surgeons work hard to ensure that every tooth is removed painlessly and with a minimum of trauma to the surrounding tissue and structure. In order to do so, they will utilize the most appropriate types of anesthesia and supportive sedation measures. In some cases, the type of anesthesia and sedation treatments used will mean that the patient can’t drive a vehicle afterward.

Local V General anesthetic

Based on a comprehensive evaluation of the patient, the dentist will decide if the tooth extraction should be performed in the dental office or hospital with either a local or general anesthetic. If a local anesthetic is used alone then the patient will be permitted to drive immediately after the dental appointment. If the extraction is done under a general anesthetic, the patient should not drive for at least 48 hours afterward.

If a patient is fearful of needles or is sensitive to the pain caused by a local anesthetic injection, the dentist will suggest using sedation techniques to support the patient during the tooth extraction.

Conscious Sedation

If the tooth extraction is likely to be a difficult surgical extraction, or if you are particularly anxious about the procedure, your dentist might recommend the use of sedation agents to make sure you are comfortable right through the procedure. 

However, it is important to know that although sedation techniques are very effective at relaxing and calming the patient during the tooth extraction, some methods do directly target the brain and nervous system. This means that certain sedation options will have after-effects that impair your clarity of thought and judgment to an extent that you will not be permitted to drive yourself home.

Complications

Another risk following a dental extraction that could affect driving is prolonged bleeding.  If patients have trouble clotting because they take blood thinners or have a clotting disorder, they will bleed longer than normal.  Excessive bleeding can lead to light-headedness, drowsiness, and an impaired ability to drive.

General Health

For some patients, their overall health condition could predispose them to weakness following a dental extraction.  For example, someone with abnormally low blood pressure would have a high risk for fainting and lightheadedness following any type of procedure and should not drive afterward.  

Due to the medications involved in the removal of a tooth and the after-care, your doctor performs a thorough medical history, discussing any potential interactions or side effects with the patient.  When a doctor anticipates this potential due to medical factors, he or she will alert the patient to the need for a driver.

Simple v complex tooth extractions

For most simple tooth extractions, a small amount of local anesthetic is usually sufficient to ensure that the patient experiences a comfortable procedure. In these cases, the patient will be fit and able to drive home safely.

However, tooth extraction procedures can vary widely in terms of complexity and time required.  And there are some scenarios where a local anesthetic alone is not suitable. Some examples include:

So although local anesthesia alone is a very effective and safe treatment for the prevention of painful sensations during a tooth extraction, it is not always sufficient by itself.

Before any tooth extraction procedure takes place, the dentist will need to do preliminary checks and evaluations. This includes a full mouth examination and a detailed study of your medical and dental history. Dentists will also assess the psychological state and anxiety levels of their patients by asking them how they feel about undergoing the tooth extraction and how well they have tolerated dental work in the past.

Based on the pre-assessment examinations, medical history, and detailed discussion regarding any anxiety or phobia issues, the dentist will recommend the most suitable anesthetic treatment.

Available treatments include –

If your treatment plan involves a general anesthetic or includes oral or IV sedation, then you will not be able to drive home.

Regardless of whether a patient elects to be sedated, all extractions involve the use of local anesthetic to eliminate painful sensations during the procedure. The patient should feel no pain until the local anesthetic’s effects wear off, which is typically several hours. 

The end of the visit will include very specific post-operative instructions for the patient to follow.  The dentist will give those to the patient’s driver or responsible party if the patient has been sedated.  After undergoing sedation, the doctor will instruct the patient not to drive for a minimum of twelve hours to ensure that all sedative medication has worn off.

Clear communication is necessary during a pre-operative appointment to explain the need for a responsible adult to drive the patient when oral or intravenous sedation is provided.  The dentist does have a right to refuse the treatment and should do so if a patient does not have another adult to drive him or her home following a procedure involving sedation

Driving after a general anesthetic

What is it? – General anesthesia produces a sedation that involves medically controlled unconsciousness of the patient.  An anesthesiologist administers sedative medications via inhalation mask or intravenous injection to eliminate pain and any other sensation during surgical procedures.  True inhalation sedation is a type of general anesthesia, not to be confused with laughing gas, which we describe below.

When is it used? – General anesthesia is used when a complicated surgical procedure requires complete unconsciousness and control of the patient.  General anesthesia is not commonly used in dentistry, and rarely, if ever, for a single tooth extraction.

How does it work? – General anesthetic medications block nerve signals in the brain and body to keep you from feeling pain or experiencing other sensations. 

Can you drive afterward? – No, not for some time.  Patients who undergo general anesthesia will be kept in a hospital or surgical facility until they are awake and dismissed to a responsible adult.

Driving after a local anesthetic

What is it? – Local anesthetic is a medication applied to a small area of the body for a localized effect.  It does not spread into the bloodstream or affect other areas of the body.  It causes a numb sensation so that the patient senses no pain in the affected area.

Local Anesthetic Only – When people choose to undergo no sedation during an extraction procedure, they still receive local anesthetic to inhibit sensations during the actual tooth removal.  Local anesthetic does not spread throughout the entire body, so it typically does not cause any drowsiness when used in the appropriate dosage.  Some studies, however, show a decreased braking time in patients following oral surgery, so there is minor potential for an effect on driving of which you should be aware.

When is it used? – Local anesthetic is used for many dental procedures and other medical procedures involving a small, localized area of the body.  Dentists use local anesthetic for fillings, dental crowns, root canals, and extractions, among other treatments.

How does it work? – Local anesthetic blocks nerve signals in a particular area.  Dentists are trained to isolate individual nerves in order to provide anesthesia (no sensation) to a specific tooth or teeth.

Can you drive afterward? – Yes!  Local anesthetic has no sedative or systemic effects on the body.

Driving after nitrous oxide

What is it? – Nitrous oxide is not a sedative but an anxiolytic (anxiety reducer).  This medication is inhaled through a nosepiece and is common in the dental office.  It produces a state of relaxation, but not sleep or unconsciousness.  Nitrous oxide is very safe and is often used to help children tolerate dental procedures.

When is it used?– Nitrous oxide provides a mild state of relaxation, helping patients who suffer from dental fear or anxiety to undergo their needed dental treatments.  It provides a sense of calm and reduced awareness of the sensations of a dental office, as well as a mild amnestic effect (people don’t remember the entire appointment and feel that time passed very quickly).

How does it work? – When inhaled, nitrous oxide produces an anxiety-reducing effect in the brain.  It is impossible to overdose on nitrous oxide, so it is one of the safest drugs used to help patients undergo treatment. 

Can you drive afterward? – Yes.  After treatment is complete, the patient breathes 100% oxygen for five minutes, which removes all nitrous oxide from the system.  There is no “hangover” effect or prolonged sedation.  Patients can drive themselves home after having breathed laughing gas.

Driving after Oral Sedation

What is it? – Oral sedation is a type of conscious sedation.  This means that a mild sedative produces a state of drowsiness or sleep, and the patient remains capable of responding, breathing, walking, etc…  Oral sedation is commonly used in dental offices to help patients fight dental fear and undergo the treatment they need.

When is it used?– Oral sedation is safe and effective, and many patients find it less intimidating than injected/intravenous sedation.  The idea of simply taking an oral medication seems less “scary” and appeals to many who desire to sleep through their dental procedures.

How does it work? – When inhaled, nitrous oxide produces an anxiety-reducing effect in the brain.  It is impossible to overdose on nitrous oxide, so it is one of the safest drugs used to help patients undergo treatment. 

Can you drive afterward? – No.  Oral sedative medications produce a prolonged sedative effect, and it is not safe for patients to drive after receiving them.  The dentist will not allow a patient to drive home after oral sedation and will only release the patient to a responsible adult.

Driving after IV sedation

What is it? – Intravenous sedation is another type of conscious sedation, like oral sedation, and it incorporates many of the same medications.  Contrary to popular belief, IV sedation is actually safer than oral sedation because it is much easier to control the specific dosage a person receives through intravenous administration than through oral administration.  IV sedation requires special certification, and it is most commonly offered in offices of oral and maxillofacial surgeons.

When is it used?– IV sedation has a very fast onset and is easily adjusted to the patient’s specific needs.  It provides more predictable results than oral sedation, and it allows the surgeon to work efficiently on a calmly sleeping patient.  

How does it work? – IV sedation medications work in the same way as oral sedation, but the doctor can more easily customize the specific level of sedation achieved.  It produces a relatively deep sleep by depressing the central nervous system.

Can you drive afterward? – No.  As with oral sedation, the medications used in intravenous sedation cause a prolonged sedative effect, and the central nervous system remains depressed for several hours following the procedure.  The doctor will only release the patient to a responsible adult driver.

How Will Someone Know if They Need a Driver?

For a scheduled tooth extraction, the dentist will inform the patient at the planning (pre-op) appointment.  If a tooth extraction is unscheduled and urgent to address an emergency situation, the dentist will work with the patient to access a driver as needed based on the dentist’s responsibilities noted in the previous section.

For those with medical conditions that could impact someone’s ability to drive after a tooth extraction, even without sedation, the doctor will make a specific recommendation during the pre-operative visit.

What are the Responsibilities of the Dentist? 

As far as the legal liabilities of the doctor performing the oral surgery, it will vary based on the laws and regulations of each specific region.  There are certain professional responsibilities guiding dentists when it comes to allowing patients to drive after a tooth extraction.  

The dentist is responsible for completing a thorough evaluation of the patient’s medical history, including all medications and medical conditions.  Any medications known to cause prolonged bleeding times or medical conditions predisposing a patient to low blood pressure or fainting are red flags that the patient might have trouble driving himself or herself home after an extraction.

The dentist also must take responsibility for the state of the patient upon dismissal.  Any patients who seem unwell, dizzy, confused, or otherwise impaired following a dental procedure will not be dismissed to drive home.  The dentist typically delegates to a staff member to call a family member or loved one to come to pick up the patient and monitor the patient until that time.