Who is dental treatment under general anesthesia for?
General anesthesia for dental treatment is considered first for patients who cannot cooperate with treatment, such as young children and people with disabilities, and for extensive or urgent treatment. According to the American Academy of Pediatric Dentistry (AAPD), in children it is reserved for situations where basic behavior guidance has not worked, for children who cannot cooperate because of their age or a disability, and for extensive or urgent treatment.
Severe dental anxiety comes into consideration only when other measures have failed: most anxious patients can still be treated under local anesthesia, with a clear explanation beforehand and an adapted pace; sedation or general anesthesia is considered when these measures are not enough, or when a medical condition or the extent of treatment requires it, and is provided by a qualified team. If anxiety is your main concern, see also dental care for anxious patients.
Children and patients with disabilities
Two groups of patients are concerned first.
Young children
For young children who cannot cooperate during complex dental treatment, the dentist assesses how well the child can cope and how much work is needed. Sometimes, grouping many treatments into one session under general anesthesia is better than several distressing visits that could damage a child's trust over the long term (see pediatric dentist in Jerusalem).
Developmental or neurological disabilities
Patients with developmental or neurological disabilities often need general anesthesia for dental treatment. Involuntary movements, communication difficulties or being unable to follow instructions can make routine treatment impossible. Treatment is adapted to each patient's needs, in close cooperation with the family and the medical team. General anesthesia makes thorough, good-quality treatment possible even in very complex cases.
Who should not have dental treatment under general anesthesia?
Advanced heart disease
Patients with advanced heart disease or uncontrolled heart failure are at significant risk under general anesthesia. The cardiovascular system is under considerable strain during anesthesia, and the heart must work well enough for the procedure to be safe. In these cases, alternatives such as sedation or reinforced local anesthesia are considered, in close consultation with the patient's cardiologist. Sometimes, adjusting heart medication makes general anesthesia possible at a later date.
Severe lung disease
Severe lung disease, such as uncontrolled asthma or advanced chronic obstructive pulmonary disease (COPD), limits the possibility of general anesthesia. Anesthetic drugs can affect breathing and blood oxygen levels, and the risk increases when lung function is poor. Lung function tests and advice from a lung specialist are part of the preparation.
Pregnancy
Women who are pregnant are usually not candidates for general anesthesia for elective dental treatment. Non-urgent treatment under general anesthesia is best postponed until after the birth. Urgent dental treatment is done at any stage of pregnancy, usually under local anesthesia, which the ADA and the American College of Obstetricians and Gynecologists (ACOG) consider safe in pregnancy; if general anesthesia is still needed, the decision is made with the obstetrician and the anesthesiologist.
Who may administer general anesthesia for dental treatment?
Only a qualified, experienced anesthesiologist should administer general anesthesia during dental treatment. The anesthesiologist continuously monitors the patient, adjusts the depth of anesthesia throughout and manages any complication. An anesthesiologist familiar with treatment in the mouth lets the dentist focus on the dental work while the anesthesiologist takes care of the patient's safety. According to the ADA guidelines, sedation and general anesthesia require specific training and monitoring.
The dentist treating the patient must also have appropriate training and experience in working under general anesthesia, which calls for specific technical adjustments and efficient work within the limited time of the anesthesia.
What the clinic offers instead of general anesthesia, and why
The clinic does not provide dental treatment under general anesthesia, IV sedation or nitrous oxide. Dr Haim Aseriel, a dentist in Jerusalem, treats patients under local anesthesia, with light oral sedation on prescription when needed.
The reason: most patients, anxious patients included, can be treated under local anesthesia with a clear explanation beforehand and an adapted pace, and professional guidelines start with these measures. In children too, according to the AAPD, general anesthesia comes only after basic behavior guidance; and according to the American Dental Association (ADA), sedation and general anesthesia require specific training and monitoring.
How is general anesthesia done?
1. A thorough pre-anesthesia consultation
Preparation starts with a consultation that gathers your full medical information. A careful review of your medical history, current medications, known allergies and any previous experience with anesthesia is essential to plan safe anesthesia. Recent blood tests, records from your doctors and sometimes further tests such as an ECG or a chest X-ray are often needed. You also receive detailed instructions about fasting from food and drink, continuing or pausing your regular medications, and arranging to be accompanied home.
2. On the day of treatment
On the day, you arrive at the equipped clinic or hospital fasting, as instructed. In the treatment room, the anesthesiologist connects monitors that continuously measure heart rate, blood pressure, blood oxygen, breathing rate and exhaled gases. This close monitoring allows any change in your condition to be spotted and dealt with immediately. An IV line is often placed to give fluids and medication during the procedure.
3. The anesthesia itself
Anesthesia is usually given in stages. The anesthesiologist first gives calming and pain-relieving medication through the vein, then induces full anesthesia with further intravenous medication or anesthetic gases breathed through a mask. Once you are fully asleep, a breathing tube is placed through the mouth or nose into the windpipe (trachea) to keep the airway open, connected to a ventilator, and breathing is controlled. The depth of anesthesia is adjusted throughout the dental treatment.
4. Waking up
When the dental work is finished, the anesthesiologist stops the anesthetic drugs and lets you wake up gradually. Waking up takes place under close supervision, and you stay connected to the monitors until you have fully recovered. The breathing tube is removed only when you are breathing well on your own and the airway is clear. You then stay in a recovery area for a while, where trained staff check your vital signs before you are discharged home.
What happens to your body during general anesthesia?
Under general anesthesia, you are completely unconscious and unaware of the treatment.
You feel no pain and form no memories of the time under anesthesia. The anesthesiologist monitors your breathing, heart rate and blood pressure continuously throughout the procedure.
Examination, treatment plan and price quote
detailed and personalized
During the consultation, Dr Haim Aseriel examines your teeth, explains all the options and gives you a transparent price quote, with no obligation. The clinic is at 12 HaTnufa Street, Jerusalem.
Which dental treatments can be done under general anesthesia?
Complex, extensive dental treatments that take a long time can be done efficiently under general anesthesia. Multiple root canal treatments, many fillings, preparation for crowns and bridges, and dental implants can be done in a single session. For example, a patient who neglected their teeth for years because of severe anxiety can receive a full mouth rehabilitation, including extractions, root canals and multiple restorations, in one treatment day.
Complex surgical extractions
Complex surgical extractions, including removal of several impacted wisdom teeth (see wisdom teeth removal), are well suited to general anesthesia, especially when the teeth are hard to reach or close to nerves and blood vessels. The patient does not move, and the oral and maxillofacial surgeon can work continuously.
Multiple dental implants
Multiple implants, especially with a sinus lift or a bone graft, suit general anesthesia well. Placing several implants, completing the preparatory procedures and even fitting temporary teeth in one session can shorten the overall treatment. Computer planning from 3D imaging lets each implant position be set before surgery.
Complex cosmetic treatment
Extensive smile makeovers, with gum contouring, multiple composite restorations, porcelain veneers and ceramic restorations, can be tiring to complete in ordinary appointments. Under general anesthesia, much of the work can be done in one or two sessions.
What to consider before treatment under general anesthesia
Planning all the necessary treatment carefully and in advance is essential to make the most of a session under general anesthesia. Before the date, the X-rays needed for planning, sometimes 3D imaging, and a full dental examination are done. A detailed plan is then prepared in order of priority: the most urgent treatment, such as extracting infected teeth or root canals in areas with active infection, comes first, followed by restorative and cosmetic work, so that the most important treatment is completed even if the session has to be shortened.
The length of anesthesia is limited, so it is important to be realistic about how much can be done in one session. The duration is agreed in advance with the anesthesiologist, to allow substantial work while keeping you safe and allowing a quick recovery. For very extensive rehabilitation, two separate sessions a few weeks apart may be planned, with a check in between that the tissues have healed properly.
General anesthesia for dental treatment: eligibility through an Israeli health fund
Israel's health basket covers general anesthesia for dental treatment only in specific cases where treatment is not possible without it. According to the Ministry of Health, eligibility includes, among others:
- children under 5 with early childhood caries;
- people with autism, an intellectual disability, cerebral palsy or Down syndrome, people with a mental illness, patients with severe heart disease, and patients with certain other conditions;
- treatment of dental injuries in children, when the referral for anesthesia is made within 6 months of the injury;
- surgical treatment in children under 18 in defined situations, such as removing impacted teeth that may harm the development of the dentition, on the recommendation of an oral and maxillofacial surgeon.
Eligibility does not include general anesthesia for an extraction because of lack of cooperation alone. The anesthesia is given by an anesthesiologist, in hospitals, health fund clinics and clinics under agreement. Contact your health fund (kupat holim): it refers you to the place of treatment, and treatment in a hospital usually requires a commitment form from the fund. Treatment done privately is not reimbursed by the health basket; any further coverage depends on your supplementary insurance.
How much does general anesthesia for dental treatment cost?
The cost of general anesthesia depends on several factors, starting with how long the anesthesia actually lasts. It also depends on the type of facility (an equipped clinic or a hospital), the anesthesia team and the monitoring equipment required, so it is set in a written quote after the examination and treatment planning. A longer procedure costs more, but grouping many treatments into one session can save the cost of several separate appointments.
Patients with complex medical conditions or higher risks are usually treated in a hospital, where more support systems are available.
| Type of facility | Equipped private dental clinic | Hospital |
|---|---|---|
| Cost | Usually less expensive | Higher cost of using an operating room |
| Equipment and team | Appropriate equipment and trained team | Additional support systems available, recommended for higher-risk patients |
For private or US insurance, the clinic provides itemized receipts you can submit for reimbursement; coverage depends on your policy.
General anesthesia in dentistry: frequently asked questions
Dental treatment under general anesthesia is for patients who cannot be treated under local anesthesia, even with preparation and reassurance or sedation: first young children and people with disabilities who cannot cooperate, and extensive or urgent treatment; severe dental anxiety only when other measures have failed. The decision is made after a medical assessment.
Patients with advanced heart disease, uncontrolled heart failure or severe lung disease are at significant risk under general anesthesia and need an assessment by their treating doctor. In pregnancy, elective dental treatment under general anesthesia is usually postponed until after the birth.
Only a qualified, experienced anesthesiologist should administer general anesthesia for dental treatment. The anesthesiologist continuously monitors the patient, adjusts the depth of anesthesia throughout the procedure and manages any complication that may occur. The clinic does not provide general anesthesia; treatment there is done under local anesthesia, with light oral sedation on prescription when needed.
Under general anesthesia, complex and extensive dental treatment that takes a long time can be done, such as surgical extractions (for example of impacted wisdom teeth), multiple root canal treatments and fillings, and dental implants, sometimes in a single session. The scope is agreed in advance with the anesthesiologist, according to the patient's medical condition.
The cost of general anesthesia for dental treatment depends mainly on how long the anesthesia actually lasts, the type of facility (an equipped clinic or a hospital) and the team and equipment required, and is set in a written quote before treatment. Israel's health basket covers general anesthesia for dental treatment only in specific cases, such as young children with early childhood caries or certain disabilities, through the health funds (kupot holim), so check eligibility with yours in advance.
Sources
- American Dental Association, Guidelines for the Use of Sedation and General Anesthesia by Dentists, 2016 – View source
- American Academy of Pediatric Dentistry, Behavior Guidance for the Pediatric Dental Patient – View source
- MedlinePlus (U.S. National Library of Medicine), Endotracheal intubation – View source
- American Dental Association, Pregnancy (Oral Health Topics), 2025 – View source
- American College of Obstetricians and Gynecologists, Committee Opinion 569: Oral Health Care During Pregnancy and Through the Lifespan, 2013 – View source
- Israel Ministry of Health, Kol HaBriut: General anesthesia for dental treatment (in Hebrew; eligibility conditions updated 26/02/2025) – View source
- Israel Ministry of Health, Dental health services for children in the health basket (in Hebrew) – View source
