GENERAL ANESTHESIA
General anesthesia has been an important aspect of dentistry since 1844, when Horace Wells first administered nitrous oxide (N2O) to induce the loss of consciousness. (In fact, Dr. Wells was the recipient [the patient], not the administrator of the N2O.) General anesthesia was, for many years, an integral part of the pain-control armamentarium of dentists primarily because other techniques of pain control did not exist or were less well developed. With the introduction of local anesthetics (cocaine) in the 1870s and their steady improvement in the 1900s with the introduction of procaine and tetracaine and later of the amides (e.g., lidocaine, mepivacaine) in the 1940s, the need for general anesthesia as a primary means of achieving pain control during dental treatment diminished. A second need for general anesthesia was in the management of dental fears and anxieties. For well more than 100 years, general anesthesia was the primary technique used for this purpose. However, with the development of newer drugs capable of relieving anxiety without inducing the loss of consciousness, our ability to manage dental fears through minimal or moderate sedation techniques increased dramatically, further diminishing the role of general anesthesia in the practice of dentistry.
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