History of General Anesthesia

The first anesthetic gases were discovered as early as the 13th century, but it wasn't until 1844 that a dentist named Horace Wells discovered the possibilities of using general anesthesia in surgery. Then, in 1936, Harry Langa used nitrous oxide gas as a sedative for dental procedures, leading to the formation in 1953 of the American Dental Society of Anesthesiology (ADSA), an organization that promotes methods of pain control in dentistry.

In the 60's intravenous sedation became more predictable and effective than nitrous oxide. By 1971, the ADSA established a fellowship in general anesthesia to recognize dentists who were qualified to administer general anesthesia, and to establish criteria to become an ADSA fellow. Today almost every graduating dental student is proficient in administering nitrous oxide. This method of treatment is so safe that the major insurance companies consider the use of nitrous oxide in the same classification as local anesthesia.

Kevin Toal, D.D.S. – Furthering Anesthetic History

Dr. Kevin Toal's study of general anesthesiology began in 1958 and continued on through 1960 in a preceptor program with Dr. J. Freiheit, M.D., at Lutheran Medical Center in St. Louis.

After his preceptorship, because of a shortage of physician anesthesiologists, he was asked to remain on staff at Lutheran Medical Center to administer general anesthesia for general surgery, which he did for nine years, taking cases on rotation and emergency call.

It was during the early 1960s that he began to use intravenous sedation with local anesthesia for those dental patients whose needs did not require general anesthesia.

Since the 60's, the development of agents like Valium has made the use of intravenous sedation far more useful in dentistry. However, general anesthesia in a state licensed surgical center is still needed for the medically compromised patient, patients with extensive restorative needs, or those patients with deep-seated phobias. He presently is retired after 55 years of practice.

Together with his daughter, Dr. Maureen Toal, they have brought the use of general anesthesia into the private practice, outpatient surgical setting at the Center for Dental Rehabilitation - unlike any other dental practice in the country.

“Using a highspeed handpiece with some of these patients is like trying to write your name on a bouncing ball.”

-- Dr. Kevin Toal, who pioneered the use of general anesthesia for dental phobics.

Back to top

General Anesthesia Today

Today, general anesthesia is administered at the Center for Dental Rehabilitation exclusively by a board certified MD anesthesiologist. In this manner we are able to provide comprehensive general restorative and oral surgery procedures in a very predictable and safe environment.

When receiving general anesthesia, you will be intubated (a tube placed into the wind pipe) to allow the anesthesiologist to protect the airway and administer anesthetic agents while Dr. Toal and her staff address your dental needs. If the procedure is scheduled to last at least five hours, or if warranted by your health status, Dr. Toal may recommend that you stay overnight at the hospital for observation.

Conscious sedation, which involves the use of intravenous (IV) medicine, is administered by Dr. Toal and/or the MD anesthesiologist. You will receive medications through a catheter in a vein in the arm or hand. This provides true sedation, accomplishing both pain relief and amnesia; you will be able to rest comfortably and breathe on your own.

During the procedure, the doctor and a registered nurse will monitor your health using such methods as EKG, pulse oximeter, and blood pressure measurement. An evaluation of each patient’s medical history and a physical exam by the patient’s primary physician are required prior to any procedures. If a patient does not have a physician, Dr. Toal and her staff have internists available to assure the most predictable and highest quality results.

To learn more about the benefits of sedation dentistry, or to schedule a consultation with Dr. Maureen Toal, contact the Center for Dental Rehabilitation today.