Three levels. Chosen by case.
Oral sedation
A pre-procedure medication that takes the edge off anxiety and produces mild relaxation. The patient is awake, responsive, and breathing normally. Suitable for shorter implant procedures and patients with mild to moderate dental anxiety. Onset is gradual; the patient still needs accompaniment for transport home.
IV sedation
Medication delivered through an intravenous line that produces a deeper, more controllable sedation. The patient is breathing on their own but is generally not aware of the surgical work; most patients have little to no memory of the procedure. Onset and recovery are both faster and more predictable than oral sedation. The standard choice for many All-on-4 cases and most longer implant procedures.
General anesthesia
Full anesthesia for longer or more complex cases. The patient is fully unconscious; airway management is handled by the anesthesiologist. The standard choice for zygomatic surgery, extensive full-arch cases, full-mouth reconstruction surgical phases, and patients with significant medical complexity or severe dental anxiety.
The choice between levels is made at the pre-anesthesia consultation, considering the procedure length, complexity, your medical history, and your preferences.
It changes the cost, the coordination, and the safety profile.
Cost
At practices without in-house anesthesia, complex implant surgery often requires transferring the patient to a separate sedation facility, adding a facility fee, an anesthesiologist’s professional fee, and sometimes a hospital admission. None of that is incurred when the anesthesia is delivered in the same building as the surgery. The cost of in-house sedation is built into our treatment quotes; there are no surprise charges.
Coordination
The anesthesiologist assigned to your case reviews your medical history and conducts the pre-anesthesia evaluation before surgical day. They are in the operatory with Dr. Metwally during your procedure. There is no handoff to an outside provider who hasn’t seen your case.
Safety
Our surgical suite is fully equipped for in-office anesthesia, with the monitoring, emergency equipment, and trained personnel current standards require. The anesthesiologist at your case works in this room alongside Dr. Metwally. Familiarity matters in anesthesia; delivering it in the same facility as the surgery produces consistent outcomes.
Credentialed. At our facility.
Surgical sedation and general anesthesia at Revive are administered by anesthesiologists who specialize in outpatient surgical sedation. They come to our facility for your case. You will meet your anesthesiologist before surgery to review your medical history, current medications, and any prior anesthesia experiences.
Every sedation and anesthesia case at Revive is staffed and equipped consistent with current Ontario requirements for outpatient anesthesia. Specific permit wording will be published here once doctor sign-off is complete; we’ll confirm the regulatory framework in writing at your consultation if you’d like that detail before it’s published.
Before, during, after.
Before
Pre-anesthesia consultation as part of your treatment planning, covering medical history, current medications, prior anesthesia experiences, and any specific concerns. Written pre-op instructions: fasting timing, medication holds, day-of logistics. A phone confirmation the day before surgery. Transportation arranged.
During
IV access placed (or oral sedation administered, depending on plan). Monitoring established. Anesthesia delivered, depth maintained throughout the procedure by the anesthesiologist. Surgical work proceeds as planned.
After
Monitored recovery in our recovery space until awake, oriented, and stable. Post-procedure debrief with Dr. Metwally (the parts you’ll remember). Written post-op instructions covering diet, medication, activity restrictions, and warning signs. Discharged home with your driver. We call you the day after surgery to check in.
The next 24 hours
Drowsiness, mild grogginess. No driving, operating machinery, signing important documents, or consuming alcohol for 24 hours after sedation. Light meals, hydration, rest. Most patients are largely back to normal by the next morning.
Ontario standards. In writing.
In Ontario, the delivery of sedation and general anesthesia outside a hospital setting is regulated. The exact regulatory framework, permit classes, mandatory monitoring, emergency preparedness, facility standards, is set by Ontario’s relevant regulatory bodies. Our surgical suite, our monitoring equipment, and our emergency protocols operate within that framework.
The specific permit wording, permit class, and the named provider under whose authority anesthesia is delivered at our practice will be published on this page and on our team page once doctor sign-off is complete. We’ll provide written confirmation at your consultation if you’d like that detail before publication.
If sedation is a deciding factor for you, ask at the consultation.
Anxiety, prior anesthesia complications, complex medical history: all of these shape the sedation plan and are worth raising explicitly at the pre-anesthesia consultation rather than at the operatory door. Book a consultation and tell us at booking if this is the question you want answered first. We’ll structure the appointment around it.