Office-based anesthesia in dentistry. Past, present, and future trends.

The history of office-based anesthesia dates back to the discovery of nitrous oxide and ether in the 1840s. In recent years, advances in intravenous anesthetic techniques and the rising costs of hospital-based services have combined to promote the practice of ambulatory anesthesia. Dental patients who may benefit from office-based anesthesia include patients undergoing stressful procedures, fearful patients, medically or behaviorally challenged patients, young children, and patients with a history of gagging or local anesthesia problems. The future of office-based anesthesia in dentistry appears bright. Its development, however, will be influenced by organized dentistry, medical anesthesia, and other groups interested in pain and anxiety control, and state legislatures reacting to public demands for both safe and cost-effective anesthesia care.