At Virginia Oral, Facial & Implant Surgery, patient comfort and safety are of paramount importance. We support both through an array of options for anesthesia. Our highly-trained and experienced team works with patients to choose an approach based on their procedure, needs, and preferences.

Unlike doctors who rely on sedation dentistry — which tends to use inexact oral medication for patient comfort — Dr. Gocke and Dr. McAdams are certified to use the full range of anesthetic techniques for McLean, VA patients. Dr. Gocke has completed years of specialty training, including rotations in anesthesia for general, heart, and obstetric surgeries. He has also performed more than 5,000 I.V. anesthesia-based procedures over his 15-plus years of experience.

The Differences Between Sedation Dentistry and Oral Surgery Anesthesia

Sedation dentistry is a method that practitioners sometimes use to increase patient comfort during dental procedures. It typically involves some type of oral medication for reducing anxiety. However, sedation dentistry is not as predictable and controllable as the types of anesthesia that an oral and maxillofacial surgeon like Dr. Gocke and Dr. McAdams can provide.

Our oral & maxillofacial surgeons can provide anesthetic options, such as IV sedation, that are more targeted and precise than oral sedation. Their techniques allow for careful monitoring, and they can deliver the right amount of medication based on a patient’s height, weight, and metabolism. These options also wear off shortly after a procedure ends, so patients should not feel groggy following their visit.

An Overview of Anesthesia With Virginia Oral, Facial & Implant Surgery

Our patients may receive one or a combination of the following anesthetic options.

Local Anesthesia

Local anesthesia is an injectable medication that completely numbs the treatment area. Patients who receive only a local anesthetic remain awake throughout their procedure. They don’t feel pain, but they may sense pressure as Dr. Gocke or Dr. McAdams operate. Every patient receives local anesthesia as part of their treatment.


In certain procedures, like wisdom teeth removal, Dr. Gocke will apply EXPAREL to the surgical site. EXPAREL is a non-opioid, long-lasting pain medication. The anesthetic greatly enhances the patient experience after surgery and has the added benefit of limiting exposure to potentially addictive opioids.

Nitrous Oxide

If patients want to relax a little during their procedure, our oral surgeons can provide nitrous oxide, more commonly known as laughing gas. This option simply takes the edge off and offers a calming effect without putting you to sleep. Unlike sedation dentistry, however, our surgeons can control the flow of nitrous oxide as well as help patients recover quickly once the procedure ends.

IV Sedation

For procedures such as dental implant placement and bone grafting, our patients typically receive anesthesia through an intravenous line. Our oral surgeons are certified to perform IV anesthesia in-office and carefully monitor patients throughout their treatment.

With this option, patients experience a deep calm similar to twilight sleep, during which they don’t feel or remember anything about their procedure. Typically, patients come into the treatment room, watch a little TV or Netflix® while they breathe in nitrous oxide, and, once they are extremely relaxed, the surgeon starts the IV line and administers the anesthetic. Most patients are surprised at how quickly time passes during their visit.

Afterward, patients move to a separate and private recovery room where they can have heaters and blankets to keep them comfortable. At this point, a family member or other caregiver can join them and wait until they are ready to head home. Patients cannot drive for 24 hours after IV anesthesia.

Dr. Gocke has performed over 5,000 IV anesthesia cases.

Video: Hear Heather’s experience with Dr. Gocke.

Common Questions Patients Ask About Anesthesia and Sedation Dentistry

  • Will I be fully asleep with IV anesthesia?

    This anesthetic approach allows different degrees of unconsciousness. You will not be aware of or remember the procedure. It should feel as if only minutes have passed between the time that you walked into the room and the time that you’re ready to go home.

  • How long will I feel the effects?

    The effects of IV anesthesia should wear off quickly, as our surgeons can control the flow of medication through the line to time it with the end of your procedure. This is one way in which IV anesthesia differs from sedation dentistry.

  • Will I be in pain after oral surgery?

    Dr. Gocke and Dr. McAdams are very focused on patient comfort. With our anesthetic protocols, most of our patients are numb for 4-8 hours following their procedure and for up to several days with EXPAREL. Dr. Gocke also encourages patients to take Ibuprofen right away to manage any discomfort they experience.

Learn more about how our anesthetic options compare to traditional sedation dentistry. Contact Virginia Oral, Facial & Implant Surgery in McLean, VA by calling (703) 388-2805, or schedule a consultation online.