local. Although, I assume this is in a special needs population. So you dont have to paralyze if you dont want to. You may need to if you intubate or you can do it deep. LMA might work if your dental guy is ok with it and is used to working around it. You could even do it under MAC, block if you want to deal with the headache.
Oral surgeons do most of their wisdom teeth with sedation+block in the office, no airway management needed. If you're putting them to sleep, a nasal tube is more convenient but not required, and there's no need to paralyze. An LMA would be pretty bulky to work around, not to mention the risk of dislodging it with surgical instruments. IMO, the risks and PITA factor (for both you and the surgeon) of doing an LMA far outweigh the benefits.
Ok here in Belgium most people when doing all 4 teeth do it under GA if they want to go local they do one side at the time.
Yes we go with a nasal intubation most people give a little muscle relaxant.
Just wanted to know how others do it but if it's all local by surgeons...