Dental Extraction Appt. Coming Up

[Slagdor]

My gold crown fell out over the weekend. I went in to see a new Dentist today, and they explained I don't have enough tooth left to recover to put a new (or existing) crown on. They explained I should really just have it removed. That's fine with me. They are also recommending I have three wisdom teeth removed. One was already removed years ago due to infection.

My question is about sedation.

The Dentist offers "Nitrous Oxide" and "Sedation Monitoring". Both are conscious sedation, I think?

They also partner with a different dentist who is willing to do IV Sedation.

The IV Sedation costs $800 USD. That's more than I'd like to spend, and I hate needles anyway. Plus, I am scared about being sedated. I also think I have sleep apnea, which I mentioned to the Dentist today.

The Nitrous Oxide and Sedation Monitoring are much cheaper -- only $100 USD per (one or the other, not both).

The only memory I have of sedatives is when I had the infected wisdom tooth removed 10 years ago. I do not remember being given an IV. A mask was put over me for a half hour, and then someone came in, they put me to sleep, and I woke up later without a tooth. Does anyone know what kind of sedation I might have been given?

Also, do others recommend Sedation Monitoring (pill?) or Nitrous Oxide?

Am I at risk likely having sleep apnea and being overweight? I'm 5'11", 230lbs.

Thanks for any help you can give me! I just want to make an educated decision.

 

[BoxerMom]

Hi there! I had nitrous years and years ago, so I can’t help you with that, and if Sedation Monitoring is a pill, well you’d have to ask what they give you. But, I can give you some info on the IV sedation. I had all my teeth extracted in September under IV sedation. I am overweight as well, but I had no problems. They told me before the procedure that I would be consciously sedated, so it’s not like being put under for an operation, which requires a breathing tube to be inserted. They also mentioned that when you’re sedated like that, sometimes you forget to breath, and I distinctly remember them telling me to take a breath. So there was an assistant there with me who’s only job was to watch me breath and made sure to remind me when I didn’t. My dental phobia was so bad that sedation was the only way for me, and I know how expensive it is. I cannot say whether you’d be at risk if you have sleep apnea, but that is something that you definitely need to let them know. They will be able to help you make the right choice for you.

 

[Enarete]

Hi Slagdor,

we have an extensive article about nitrous oxide here. It should be able to answer quite everything you have been wondering about it.

I have no idea what sedation monitoring is supposed to be, the only thing that comes to my mind would be monitoring of your vitals to see how you are doing (in case of nitrous that would mean a device on your finger that constantly monitors pulse)

 

[Slagdor]

I asked my Dentist today about Sedation Monitoring. They said it was the alternative to Nitrous Oxide -- they prescribe Halcion the night before. I've never taken Halcion, so I don't know anything about it. I told them I take Lexapro for anxiety, but I want to be sure there are no drug interactions. I told them about my Sleep Apnea. I feel like I just have to trust them to know the risks.

 

[Enarete]

That’s interesting. So the Sedation Monitoring means them prescribing Halcion? If there was any issue with the sleep apnea they would surely have let you know.

 

[Aurora10]

I asked my Dentist today about Sedation Monitoring. They said it was the alternative to Nitrous Oxide -- they prescribe Halcion the night before. I've never taken Halcion, so I don't know anything about it. I told them I take Lexapro for anxiety, but I want to be sure there are no drug interactions. I told them about my Sleep Apnea. I feel like I just have to trust them to know the risks.

Oh, that's referred to generally as oral sedation and works well for many people?. I was considering sedation in some form and my dentist told me that they could use halcyion as it's generally very reliable. It isn't as reliable as IV sedation but that can be costly so a lot of people go with oral sedation. Have you been diagnosed with sleep apnea or do you just think that you may have it? What did the dentist say when you told him? Hopefully you will feel you can trust the dentist and his team enough to move forward with this, let us know how it goes?

 

[Aurora10]

My gold crown fell out over the weekend. I went in to see a new Dentist today, and they explained I don't have enough tooth left to recover to put a new (or existing) crown on. They explained I should really just have it removed. That's fine with me. They are also recommending I have three wisdom teeth removed. One was already removed years ago due to infection.

My question is about sedation.

The Dentist offers "Nitrous Oxide" and "Sedation Monitoring". Both are conscious sedation, I think?

They also partner with a different dentist who is willing to do IV Sedation.

The IV Sedation costs $800 USD. That's more than I'd like to spend, and I hate needles anyway. Plus, I am scared about being sedated. I also think I have sleep apnea, which I mentioned to the Dentist today.

The Nitrous Oxide and Sedation Monitoring are much cheaper -- only $100 USD per (one or the other, not both).

The only memory I have of sedatives is when I had the infected wisdom tooth removed 10 years ago. I do not remember being given an IV. A mask was put over me for a half hour, and then someone came in, they put me to sleep, and I woke up later without a tooth. Does anyone know what kind of sedation I might have been given?

Also, do others recommend Sedation Monitoring (pill?) or Nitrous Oxide?

Am I at risk likely having sleep apnea and being overweight? I'm 5'11", 230lbs.

Thanks for any help you can give me! I just want to make an educated decision.

The sedation you had years ago with the mask sounds like gas GA, but I'm not 100pc sure.

 

[Gordon]

I'd be a bit nervous of offering oral sedation to somebody with your BMI and your other issues. I'd be a whole lot happier going for the nitrous route.

 

[Slagdor]

I'd be a bit nervous of offering oral sedation to somebody with your BMI and your other issues. I'd be a whole lot happier going for the nitrous route.

That's interesting. I don't feel like I'm that overweight, but maybe I am.

You would be uncomfortable giving me Halcion?

 

[MountainMama]

I have had both nitrous and oral sedation in the past year for tooth extractions. The nitrous was much, much better in my opinion. The pill I took was not a different kind, but it just kind of made me chill, but did not help me ignore what was going on around me. The nitrous helped me relax to where I could kind of tune out but was still aware, if that makes sense. It was almost like that stage right before you fall asleep, where you know what it going on but are relaxed.

 

[Gordon]

That's interesting. I don't feel like I'm that overweight, but maybe I am.

You would be uncomfortable giving me Halcion?

I couldn't give you Halcion, it's not available here
I personally don't like using Oral sedation where the patient has some potential issues with their airway. Just not enough control for my peace of mind. OTOH, I had the luxury of being able to use any sedation modality that I think suits best, IV, IS or Oral.

 

[Slagdor]

Oh, that's referred to generally as oral sedation and works well for many people?. I was considering sedation in some form and my dentist told me that they could use halcyion as it's generally very reliable. It isn't as reliable as IV sedation but that can be costly so a lot of people go with oral sedation. Have you been diagnosed with sleep apnea or do you just think that you may have it? What did the dentist say when you told him? Hopefully you will feel you can trust the dentist and his team enough to move forward with this, let us know how it goes?

I have not been diagnosed. I'm going to see my doctor next month about it. I simply think I have it based on how much I'm snoring. I wake up with headaches sometimes and dry mouth. Typical symptoms. I did explain all of this to the dentist. He just went into talking about how he uses a CPAP machine, and I would benefit from having one. He didn't seem concerned or anything. I'm probably going to get Nitrous Oxide.

If I'm not in any pain, I'll probably be okay. I had a root canal that took three visits and was the most pain I've ever been in years ago. Ironically, that tooth with the root canal is the one that the crown fell off of and needs to be extracted. It's been nothing but trouble for me. That root canal is what CAUSED my dental phobia. I also have Generalized Anxiety Disorder, I've had PTSD, and I take anxiety medication. Living in fear is exhausting.

 

[Aurora10]

I have not been diagnosed. I'm going to see my doctor next month about it. I simply think I have it based on how much I'm snoring. I wake up with headaches sometimes and dry mouth. Typical symptoms. I did explain all of this to the dentist. He just went into talking about how he uses a CPAP machine, and I would benefit from having one. He didn't seem concerned or anything. I'm probably going to get Nitrous Oxide.

If I'm not in any pain, I'll probably be okay. I had a root canal that took three visits and was the most pain I've ever been in years ago. Ironically, that tooth with the root canal is the one that the crown fell off of and needs to be extracted. It's been nothing but trouble for me. That root canal is what CAUSED my dental phobia. I also have Generalized Anxiety Disorder, I've had PTSD, and I take anxiety medication. Living in fear is exhausting.

That's so true, fear IS exhausting. I know how painful root canals can be, 2 of the 3 I've had were extremely painful and they failed, awful isn't it? I'm glad you're going to see your dr and if nitrous oxide works for you then go for it. Keep us updated!

 

[Slagdor]

My dentist office called me this morning to ask if I would opt for ORAL SEDATION (Halcion), or NITROUS OXIDE.

To be clear, I had decided to have NITROUS OXIDE.

The plan was to have FOUR TEETH extracted (3 wisdom, and one other molar).

When I explained to the office that I wanted NITROUS OXIDE, they expressed concern that NITROUS OXIDE would be uncomfortable for the length of the appointment - 2.5 hours.

Is it normal to use ONLY NITROUS OXIDE during multiple extractions? Should I also be using Halcion ORAL SEDATION?

They have me worried again about all of this. Am I going to be in pain and serious discomfort if I elect only NITROUS OXIDE?

 

[krlovesherkids777]

Slagdor,

Whether they use Halcion or Nitrous , you should not be in any pain if they use the right amount of local anesthetic! I have had all teeth taken out pretty much by local alone have only felt a bit of pain when they took out while I still had an infection, otherwise its been completely pain free. The Halcion and Nitrous are for the anxiety/relaxation sake , I know @MountainMama has given me a lot of info on Nitrous and has good experience with it.

 

[Aurora10]

My dentist office called me this morning to ask if I would opt for ORAL SEDATION (Halcion), or NITROUS OXIDE.

To be clear, I had decided to have NITROUS OXIDE.

The plan was to have FOUR TEETH extracted (3 wisdom, and one other molar).

When I explained to the office that I wanted NITROUS OXIDE, they expressed concern that NITROUS OXIDE would be uncomfortable for the length of the appointment - 2.5 hours.

Is it normal to use ONLY NITROUS OXIDE during multiple extractions? Should I also be using Halcion ORAL SEDATION?

They have me worried again about all of this. Am I going to be in pain and serious discomfort if I elect only NITROUS OXIDE?

You shouldn't be in any pain, if you are then you just let them know so they can give you more LA. Your pain doesn't depend on having nitrous or not, you shouldn't have any at all But yes, it can be uncomfortable to sit for that length of time and that's probably what their concerns is based on.
As for the choice of sedation, many people don't have anything other than LA, and others opt for GA, and then there's oral and IV sedation in between. Nitrous is for mild sedation and it is also an analgesic and it works really well for lots of people. It really depends on how anxious you feel about having dental treatment and what options are most suitable for your particular situation.
It sounds like you might want to make an appointment to see your dentist face to face and discuss everything. I'm sure that you will feel a lot better when you fully understand the dentist's thoughts on your procedure?

 

[Slagdor]

Should I be taking Halcion AND Nitrous? The dentist is supposed to call me some time today so I can ask a few questions about it. I was just going to opt for Nitrous. As long as I'm not in pain, I don't care much. Is 2.5 hours of extraction too long for ONLY Nitrous?

 

[Aurora10]

Should I be taking Halcion AND Nitrous? The dentist is supposed to call me some time today so I can ask a few questions about it. I was just going to opt for Nitrous. As long as I'm not in pain, I don't care much. Is 2.5 hours of extraction too long for ONLY Nitrous?

I'm sure the dentist will be able to answer your questions when you speak to him and hopefully one of the dentists here can give some advice and reassurance

 

[Gordon]

2.5hrs is fine for nitrous. It doesn't wear off while you continue to breath it.

 

[Enarete]

I think the advantage of oral sedation (pills that you take before the procedure) is that it makes you feel more comfortable even before the procedure, in case you struggle with pre-appointment anxiety.

There are enough people who had extractions and wisdom teeth out without sedation. As krlovesherkids and Aurora suggests, your dentist will make sure to numb you up beforehand anyway and it is the numbing that will take care of the pain. Not suggesting you go without sedation, just making it clear that procedures are supposed to be painless even without.

So the actual questions to make a decision would be: how much anxiety do you usually suffer before a procedure, how hard is it for you to feel relaxed during a procedure and would you like to have something beforehand.

By the way, may I ask you whether sedation was something you required or something your dentist suggested?

Hope your chat with the doctor went well by the way, keep us updated.