Dentist says I need 7 teeth pulled, questions about this

[BensonBooga]

About a week ago my wisdom tooth either broke or a filling came out, and it was cutting my cheek upon eating and talking so I had no choice but to visit a dentist, lack of money and anxiety has kept me away from them in 5 years. I buried my head in the sand, even as multiple teeth started to crack apart every few months.

The dentist says I need about 8 fillings and approx 7 extractions (extractions to be referred to a hospital). How do dentists get broken teeth out and is it better to leave roots behind and just cut off what is visible ? I am concerned of complications. Will they (the hospital) likely remove all teeth same day ? I don't want to be knocked out as I am a huge guy, morbidly obese (general anaesthesia can be risky for massively fat people), and I don't want the risk given I am not in any pain from my teeth, I think most are nerve dead. Would there still be nerve pain in extraction if the tooth is dead ?

I suffer from hyperacusis and tinnitus, I hear that they will need to cut my wisdom teeth in quarters to remove them, or at least one of them as it is below the gum. My hyperacusis means I hear everything at 5x the level of normal people and noise also hurts, will the saw be used for long and is it also used to cut the bone to get the teeth ? I am absolutely terrified of the thought of saw/drill noise and making my tinnitus and hyperacusis worse.

I was also told my larger lower wisdom tooth has curved roots from an x-ray, and the dentist said this will be a tricky extraction. Can the dentist at the hospital do this sort of thing without much issue ? I am in the UK by the way, not sure if ours are different to US, Australia, etc. Why does it need to be removed given it is not giving any pain ?

I remember about 15 years ago I was told by a dentist to have 2 broken teeth removed, that the gum had sealed over, as they can cause issues in the future, but I have not had any problem yet with them and no pain so I didn't do it. Is it better I just leave my broken teeth ? I have been told I will need dentures when the teeth are removed as a few of the front teeth will need to be taken out so I can't have a bridge. I feel stuck between having a horrible smile but no other issues, and needing them removed to get dentures. The thought of dentures in my 40s (I am 45) seems worse than my current awful teeth, not sure why, maybe if I had a family and lots of friends I would think different, but I am home alone all the time like a recluse (for non teeth reasons, mostly my anxiety and issues with noise, I have to wear hearing protection where-ever I go, but this is no use at the dentist due to the bone conduction occlusion effect).

Regarding my fillings, again due to the noise I am going to have to find a place that does soft and hard tissue laser, such as the Fotona LightWalker. Does anyone here have any info on that ? Is it much quieter than the drill ? Do most dentists also now use a quieter electric drill over the air ones ?

I am really scared as I have horrible anxiety, it is probably obvious from the below photos I haven't been to the dentist in 5 years, so my teeth are a mess. I have some 3D images of them below, beware the horror show. Any help or advice appreciated, thanks.

Link to teeth photos : https://postimg.cc/gallery/HpX0rPB

 

[Gordon]

I'm trying to spot your questions in amongst this, please repost if I miss something.

How do dentists get broken teeth out and is it better to leave roots behind and just cut off what is visible ?

Pretty easily. Much easier to get broken teeth out than whole ones normally. You just push on the roots in the right direction. No, really it's better not to do that. The roots are where the bacteria live which cause all the problems, so you want rid of them.

Will they (the hospital) likely remove all teeth same day ?

Definitely.

I don't want to be knocked out as I am a huge guy, morbidly obese (general anaesthesia can be risky for massively fat people), and I don't want the risk given I am not in any pain from my teeth, I think most are nerve dead.

It's risky but it's not automatically a death sentence. Possibly some deep sedation would be a better alternative but all dental in-patient anaesthesia is done by a consultant anaesthetist, so they really know what they're doing.
The risk you're taking is that there is no way of predicting when these broken teeth will flare up, could be before you're heading off on holiday, could be Xmas day, whatever. So you need to decide if you want the treatment done on your terms or not.

will the saw be used for long and is it also used to cut the bone to get the teeth ?

We don't use saws.

Can the dentist at the hospital do this sort of thing without much issue ?

Yes. They do it all the time.

Why does it need to be removed given it is not giving any pain ?

See above.

I am home alone all the time like a recluse (for non teeth reasons, mostly my anxiety and issues with noise, I have to wear hearing protection where-ever I go, but this is no use at the dentist due to the bone conduction occlusion effect).

Then you don't need to wear the dentures. Maybe just pop them in if you've got company or when needed for social purposes.

Regarding my fillings, again due to the noise I am going to have to find a place that does soft and hard tissue laser, such as the Fotona LightWalker. Does anyone here have any info on that ? Is it much quieter than the drill ? Do most dentists also now use a quieter electric drill over the air ones ?

Ideally you'd want the fillings done at the same GA as the extractions.
All drills are quieter these days, there's not a great deal of difference between air rotors and electric ones IME. Lasers are great but you can't do everything with a laser, you still need a handpiece for some work.

Hope this helps, let me know if I missed anything.

 

[BensonBooga]

Thanks so much Gordon, very much appreciated. I do have a few more questions if at all possible. [note, where I mention noise issues it is not so much me consciously hearing them, but more my concern the noise can make my hyperacusis and tinnitus worse, so even being sedated/knocked out my ears would still be subjected to noise, a toddler screaming close to me made my hyperacusis and tinnitus permentanly worse, hence why I worry so much]

1. Regarding the saw I mentioned, some years ago for my broken wisdom tooth (that I chickened out of having removed) I was told by the dentist he would need to cut the tooth in to 4 parts to take it out. If not a type of saw, what is used for this ? Just a standard drill ?

2. When removing some roots, will they need to cut in to bone, if so how noisy is this ? Someone mentioned when they were having a difficult impacted tooth removed the dentist used something that sounded like a jackhammer with all the noise and vibration. What tool would this likely have been?

3. I have wondered if my jaw may be causing some of my ear discomfort issues as often when I move my jaw it feels like it is tugging/pulling something in my right ear and it can feel like I have been slapped in the ear. Doctor felt my jaw and looked in my ear but couldn't see anything. I really want a CBCT scan done. Are these difficult to get approved of or quite easy these days ? I hear they may need referrals. The dentist gave me a referral for a OPG but I also want more detail especially of the jaw. Do they automatically take pictures of the entire mouth/jaw or only select parts ? Do CBCT scans show nerves ?

4. One of my front 2 teeth will need to be removed as it is cracked and decayed (as seen in photos in original message). How would that most likely be removed as I presume it will break when pulled, are front teeth relatively easy to take out even if it breaks ?

5. What is likely to be the most noisy instruments used for extracting teeth of all sorts ?

6. Finally, what would be a ball park time for removing 7 teeth ? Are we talking many hours or within an hour ? I realise this will differ depending on complications or not. What is the average time for each tooth ? You might be able to tell more from the photos I posted.

Thank you so much again Gordon. I really appreciate your advice. Extremely useful to hear.

 

[Gordon]

I think the noise associated with dental treatment is a fair bit less than the noise of a screaming toddler. If my grandkids are anything to go by!

I was told by the dentist he would need to cut the tooth in to 4 parts to take it out. If not a type of saw, what is used for this ? Just a standard drill ?

Yes, pretty much.

When removing some roots, will they need to cut in to bone, if so how noisy is this ? Someone mentioned when they were having a difficult impacted tooth removed the dentist used something that sounded like a jackhammer with all the noise and vibration. What tool would this likely have been?

Sometimes yes, but mostly the roots just sort of scoop out if you push on them the right way. That would have been a standard slow handpiece. We tend not to use them for sectioning teeth any more. Mainly because it's horrible for the patient.

I have wondered if my jaw may be causing some of my ear discomfort issues as often when I move my jaw it feels like it is tugging/pulling something in my right ear and it can feel like I have been slapped in the ear. Doctor felt my jaw and looked in my ear but couldn't see anything. I really want a CBCT scan done. Are these difficult to get approved of or quite easy these days ? I hear they may need referrals. The dentist gave me a referral for a OPG but I also want more detail especially of the jaw. Do they automatically take pictures of the entire mouth/jaw or only select parts ? Do CBCT scans show nerves ?

Quite possibly. Have a read about TMJ dysfunction on here: https://www.dentalfearcentral.org/faq/tmj-pain/
Do NOT start looking this up on Google, there are a load of quacks out there for the subject.

What do you think you'll get from a CBCT? It's a fair amount of radiation for limited benefit.

How would that most likely be removed as I presume it will break when pulled, are front teeth relatively easy to take out even if it breaks ?

Not necessarily, in fact probably not, and yes, fairly easy when it does happen.

What is likely to be the most noisy instruments used for extracting teeth of all sorts ?

The teeth make squelching/squeaking/crunching sounds as they come out, the instruments don't make any noise at all.

Finally, what would be a ball park time for removing 7 teeth ? Are we talking many hours or within an hour ? I realise this will differ depending on complications or not. What is the average time for each tooth ? You might be able to tell more from the photos I posted.

2-5 minutes if they don't break. Maybe 10 minutes extra per broken one. Not nearly as long as you think I've done over 100 extractions in a 3 hour general anaesthetic session before, including time taken putting the patients to sleep and starting to recover them...