IV Sedation - urgent help please

[morethanlights]

I have an appointment in 2 days to get a few badly decayed teeth extracted, and I am opting for IV sedation. Today, the receptionist called me up to confirm the appointment and everything. All was good until she "confirmed" that I was going to be under general anesthesia. I told her that I actually wanted IV sedation where I was conscious but sedated. I was under the impression that general anesthesia was when you were fully sleeping. The receptionist spoke with one of the general surgeons (or so she claimed) and told me that all IV sedations are called general anesthesia and that it is up to the surgeon how much I should be under? She said that I will be "sleeping" but I'm not sure if she was simply oversimplifying and calling it "sleep" just because I would be sedated or because I would actually be unconscious and sleeping. To me, it just sounded like she had no idea about the technical aspects of sedation or general anesthesia, and was just referring to any type of "sleep" (meaning both twilight sleep AND full unconsciousness) as being under general anesthesia. Does any of this make sense?

I'm supposed to go on Thursday for the extractions but all this stuff has me very worried now.

- I'm in the United States
- What does she mean when she tells me that IV sedation = general anesthesia?
- What are some straightforward black/white questions I can ask them to figure out what the heck they're talking about?
- Am I misinformed or confused regarding my assumptions about this?

Thanks in advance!

 

[RP]

To the best of my knowledge the typical oral surgeon does more of a moderate sedation, you are totally unaware of the extractions, yes, put to sleep but breath on your own. This is what's commonly referred to as a general but it is not like having general anesthesia during surgery in a hospital where you cannot breath on your own or lose your reflexes.The medications used are the same as conscious sedation just more of it. IV sedation is precise because the doctor can control how deeply you are sedated and the medications they use have reversal agents so you can be immediatly brought out of sedation if need be.

The attached link may help.

IV Sedation

Find out all about IV dental sedation: what does it feel like, is it safe, and how do the sedation drugs midazolam and remimazolam differ?

www.dentalfearcentral.org

I just experienced this at the oral surgeon's, in my opinion it's the way to go!

Hope that helps rather than adding to the confusion.

rp

 

[sugars03]

Thanks RP,
I am supposed to go under IV sedation as well and I've never been sedated before. I was wondering what it was. I'm supposed to extract 5 teeth (4 wisdom and 1 broken molar).. I'm so scared it isn't funny..
I have such a weird phobia that everytime a dentist puts his hand in or near my mouth I gag.. i feel really silly and REALLY wish it would go away, i can't even get a cleaning done so I opted for the dentist to do a prophy before he extracts my teeth. I'm so fed up and really wish I could get rid of this phobia because there is no rationale for my fear..
I really appreciate the website though.. thumbs up to you guys

 

[Stress Doc]

IV sedation uses medications called benzodiazipines. They are tranquilizers that produce a deep state of relaxation. RP is right, GA is much different and uses different medications.

Recovery is much quicker because sedation is not as deep.

 

[morethanlights]

I'm really worried about gagging while being sedated. I gag partly because I panic whenever things are in my mouth and I REALLY gag whenever it's dried out and opened wide. Will IV sedation get rid of the gag reflex?

I have my extraction scheduled for 2 PM today and once again I could not sleep (4 AM right now). This sucks.

 

[Gordon]

Yes, IV pretty effectively suppresses gagging. Although it's a bit late to tell you now, hope things went well for you.

 

[morethanlights]

Not too late.. my appointment is in 1.5 hrs. I'm sweating and shaking right now.

 

[RP]

Well........ how was it, been thinking about you, sending good thoughts.

 

[morethanlights]

I got your PM, thanks!

Anyway, here's how it turned out.. after freaking out before the appointment including several trips to the bathroom, we left for the surgeon's place. We got there and I had to spend like 15 mins filling things out. Then was X-ray time . I hate x-rays because they jam those huge film things in your mouth,and it always makes me want to gag. I told the assistant and she replied "you won't have to worry about that." "Yeah, right" I thought . But they had one of those more modern x-ray machines, where all you do is bite down on this tiny plastic thing and put your head in this head-holder thing, and the film and x-ray gun rotate around your head, making a full panoramic with nothing put in your mouth. Amazing!

On to the extraction part.. I got seated in the chair and the assistant hooked me up to an automatic blood pressure cuff, the thing they put on your finger that measures oxygen level and pulse, and two electrode things (one on each wrist) to also measure pulse. This is where I started to get nervous. My heart rate was at a constant 110 and I was very scared. I asked her a few questions about the IV sedation and she was very reassuring and answered all my questions. Then she developed the x-rays and the surgeon came in. He took a look at them and asked what I would like to do (his sheet said I was there for 3 extractions of broken/decayed teeth and possibly wisdom teeth). He looked in my mouth and told me that the wisdom teeth had to be taken out anyway, but it was up to me whether I wanted to do it now or come back. I told him that I would just like to get it all out today. He put a rubber tube around my arm above the elbow and looked for a vein to put the IV in. The IV felt like.. an IV.. like a little shot, I've definitely had immunizations that have hurt worse than the IV. Like those skin scraping tests and the shots where they shoot a bubble under the skin, that is like 100 times worse than what the IV was like. He hooked up a fluid drip at first, and then put in an initial thing of some chemical to calm me initially. I sat there for 5-10 minutes watching my BP and heart rate decrease on the cool screen thing they had set up. Then he put in the actual sedative. I told him I was very nervous and he said that I would be out in a few seconds. As he put in the solution, I felt myself getting tired and "out of it", sort of like when you first feel the effects of nitrous but not as strong.

The next thing I know, I'm in a sort of haze. I remember random things from here but not much really. I will write the things that I remember, a little later in this post.

Came home, and had a lot of blood in my mouth and in the gauze. After drooling blood in the sink (in an attempt to evacuate the blood without rinsing or spitting) I replaced the several gauze pieces. I then realized that I was in a significant amount of pain. I had a headache and my jaw hurt where the wisdom teeth had been. I took 400mg of Advil (ibuprofen) because the Vicodin/ibuprofin mix pill they prescribed me instructed me to eat before taking, put an ice pack on my face and watched TV/laid in bed/took a nap for an hour or so. Then I got up and the pain was gone. Attempted to eat some scrambled eggs (don't do this, there's a small piece of egg stuck by the blood clot on one of my wisdom sockets, but I'm just going to let it sit there until I do a gentle rinse tomorrow. Then I had some warm soup, and some chocolate pudding. I took my antibiotic, drank a lot of water, and I'm feeling fine, just a little sore. I might take another Advil dose before I go to sleep if the pain starts to return. I've been using ice packs on and off (they say to use it constantly because it will reduce swelling later on) but it's hard when you only have one ice pack!

Anyway, I am feeling amazingly happy now that 7 problem teeth are GONE from my mouth! Even though my breath isn't all that great (given the plaque, blood, and that I can't brush my teeth for at least 24 hrs) it smells and tastes like wonderful fresh mint compared to the disgusting rotten tooth smell/taste it had just several hours ago. IV sedation was amazing and I'd do it again in a heartbeat.

Although it pretty much seemed like I was sleeping from the actual sedation until I arrived home, here are some things I remember (and that my girlfriend told me I said/did). All these things that I say I remember from here, I don't remember 100%, it's kind of like remembering a dream.
- I remember looking at the IV tube when the surgeon was putting in the sedative. I saw some tiny air bubbles and I asked him if that was safe. He said they were so small they wouldn't do anything.
- I remember when he first put the bite block in my mouth. I did not want to open my mouth so I half way resisted for like .5 seconds (I remember him prodding me to "open your mouth"), but then I let him and he put it in and that was that.
- I think I remember him chipping away at my lower right wisdom tooth. I don't remember any pain or anything. This could be a made up memory from something else I read though.
- The next thing I remember is that I was in a "recovery" bed with a pillow and blanket. I remember that I was very comfortable there, but then I sat up. I realized that I "still felt tired" and I tried to lay back down, but my girlfriend told me to try to stay sitting up.
- I remember asking the assistant about post-op treatment, but I don't remember what she said.
- I remember asking if they could show me all the teeth they pulled out, but the assistant said that they were all broken up and thrown away already.
- I remember asking them to give me the bill several times.
- I remember asking my girlfriend where she put my iPod and my sunglasses.
- My girlfriend told me that while we were sitting down with the cashier lady, I started to interrogate the cashier about post-op care even though the assistant had just explained everything.
- We went to a drive-thru pharmacy and I remember thinking that the drive-thru window was very high up, and I remember staring at a yellow button that said "push to call" or something. Then, I thoughtfully suggested to my girlfriend that she press that yellow button to call someone, since no one was at the window. "Oh, thanks.." she said.

Then we were at home. Thanks everyone for your kind comments and posts in the several threads that I have on here, and thanks to everyone that posted success stories, which I intensely read for days non-stop before my appointment.

I will be sure to start a whole thread in "success stories" after I heal, where I will explain my entire history (bad experiences as a young child), and numerous success stories of my own including 5 root canals, full root planing, and now I can add these 7 extracted teeth too!

 

[urban.i.stika]

Wooohoo!!!

So happy it went well for you! You are well on the way to restoring your dental health, so well done. You should be very proud of your efforts today.

I must say, you have also given me confidence in your post, as I have to go and get my wizzies out (3 at this stage) and hopefully it's under IV sedation too.

Thanks for the update!

 

[RP]

You did it!!!!!! Great job.

 

[PrincessPinkyPants]

im so glad it went so well for you! i was scared b/c you read my story before you went and stated that i worried you so i felt soooooo bad.

Keep us updated on hwo you are healing!!!

 

[morethanlights]

Thanks everyone for the kind words!

Healing seems to be going well. Last night I took another antibiotic before bed. This morning I woke up and was sore again, mainly in the jaw by the lower wisdom teeth, so I took some more Advil and got the ice pack and the soreness is gone now. Someone from the surgeon's office just called me to see how I was feeling. She said I can start with salt water rinse today, and an antiseptic (clorhexidine gluconate) mouthwash tonight. I still have that small piece of scrambled egg lodged in one of my sockets so hopefully that will fall out with the salt water rinse. I am, however, worried about rinsing too hard and dislodging one of the blood clots or something. I also have a few stitches that will dissolve by themselves. They are kind of annoying because it sometimes feels like something big is stuck in the sockets and rubbing against my tongue/cheek but it's just the stitches.

I have an appointment set for next week for them to check up on how the healing went.

Anyone that is worried about extractions under IV sedation, have no worries at all! It honestly is much easier than root canals under nitrous (and even those aren't bad whatsoever). The worst part of it all is waiting to get it done, because you freak yourself out and make yourself sick with worry beforehand. I am living proof that anyone can do this. I feel ill at the very thought of dentistry, I gag even the dentist even sticks that little mirror in my mouth, and I panic very easily. Who would have thought I would be able to get 7 extractions done all in one sitting, and I'd be willing to even do it again?

 

[urban.i.stika]

Great to hear the pain is minimal!

Just thought I'd share a tip in regards to the saltwater rinses. After my extraction, I found that just taking a half mouthful of the water and slowly tilting your head to let the water sit over the extraction site itself (if that makes sense!) for about 30 seconds each time, is the easiest way to do the rinses. At least for the first few days while things are still tender. The saltwater will relieve the swelling anyway, and surprisingly it doesn't sting at all... so you'll love doing it after a few goes!

The food particles should dislodge pretty quickly with the saltwater.

 

[morethanlights]

Thanks for the tip. I've stopped worrying about the food particles and have started to worry about one of my extractions. Tooth #3 was a failed root canal where probably more than half of the crown (or whatever the exposed part is called) broke off, exposing the void where the root once was and developed a chronic infection that I dealt with for about a year until I got it pulled. Now the socket for #3 seems to be the only one that is still bleeding. It's not like it's bleeding a lot, but I can definitely taste blood in my mouth and it's coming from that socket. It is visible if I spit, and I can see some on my tongue if I place the tip of my tongue near the socket.
In a few hours it will be 72 hrs since the extractions. Is something wrong?

 

[urban.i.stika]

I wouldn't panic about the blood. You've had a fair few extractions, and blood always looks worse when it's mixed with saliva. Because it's 72 hours after and you are concerned about it, I would call the dental clinic and ask about it. If anything, to put your mind at ease and to err on the side of caution.

I've read that extractions can weep blood up to a few days after surgery. But I'm not a dentist, so I'm not exactly sure. A quick phonecall will put your mind at ease!