Need a lot of work.. questions re: IV sedation & extraction

[morethanlights]

Hello. I joined this forum earlier this year with some questions, and now I have some more. First some background. I have never taken care of my teeth and have put off getting work done for a long time, I think due to some traumatic experiences with my childhood dentist. Because of this, I have had a lot of root canals and cavities in my life, but recently things have gotten worse. Last year I had some issues with a couple failed root canals. Because of this I kind of stopped brushing my teeth (stupid, I know). Things got really bad and I ended up forcing myself to go to the dentist to get things taken care of. I was told that I needed to get a couple teeth extracted, a root canal, and a root canal retreatment (?), but that first I had to get deep cleaning because the bacteria in my mouth would make it hard to treat anything effectively. I got the deep cleaning and it cleaned my teeth but it also cleaned out my insurance, so I had to wait until the new year started to get additional work done (extraction, etc.). A couple months after the cleanings, a huge portion of my tooth broke off (failed root canal, needed extraction) and I was too scared to do anything about it. Because of this, I quit brushing my teeth again (stupid again) and now things are pretty much exactly where I was at before I got the deep cleaning in early 2009.

I want to get the two teeth I need extracted out. I also want to get the root canals done. Will I be required to get another root planing (I think that's what it's called) done before I get the extractions/root canals? Since I am deathly afraid of any work done in my mouth, would it be reasonable to look for a dentist that will use IV sedation for me, in order to possibly do all the work at once? Previous dentists have told me that it's not recommended to do all that at once because the entire mouth would be sore and it would be difficult to eat, but I am not really concerned about that, I just want it done as quickly as possible. Would a general dentist be able to do this, or would I have to see an oral surgeon? Also, I have a huge problem with gagging at the dentist. Will IV sedation be sufficient to fix that?

A lot of questions, I know. I'm sure I'm leaving some things out. Please let me know if you need more information, and thanks in advance for your thoughts!

 

[drhirst]

Hi,
With all those problems it is easy to get disheartened and this may be the reason you quit brushing your teeth. It must feel like you just cannot win. It’s entirely understandable.
I V sedation will definitely deal with the gagging issues. I think it would be helpful to seek out a dentist who can offer this service. Extractions and root planing can be readily done under iv sedation. Root canal treatment and fillings are a little more difficult to perform on a sedated patient.
I would have thought that the dentist would be prepared to do the extractions before you had the root planing. They may be less comfortable with doing complex treatments like root canal retreatment before the basics like healthy gums are established. I think having full mouth root planing, extractions and two root canals would be way too much treatment to have under one I V session.
Do you need so see a general dentist or oral surgeon? Well, here in the UK you would probably see a general dentist. However, in the states there is a greater tendency to see specialists, although an oral surgeon would not be able to do the root canals and probably not the root planing either.
If I were you, I would find a sympathetic dentist who can offer IV sedation. Then raise your concerns with him just as you have done on this forum. I would also carefully consider whether the teeth than need root canal treatment are really worth saving.
Just some thoughts
Lincoln

 

[morethanlights]

Thank you, Lincoln.

Yes, I am passive aggressive by nature so when things start to go wrong with my teeth I tend to shut down and quit even trying to take care of them. A terrible character trait and has hurt me much over the years.

So, you recommend root planing be done (again) prior to any extractions? What about before root canals?

The reason why I want the teeth extracted first is because they are broken and rotten and this causes terrible breath that I cannot get rid of, and is a big factor in why my life is so miserable right now. If I need to get root planing done again, then I will max out my insurance and have to wait another full year to get anything else done.

Thanks again!

 

[drhirst]

Personally, I do not thinks you need the root planing done again. The priority should be the extractions then any other treatment.
The most important factor is stablising your gums is how well you clean at home. It is possible to produce massive improvements with home care alone. So before you see your dentist get brushing and flossing big time. When brushing concentrate on the junction between the gum and the tooth rather than the tooth alone. However, you must use floss, interdental brushs or woodsticks to clean in between the teeth. If you get this right then a simple scaling rather than deep root planing may be all you need. This would then stop you maxing out your insurance. There is no point in root planing until your home care is optimal.

 

[morethanlights]

I will get started cleaning up my teeth before I go to the dentist. An extraction would warrant an oral surgeon for IV sedation?

 

[drhirst]

Yup I think so

 

[morethanlights]

Oral surgeons can't do root canals?

 

[scared0902]

I would also like to know why root canals and fillings aren't ideal under sedation...? Thanks!

 

[Gordon]

Root canals need a lot of co-operation from the patient, that's usually not forthcoming when you've used IV sedation. Fillings are more doable, but sometimes they still need more co-operation than you're going to get from somebody under IV.

 

[morethanlights]

Root canals aren't all that bad actually, I've had many done under nitrous. I was just really hoping to get everything done at once because I hate actually going in for anything..

 

[morethanlights]

Just scheduled an appointment for next Thursday. #3 and #5 are the teeth that I think will be extracted. They are failed root canals and are badly broken and decaying. I think I will be under IV sedation. I am very nervous about this all, what should I expect? Anything I should tell the surgeon beforehand?