Sedation Options and Doubtful of Extraction Need

[Aurora]

Hi. I'm new to this forum. I've never really thought about joining a forum like this, but my anxiety and fear of dental procedures is getting a little out of control and I'm getting really tired of dealing with it. I have unfortunate genetics when it comes to teeth and I tend to have a lot of issues despite taking excellent care of my teeth.

As far as wisdom teeth go... I have a few questions that I'm sure have been asked before, but I would just feel better if I could discuss them with someone.

First:
Which type of sedation is best for people with dental anxiety and fear? My SO got the twilight sedation thing, and his wisdom teeth were coming in sideways so had to be dug out of his jaw. Much more intense than mine. I would prefer to avoid general anesthesia because I had a nasty experience with it during a tonsil surgery. So it's twilight sedation (BTW, what is the drug they use?), nitrous oxide, or just straight up local. I believe valium is also an option, but valium did nothing for me the last time I took it.

Second:
Do they really need to come out? I have to admit, I've become skeptical of many procedures being a money ploy. When I was a teen, I had all four bicuspids removed, so I only have 28 teeth plus wisdoms. Granted, I have a small mouth. But my controversy comes in because one wisdom tooth has already fully erupted. It caused me 0 pain and lines up with the rest of my teeth just fine. I've read that it's a myth that your wisdom teeth erupting will make your bite crooked.

So how do I know if they really need to come out? Having my bicuspids pulled was horrible. The sounds it made, like a rope breaking inside my head was absolutely gruesome. I want to avoid having my wisdom teeth out so bad, but I also don't want to mess up my mouth. I just can't imagine any form of sedation making it bearable. I freak out and hyperventilate and cry and stuff. It's quite embarrassing and taxing.

So again, I know this has probably been asked before, but I just feel like it's anxiety relieving to ask questions.

 

[bcjch]

Wisdom teeth don't always need to be pulled. If they grow in straight and fine, and there's room in your mouth, keep 'em! It sound like at least one of them is that way.

Your wisdom teeth may be more likely to not cause trouble because of your missing bicuspids. It's my understanding that molars tend to shift forward gradually. If they have, and you don't have much of a gap left where your bicuspids were, you might have the room you need, even in a smaller-than-usual mouth.

I'm pretty sure the statements about crooked bites and the like exist because 85-95% of the time, wisdom teeth grow in horizontally or on an angle - which will cause that stuff.

About anesthetic, I don't know the name of the chemicals, but one key difference is that dentists use IV sedation instead of something inhaled like general anesthesia often is. The reaction of patients to each is a lot different; a patient may react badly to one but not to the other.

If you end up having dental IV sedation, you won't remember a thing, and you won't be freaking out. (And people coming out of it often do and say very funny things! If you end up doing things that way, have whoever accompanies you to the dentist take video.)

Also, a dentist will often use injected anesthetic in addition to your sedative - which quashes your post-operative pain for a while longer.

With nitrous oxide, you won't be out. You'll be less aware of your surroundings, but I'd bet you can still hear all the noise.

 

[RichH]

Hi - when I had my wisdom teeth removed (6 teeth: 4 impacted and 2 supernumerary teeth in the jaw bone) I opted for the IV/twilight sedation and it was fantastic.

I really have a hard time with general anesthetic for anything non-life-threatening, so this seemed like a good option for me. When I arrived at the oral surgeon, they first put me on nitrous oxide to calm the nerves and also while they hooked up the IV. The IV drip starting was the last thing I remember, and waking up in the recovery room was the next thing. When I was out, they also injected the surgical sites with local to numb the pain when I woke up.

If you go with the IV sedation, you'll be in and out in 10 minutes according to your perspective of how things went - in reality it could be hours and you'd never know. Make sure someone can drive you to/from the appointment and sit with you for the rest of the day of the surgery. I remember being pretty tired after mine, as the only real side-effect.

In terms of whether you actually need the surgery or not, honestly if you trust your dentist/OS and they are recommending the extraction, then they probably do need to come out. You can certainly quiz them for their reasoning which may help reduce some of the skepticism.

Good luck!