Sorry, here's another one - Sedation in UK?

[LoveKettle]

I'm so confused.

When having *trickier* wisdom teeth out, ie. too complex for a local anaesthetic, I get the impression from reading the NHS websites that you have a general anaesthetic.

But I've read plenty on here about IV sedation and a member helpfully alerted me to this possibility..

So basically...having wisdom teeth out on NHS that are, say, partially impacted lower ones, do you have to have a GA in hospital? Can you ask for an IV sedation? Because I'm GA-phobic, I think.

If not, can you get IV sedation privately?

 

[littlestar88]

Im not sure what the NHS does about wisdom tooth extractions. But don't be scared of getting GA...I wish my dentist offered it but he says IV is enough!

But you can certainly get IV from a private dentist. Not all of them offer it but there are plently that do.

 

[LoveKettle]

ooo IV is waaay enough for me ive read up too much on anaesthetic awareness probably

 

[Hayley]

I'm on the waiting list for my WTs out and I have looked into the possibilities and options extensively.

Basically, the NHS stopped offering patients the choice of GA for WT extraction because it was too costly and there are risks with a GA. The latter was, I believe, hyped a little in order to put people off asking for it, thus enabling the general public to feel better about the cost cutting exercise (I'm a tad cynical about our NHS).

Now, you are given the option of IV sedation, however, don't get too excited, as many dentists don't offer this. Again, there are costs involved, as there has to be someone present with the ability to resuscitate and to administer the IV. Hence, there are not many dentists that will offer this routinely. Since the rule seems to be that you can get just about anything you want if you pay for it, they seem happy to provide it when you mention cash. Draw your own conclusions there.

Regarding difficult extractions, as I understand it, impaction isn't enough on its own to warrant being termed 'complicated'. There has to be complications with the impaction (i.e. wrapped around a nerve etc) for it to be considered a complicated extraction. My WTs are severely impacted, what tooth had erupted has broken off below the gum line, they are extremely carious and yet they as yet have not been considered complicated. I am extremely worried about having them out as I have already suffered nerve damage when having a filling and am worried about the heightened possibility of this occurring again. Basically, it has to warrant being classed as a surgical procedure in order to be termed complicated.

Also, I was recently advised that from assessment consultation to treatment is at least 6 months on the NHS and the time period from referral to assessment is indefinite as it will depend on the workload of the dentist that you have been referred to.

Good luck!!

 

[Gordon]

Our local Max-Fac department at the hospital will quite happily let you have IV sedation for 3rd molar extraction, not a big issue. GA for the extractions also isn't a big deal, in fact their waiting times for local anaesthetic removal are so long, in some respects they'd rather give you a GA

 

[brit]

Our local Max-Fac department at the hospital will quite happily let you have IV sedation for 3rd molar extraction, not a big issue. GA for the extractions also isn't a big deal, in fact their waiting times for local anaesthetic removal are so long, in some respects they'd rather give you a GA

I think Hayley is referring to the position in a local NHS dental surgery rather than in an NHS hospital, where I agree I would be amazed if GA were no longer an option.
The risks of in-surgery GA were quite high....if your child died just having a tooth out, you would regret the decision for ever after (it did happen to perfectly healthy kids)..and it doesn't help the dentist's career any either....the anaesthetist at your local hospital knows what they are doing with GA and has the best equipment/drugs available, Fred Bloggs the local dentist doesn't necessarily and it rather amuses me to think that my Mum/Dad 'signed my life away' at least 3 times before the age of 10 in a surgery resembling that on display in the Science Museum next to Stephenson's Rocket - looking pretty much from the same era but actually only 1960s.

Hayley I hope you find a solution..we have heard before of mixed practice dentists agreeing to do NHS treatment whilst the patient pays a private rate (only a couple of hundred quid) for i/v sedation....don't know if you tried that one. I'm also pretty sure your NHS dentist should be referring you for hospital removal if you are phobic and have a preference for i/v/GA which they cannot or choose not to meet. Quite often if you argue your case, you will get what you ask for...but it's unfair to have to do this when stressed out about the whole situation.

That i/v sedation isn't routinely available on NHS in surgeries, is a cause for regret, the GA option having been removed....people on here seem to think this is because the reimbursement fee in England is laughably low and I suppose NHS dentists are busy enough without having to drum up extra custom whereas private dentists do need the custom so will be more willing to oblige on the i/v front.

Also on hospital GA for wisdom teeth back in the 1980s I was admitted the night before and after...whereas in the 1990s my OH found it was just a 'day-stay'.....things move on.

 

[littlestar88]

It seems silly though...if a patient is willing to pay for the sedation what does the dentist have to lose?
He just gets a patient who he can treat quicker cos they arnt stressed. I say make it more widely available and let people know! I wouldnt have stayed away from the dentist for 4 years if i had known about IV

 

[brit]

It seems silly though...if a patient is willing to pay for the sedation what does the dentist have to lose?
He just gets a patient who he can treat quicker cos they arnt stressed. I say make it more widely available and let people know! I wouldnt have stayed away from the dentist for 4 years if i had known about IV

The dentist has to do extra training in it..there are risks albeit less than GA.....so that coupled with a very low NHS reimbursement fee of about £30 quid approx....incentivises no one to go out of their way....the ones that will do it are clearly the ones who care a bit more; or have seen your logic.

 

[Hayley]

My dentist is unwilling to refer me to the hospital, and I don't really know why that is.

Perhaps it is a borough issue, but there has been no option to be referred to an NHS hospoital, plus, I have read an official NHS document that was for the health service in general which stated that GA was no longer going to be offered to patients unless there were significant problems that made it impossible for a dentist to carry out the treatment.

I have been told that the waiting lists are extensive, and I wonder if this is to try and force us NHS fee payers into the private sector in order to be treated quicker.

Whilst I appreciate that IV sedation may 'only' cost £200, tell that to my bank manager!!!! £200 is a lot to pay for a procedure that I should be able to have on the NHS which I pay for all year round in my taxes.

I'm sorry to get on my soapbox about it, but I find it totally outrageous that dentists can get away with treating patients like cattle.

I was, therefore, referring to the position in BOTH dental surgeries and hospitals in the North West of Britain. The NHS currently doesn't give a hoot for 'preferences' and obviously thinks that phobias are to be laughed at.

Gordon, I don't know where you are based, but here in the North West, the treatment plan falls only slightly short of giving you a thick stick to bite down on.

I am back to my doctor tomorrow to try and see what can be done about the mess they made of my face when they damaged my nerve. I will talk to them about being referred through my GP rather than my dentist, but they are extremely reluctant to discuss it.

 

[Hayley]

i just wanted to post as I went back to my doctor last night regarding the nerve damage in my face and my WT problem.

I have been referred to a neurologist and also an oral surgeon for the extraction of the WT.

My doctor feels that the waiting time will be less than 'indefinite'!!!

At last, there is a glimmer of what could be light at the end of this very very dark tunnel!!

H.

 

[littlestar88]

I'm glad that things are going slightly better and there is some light at the end of the tunnel.