Surgical extraction under LA

[Sezzyj]

Ok sorry for the long post
I broke my upper right 6 molar in Oct 2024. Since then I have had a constant abscess which swole so much I had 4 lots of antibiotics and it eventually burst. Now it collects in 2 pimple like things and pops. Sorry tmi

The nhs has declined sedation because my bmi is 37. They have referred me for surgical extraction under local anaesthetic.

The private dentist said they might be able to do it under sedation ( at a cost ) but never mentioned surgical or it being an issue. He seemed to not really be fazed.

Please can someone help settle my mind ? The thought of having “surgery” awake terrifies me. I attached my xray from October just for info.

Thank you

 

[Gordon]

What surgical extraction actually means is the tooth being sectioned into smaller pieces (in this case 3 parts looking at the film) and being removed bit by bit. The actual process of it is not unlike a filling, there will be a lot of water spraying about and some pushing and wiggling. After the tooth is out, it'll leave a bit of a hole so I'd probably put a stitch or two across it to close it.

Your BMI makes IV sedation risky, but inhalation sedation would be perfectly fine.

 

[Sezzyj]

@Gordon Thank you very much. Would this kind of extraction be too much for local without epinephrine? I have a heard condition and I do not tolerate it well at all.

I would much prefer to be sedated with IV but understand if I’m too chunky for that (haha) I don’t like the idea of gas inhalation.

 

[Gordon]

Would this kind of extraction be too much for local without epinephrine?

No, it's not any more painful than any other extraction or filling, any local will do.

If you don't me asking, what's the issue with the inhalation sedation?

 

[Sezzyj]

@Gordon it hasn’t been something that I have been offered on NHS or private.

The NHS don’t want to give me anything other than local. And the private dentist only mentioned IV sedation.

I have to say that it worries me because I heard that people have died using gas. But I’m sure this was back in the day and not recently.

 

[Gordon]

Different kind of gas completely. That would be a general anaesthetic, which in days of yore was a bit more risky than it is now, inhalation sedation uses different gasses and is 100% safe.

 

[Sezzyj]

@Gordon so my private dentist called and said I need to be referred to hospital for sedation. They said they will refer me to an NHS hospital, because of my BMI.

Couple of questions if you are able to answer.

Why didn’t the NHS dentist do that ?

Will sedation in hospital be any different ( like in an operation room etc?)

What if I panic as the medication goes in ?

Any help is greatly appreciated

 

[Gordon]

Why didn’t the NHS dentist do that ?

Sorry, no idea

Will sedation in hospital be any different ( like in an operation room etc?)

Maybe but not necessarily. Doing it in the theatre is usually better since all the equipment is readily to hand if there's some kind of emergency. From your POV it's not much different just a different room.

What if I panic as the medication goes in ?

Never met anyone who did, it's quite a pleasant sensation I'm told The IV drug is given slowly and in small amounts, so it's not really noticeable, it's definitely not painful.

 

[Sezzyj]

Thank you so much. I gues it’s better to be somewhere that I would be safe. I have eptopic heartbeats ( not to do with my bmi)

So it’s best I think. I will still be terrified tho