Tooth extraction - what sedation to have?

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shinyonne

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Oct 8, 2018
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I'm really sorry to cross-post this (from the Wisdom Tooth forum) but I'm pretty stressed out and need to make a decision and let the dental surgeon know.


I'm 40 years old. I broke one of my wisdom teeth about 6 weeks ago and am finally going to get it taken care of (I have all 4 wisdom teeth, not impacted). It is the upper-right tooth, a little more than a quarter of it is broken to the gum line.


I have seen the oral surgeon for a consultation. They went over my sedation options. They recommended nitrous or putting me to sleep with the IV. I really don't know which one to go for.


I'm really nervous about the whole thing. I'm a bit beside myself to be honest.


The thing is that my dental fear is part of a general extreme medical/invasive procedure anxiety that I have that has kept me from going to doctors unless I have some obvious reason to see one.


I've had some fillings and a root canal under local anesthetic.The fillings were unpleasant but OK, the root canal was a pretty difficult and traumatic experience because the freezing almost didn't take. The oral surgeon told me the extraction will be longer and more complicated than the root canal.


Beyond that this will be my first time with anything resembling surgery, as well as sedation.


So...what do people here think? I'm quite nervous at the thought of being put to sleep (As well as the IV and blood pressure cuff if they use it. I really hate blood pressure cuffs.) though I like the idea of being out entirely for the procedure.


The nitrous sounds much less invasive and is less stressful, but I'm also worried about how much of the procedure I'll be aware of and how much I'll feel if I'm just using laughing gas.


I would love some input about people's experiences with various sedation and some opinions on what I should do (I know it's a personal decision but I'd be grateful for some informed opinions). I am weighing my anxiety about the procedure with my anxiety about the various forms of sedation and am not sure which one is worse.


When I went for my root canal they said my blood pressure was too high for nitrous, but I was so nervous that I was hyperventilating and thought I was going to pass out. I have more time to prepare for this appointment so will hopefully be less stressed. (The root canal started as a a routine visit to the dentist for a toothache that became a "surprise we're going to give you a root canal right now! Here let's put on this blood pressure cuff...")


Thank you!
 
Judythecat

Judythecat

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I had an upper wisdom tooth extracted last year after getting repeated infections in the gum round about. Mine was also fully erupted. It took about six seconds, and was honestly like twisting the top off a jar. One minute the dentist was asking me if I felt anything sharp, the next she was asking if I wanted to see the tooth - it was so quick I had no idea she'd even started, let alone finished! I don't know anything about sedation, but if there is any way you could do it with local, mine was less intrusive than having a scale and polish.
 
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shinyonne

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Oct 8, 2018
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Oh wow that’s good to hear. The oral surgeon said it would take an hour and involve lots of pressure and would be more involved than the root canal (which took, if I recall, maybe 30 mins or so.)
 
Judythecat

Judythecat

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I am not a dentist, and your surgeon will have your x-rays, but my dentist told me upper wisdom teeth tend to have short, cone shaped roots, and were (in her opinion) the easiest teeth to extract. She actually had hers done by a colleague in between patients, then carried on with her afternoon appointments. I was eating dinner 90 minutes later, teaching a full day of classes the day after.
 
Enarete

Enarete

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Hi Shinyonne,

sorry to read about your root canal treatment being painful. Generally speaking, no matter what the procedure is, your dentist / surgeon should be able to numb you up properly and only go on once you do not feel anything. I have read that in case of an infection this might be more difficult, but there should always be options, even if it would mean interrupting the procedure for that day. Also, sedation is used to make you relaxed, but you will still get numbed up with a local (at least in uk).

If you are afraid to be put to sleep, well, with IV sedation you don't have to. You are conscious but very very relaxed. The catch is that you won't remember that as the drug causes amnesia. If you like the idea of not remembering the procedure, then IV sedation might be the right thing.

Nitrous is supposed to make you feel relaxed but still aware and everyone might react a bit differently to it.

Our forum dentists are experts in this so hope you will get some more accurate replies soon. Until then you can read something about both techniques here if you haven't already:
https://www.dentalfearcentral.org/help/sedation-dentistry/laughing-gas/
https://www.dentalfearcentral.org/help/sedation-dentistry/iv-sedation/

All the best wishes
 
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MountainMama

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I had a root canal on my upper left 2nd molar, then later had it extracted. The extraction was much easier than the root canal. The oral surgeon also told me that it could be complicated, due to being fragile because of the root canal. He blocked out 45 minutes for the procedure, but it ended up only taking 30 minutes. I used laughing gas (nitrous), and I was fully aware the whole time, but it definitely took the edge off and helped the local anesthetic work better. I have always had difficulty getting numb, but it worked great with the extraction.
 
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sharon

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I've had two teeth extracted in the last couple of years and both were very easy. I was going to be put to sleep for the first one and I'm so glad I wasn't as it took less than 5 minutes, it was probably one of the easiest dental appointments I have ever had. There was a bit of pressure but no pain or unpleasantness at all. The other was a molar and a little more complicated as the root was "shattered" so he had to pick the little pieces out. But even that wasn't painful or uncomfortable, just tedious. It took maybe 10 minutes. Again, I'm glad I was awake.

I'm not sure what your dentist is seeing that makes him think it will be more complicated than a root canal. I'm wondering if the roots are twisted.

I've only had nitrous once (I was 14 years old) and didn't like it. But everyone else I know who tries it loves it. That might be a good option for you. How about valium?
 
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shinyonne

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Oct 8, 2018
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I thought I would post an update.

After postponing this extraction because I was sick with the flu, I finally had this tooth out the day after Christmas.

I opted for the nitrous (laughing gas), which I’d never had before. I found it took the edge off a bit but I didn’t feel dramatically different. Overall I thought the nitrous was a good idea.

The procedure took about 20-30 mins. The worst parts were the injection into the upper palate and the sounds of the tooth cracking and crunching. I listened to music on my phone during the procedure. The dental hygienist warned me that this might make the sounds of the procedure seem louder so maybe that’s why I found the sounds very unnerving. There was also a lot of pressure and feelings of pulling or twisting.

The dentist said I had a huge cavity and the tooth kept disintegrating as she was trying to remove it, which made the extraction more difficult.

I’m glad I finally had it done. Now I’m waiting for it to heal.
 
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geos

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Glad to hear it went well. I hope you are taking good care of yourself now.
 
krlovesherkids777

krlovesherkids777

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Hi, also wanted to say.. really great to hear you got it out and made it through the extraction. Hope it heals quick and well :)
 
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