Wisdom teeth extractions at age 50 - terrified

[LauraB]

HI all, new here.
I'm getting all 4 wisdom teeth out plus another molar at the end of next month. I'm getting knocked out for it. I've never been put under (terrified) and never had a tooth pulled!!
Lifelong terror of dentists as it is. This is my worst fear. Been putting it off for many years. Shaking thinking about it.
I can't take any benzo drugs (ativan, valium, etc.). The only painkiller I can take is ibuprofen.

For getting knocked out, the are only using propofol alone (because I can't have anything else with it they normally use), and because I have an ungodly terror of being numb, they're not going to freeze my jaw....they are only going to infiltrate the areas of extraction. (Because, if I wake up with my entire tongue and jaw numb, I will absolutely panic). Is that going to be enough??
Oral surgeon said I might "move around more" while knocked out as opposed to people who get the fentanyl or versed with the propofol. What does that mean?? Will I wake up?? I don't want to wake up during it!!

And, I'm terrified of pain. Since I won't be fully numb!
I can't take ibuprofen on an empty stomach, so I have to have food....which means, I will have to eat something (liquidy of course) immediately afterwards so I can get some ibuprofen down.....how am I supposed to be able to do that, bleeding and with gauze in my mouth??
AND - another terror, I do not want to get anything in the sockets right after, but they tell you DON'T RINSE for at least a day. HOW do you keep your mouth clean when you can't rinse or spit?? If I eat, how do I keep my mouth from getting infected that first day if I can't rinse after eating?? I will have to eat several times in order to take ibuprofen for pain.

Last question I think - HOW do you get the tooth paste out of your mouth, later on when you can start brushing, if you can't spit, or really rinse?? I have experimented with this, and it's impossible! Especially your tongue.

The only good thing about all this is that on their scale of 1-4 for level of difficulty, all 5 of my teeth are a 1. They're all fully erupted, and my wisdom teeth apparently have short roots, not to mention some bone loss so they're all a tiny bit mobile. So I am HOPING that means it will be an easy extraction, and won't be a horrible healing process. ???

Any and all advice and help GREATLY appreciated!! Thank you!

 

[Gordon]

Don't panic!
1) Propofol only GA is very common in the UK, it avoids a lot of the issues that conventional GA causes, such as post op nausea and vomiting. It's very effective, the recovery time is much shorter too, which is good. You won't move around more and you certainly won't wake up.

2) Infiltration will be perfectly effective for immediate post op pain relief, it's all I ever used, never put in nerve blocks after GA, it's not required.

3) You won't be bleeding (they should suture the sockets) and any gauze should be removed before you're discharged. If it isn't then take it out yourself, it's not necessary to walk about all day with a stupid lump of gauze hanging out your mouth

4) Rinse out gently with warm salty water after a few hours, spit out gently, just use some common sense

5) I was starving after getting my wisdom teeth out so I went to the staff canteen and had a nice lunch, steak pie, chips (fries?) and peas. Funnily enough I didn't die or get a terrible infection. Got a bit fatter though!

6) Brush gently round the extraction sites, then spit (a little more gently as above). You shouldn't rinse after brushing anyway.

Sounds like really easy extractions, so I'd expect a simple healing process. Please tell me you don't smoke!

 

[LauraB]

Don't panic!
1) Propofol only GA is very common in the UK, it avoids a lot of the issues that conventional GA causes, such as post op nausea and vomiting. It's very effective, the recovery time is much shorter too, which is good. You won't move around more and you certainly won't wake up.

2) Infiltration will be perfectly effective for immediate post op pain relief, it's all I ever used, never put in nerve blocks after GA, it's not required.

3) You won't be bleeding (they should suture the sockets) and any gauze should be removed before you're discharged. If it isn't then take it out yourself, it's not necessary to walk about all day with a stupid lump of gauze hanging out your mouth

4) Rinse out gently with warm salty water after a few hours, spit out gently, just use some common sense

5) I was starving after getting my wisdom teeth out so I went to the staff canteen and had a nice lunch, steak pie, chips (fries?) and peas. Funnily enough I didn't die or get a terrible infection. Got a bit fatter though!

6) Brush gently round the extraction sites, then spit (a little more gently as above). You shouldn't rinse after brushing anyway.

Sounds like really easy extractions, so I'd expect a simple healing process. Please tell me you don't smoke!

Thank you so much!!!
I don't know if they will do stitches or not, the oral surgeon didn't say anything about that...in fact he didn't even look at my mouth at all, just the x-rays!

SO it's OK if I eat something right afterwards to take Advil with, & GENTLY rinse with salt water? Everything I read online says no rinsing at ALL but you are sure it's ok? I'm just so scared of dry socket with 5 teeth getting pulled!! My brother had ONE wisdom tooth pulled, came home, ate lunch, and by nighttime he was in so much pain, and for days afterwards because he gave himself dry socket...I guess by eating right away....soooo I'm nervous

I have to rinse out toothpaste (I do not use a flouride paste anyway so no point it sitting on the teeth), it's disgusting to me to think of food particles not getting rinsed away with the toothpaste I just brushed my teeth with....I probably have OCD

Unfortunately I do smoke...BUT! I can't smoke at all the day before because of the IV sedation, and I have NO intention of smoking AT ALL afterwards for many many days, or ever again for that matter!!
Sorry for my babbling fears here, I am so grateful to you for your reply THANK YOU!!

 

[Gordon]

Usually a couple of stitches are put in "just because", it's easier to do them while the patient is asleep rather than struggling with a terrified awake patient if they have a bit of a bleed later on

Sure, it's fine to eat something afterwards, just be a little bit careful not to disturb the clots too much, something soft will be perfectly OK though.

Dry socket isn't related to eating the risk factors are (in order)
1) Smoking
2) Difficult extraction
3) Lower arch more than upper arch (probably poorer blood supply)
4) Sex (women more at risk than men for some reason)

The longer you can stay off the cigarettes the better things will heal. If you can manage at least the first 12 hrs after the extractions that's pretty good.

 

[LauraB]

Thank you so much!!!
I have one last (ha ha I hope it's the last) question - I'm worried about how often I will have to be rinsing the first day. Because I will have to rinse after I eat (so I don't get food or bacteria accumulated!) in order to take Advil, so that will be a lot of rinsing the first day! Food....advil...rinse, several times that first day or I will be in pain if I can't take the advil because I HAVE to have food with it, it tears up my stomach without food
I know you said it would be OK to rinse gently, but that much rinsing makes me scared about dry socket And I'm a woman, and all 4 are coming out (along with another big molar) so, higher risk.
I'm sorry I keep asking I'm just scared

 

[LauraB]

OH darn I forgot one more thing! Sorry.....is it OK to use room temperature salt water rinse?? I keep hearing you have to use WARM, but I just can't picture having to keep getting up (when you're supposed to be resting) to warm some water to use all the time....our tap water is not good I don't want that in my mouth! So I'd have to keep re-heating on the stove (don't have a microwave). Can I just make up a bottle or something of room temp. salt water with my good filtered water??

 

[letsconnect]

There seems to be a misconception that food somehow causes infections... have a look at this thread: https://www.dentalfearcentral.org/f...y-socket-or-infection-after-extraction.30587/

You can boil a kettle full of water and once it's cooled down a bit, pour it into a water bottle (if you want to keep it warm, use a vacuum flask) together with 4 to 6 teaspoons of salt for use on the go.

 

[LauraB]

Oh thank you! It's so confusing sometimes. I appreciate that thread thanks! And thank you for the tip about the salt water, that sounds like the easiest thing to do now!

 

[Enarete]

4) Sex (women more at risk than men for some reason)

Wow, never heard about this one before!

 

[Gordon]

Yep, it's a (fairly minor) factor, probably hormone related.