Wisdom tooth extraction - terrified! Nitrous oxide or oral meds?

[MountainDweller]

Hello all, I'm new here but have been reading.
I have to have a wisdom tooth out. I had a little filling in the side which fell out during lockdown, no big drama, I thought. I wanted to wait to go to the dentist till I was fully vaccinated. Meanwhile my long term, trusted dentist retired and the people who took over her office are only ok. So I tried to find somewhere else. First place was terrible, waiting room noisy, children running everywhere, no air con in reception (I fainted), dentist laughed when I said absolutely no way were they taking it out without sedation.
Phoned a few places to try to find one that might do IV sedation. It's not common here (Switzerland) and is v expensive - I'd be adding about 1600 francs to the bill because it has to be done by an anaesthetist and an assistant. I had two out in the U.K. under IV sedation in 2004 and it was great, just the dentist and his nurse, and cost about £200. Bargain. I wish they'd taken the lot!
So IV is out because of price. I can have gas and air (nitrous oxide) and/or oral meds.
My actual question: does nitrous oxide actually do anything for a very nervous patient? Or is a nice big fistful of Xanax/Lorazepam/Midazolam more effective? (I have been to another dentist who offers it and is experienced with anxious patients and I had a panic attack. The next week I had a panic attack at the hygienist. I really want to be as knocked out as possible but the dentist says that's not the aim).
I'm sorry pretty likely to ignore that and take a load of stuff anyway. I have the chance to try the nitrous oxide in an appointment before the extraction. I'm not sure if I should go in fully loaded with as many drugs as I can tolerate or if I should just take a normal dose of Xanax and see what effect the nitrous oxide has. Then based on that increase the dose for the real thing? I am partly worried because I'm routinely on anti-anxiety meds, anti-depressants and sleeping tablets, as well as opiates and pregabalin for pain, so I have a pretty strong tolerance. I had a surgery with a spinal and sedation and I was wide awake!
Thanks for any help, sorry it's so long.
(I think my phobia comes from painful extractions as a child.)

 

[geos]

For the spinal surgery, do you know what type of sedation you were meant to have?
I'm wondering if you were wide awake during your spinal surgery with sedation because it was a conscious sedation.

For some personal experience on my side:
As a kid, I broke a leg and needed surgery. I was suppose to be under, but I was so nervous, I was wide awake during the surgery. The surgeon said I didn't panic or anything, but I was well aware of everything and the surgery was successful. A few years later I needed to have my wisdom tooth and was nervous the sedation wouldn't work. I was out and the surgery went well there too.

Now that I'm older, I needed surgery to fix an abnormally in my heart. To find where the abnormally is, you need to be awake. They give you sedation, but you are awake.

I would suggest you discuss with your doctor or dentist your past experience and your medication (current and historic) to see what they recommend for you to have the best experience possible.

 

[superjen]

When I had mine out they used iv valuim and injected novocain in my mouth. The doctor waited a very long time, but the valuim didn't make me tired so he went ahead with the removal and I watched the whole thing. I just remember lots of tugging and then chunks of tooth coming out of my mouth. Once it was all over I fell fast asleep from the valuim.

I'd say if you know the oral meds will calm you enough then take those, but be sure to let the doctor know what you've taken.

 

[Enarete]

Hi there,

sounds like you needed quite a few attempts to find a dentist that takes you seriously. Hope you have one now. I believe that this is purely about your own experience and preference. Oral meds work differently for everyone, but as you have quite an experience with them, you may be familiar with what works for you. Trying out nitrous before you commit to using it for an extraction sounds like a good idea to me. In this way you will get a reference about nitrous.

My actual question: does nitrous oxide actually do anything for a very nervous patient?

Yes. Absolutely. Some people describe it as having two beers: you are there and somewhat aware, but you don't really care. For some it can feel like almost being out now and then and only catching bits. We have a very extensive article about it here.

The best approach may be to discuss this with your dentist. They may be able to help you figure out how to get into the state of the most possible relaxation for the procedure.

All the best wishes