Question about wisdom tooth removal!!!!!!! (Well, moreso the medications/anesthesia used.)?

Question

Hello, I'm supposed to get my wisdom teeth out, but I have significant concerns about the medications to be used. The oral surgeon keeps trying to convince me to use either general anesthesia or heavy sedation saying "it'll be better and easier for both of us!" so he must be thinking that I'll get very anxious before surgery or whatever, but that's simply not the case. I know that I look somewhat frail as a 15 year old girl, but I have an oddly high tolerance for anxious situations and pain. (I had my bikini area lazered off [laser hair removal] and the technician said she's never seen anyone say that they couldn't really feel it.... most say that it's worse than childbirth.) Anyway, he wants to give me Varcet and Fentanyl, and the Varcet (last time I took it) made my heart rate go up to 187 bmp and my blood pressure to drop VERY VERY LOW, like 70/45, and I'm allergic to almost all narcotics.

Would the sedation/general anesthesia do anything for PAIN or just anxiety?

In other words.... As long as I won't feel anything (I know I'll feel pressure, hear the drill, feel my mouth being pried open, etc.), I'm not having any sedation anesthesia. Will novicane be sufficient?

To the last person who responded, the Valium was given to me when I could not stop vomiting for an unrelated incident of food poisoning and Phenergan and Zofran did not work. I was COMPLETELY asleep for over 48 hours, but I was told when I came-to that they were running all sorts of EKGs and they were very concerned with my heart because my pulse was so high yet my blood pressure was so low. SO, I was NOT anxious (since I was sleeping), nor was I in pain because I was vomiting only -- this was not for dental work. Ativan was given again when I could not stop vomiting and I had a very similar experience, only it didn't make me tired at all -- I was crawling out of my skin and I thought I was going to die (this woke me up from a sound sleep). So your analysis was way off and you should consider looking further into the effects of benzodiazepines seeing as though you work so closely with them. Read up on it: http://www.emedicine.com/emerg/topic944.htm

Answer 1

I think Novacaine would be more than sufficient. General anesthesia carries a risk of fatality, which you don't need. My oral surgeon of years ago did give me some kind of pill afterwards, and had a small room where I could lie down. I don't think any of that was necessary, my regular dentist has performed quite a few root canals and put in a bridge, all with novacaine. (Although takes a week or a bit more to get rid of the pain from the root canals.)

Answer 2

Good job researching.... Yes they are actually offering you conscious sedation. They are calling it 'general anesthesia' because most of their customers are not familiar with the term 'conscious sedation' and it would cause confusion trying to explain this difference to people. Sure, it would be better in the long run to educate the patients, but it's easier to just use the term that people are familiar with. Anyway... so you need to choose the type of anesthesia. Personally, I'd consider two things: my degree of anxiety about the procedure, and the extent of the surgery. If you are really nervous about dental work, you might want to consider conscious sedation. If your teeth have not come in, and they need to be removed from below the gum line, you might want conscious sedation, especially if you are nervous. On the other hand, if you are not phased by these types of procedures, the teeth have come in, and it's a quick and easy surgery, you might only need local anesthesia. That was the case for me, it was quick and easy and I'm low-anxiety. The sights and sounds were pretty nasty though, and I can see how a lot of people would be freaked out by it. Hope this helps you to decide.

Answer 3

Having four wisdom teeth removed can be a big deal, depending upon how deep they are and their relation to the other teeth. Your oral surgeon just wants to do the best possible job for you and he may have had a bad experience trying to do such a case under local anesthesia. If you change your mind and want general in the middle of it, giving general anesthesia could be dangerous because of possible blood in the airway.

Fentanyl is an opiod like morphine and does treat pain. Versed is a sedative like Valium and will relax you and cause amnesia. I have given it to patients for many years and have never, ever seen it cause a rapid heart rate. Same for Fentanyl. Your rapid heart rate was caused by one of two things - pain and anxiety, or much more likely, epinephrine that the dentist added to the local anesthetic.

General anesthesia does have the potential to cause nausea and vomiting, a sore throat if a breathing tube is used, and long emergence. The combination of Versed and Fentanyl in low doses is not general anesthesia, but as the doses are increased, general anesthesia can be reached with these drugs.

As a teenager I had two large canines removed under straight local anesthesia in preparation for braces. The experience was not very pleasant. The wisdom teeth are much harder to get to, and there are four of them.

If you do receive drugs for your case make absolutely certain that the oral surgeon is monitoring you, especially with a pulse oximeter.

Answer 4

I had all 4 of mine out with only novocaine and I was FINE. I had no pain, really. I didn't even leave with a prescription for any painkiller. I just took Advil (4 at a time) for the pain/swelling afterward - which was minimal. I have problems with anxiety but, strangely, I'm not bothered by the dentist at all. You do not need anything but novocaine if you have a high tolerance for pain.

BTW, my wisdom teeth were NOT impacted. All they had to do was pull them out, there was no surgical procedure involved. I don't know if that makes a difference to you or not... I'm also in the process of getting 7 root canals with only novocaine. I've also had 4 other teeth pulled with novocaine.

Answer 5

I forgot the name of the anesthesia they used but it was a gas. They asked me to count backwards and I was out before I knew it. I didn't feel a thing and apparently, they had to actually break a couple to pull them out.

Now, I was sore the days afterwards but I took percocet for a day or two.