My daughter having wisdom teeth removed. Questions?

Question

My daughter is 19, her dentist noticedc last year that her impacted wisdom teeth needed to be removed but didn't tell her until this year. All 4 are impacted.We've had a consult with an oral surgeon, who told us he'd use general anesthesia. My daughter was born with a hole in her heart. It has since closed up and she has palpitations and is under a cardiologists care.She's worried as I am , after seeing all of these plastic surgery nightmares, plus the fact that the oral surgeon told me, in front of my daughter, that 'there are always risks'.OMG, that terrified us both. The date of her surgery is Dec 28 and she's worried already, Christmas will be a disaster.I mean, she faints over blood being drawn. I'm scared for her. Any advice? The doc mentioned laughing gas, she cannot have any epi .Do you know of anything that could work besides general?I know I have a fib, a heart condition and I cannot have general.HELP!

Hi Madfor...the oral surgeon is going to talk to the cardio to get a release before the surgery. *Thanks*

Answer 1

take her to her cardiologist and tell the doctor what she is having done and ask the cardiologist.. they may have to run some tests.. I have a murmer and had several surgeries without any problems.. but my surgeon always sends me to the cardiologist just in case.. so i would do that if the oral surgeon didnt reccommend..

Answer 2

Ok, I guess I can't understand why you scheduled this without discussing it with the cardiologist first?

Wisdom teeth removal is pretty brainless and it's good to do it now before they cause real problems.

I had four impacted and had all removed when I was about 15 during Christmas break. It's no fun, you can take pills for pain and use black tea bags to control any bleeding (which usually does not happen). Keeping the mouth clean with salt water wash (or something else to keep away infection) is helpful too.

Natural medicine usually recommends that you take vitamin C in high dose (1000) to help with infection if their are heart issues.

Get some answers BEFORE she goes in, or cancel it until you have gotten enough information so you can make an educated decision for your daughter. Also, being calm and not freaking out certainly will help your daughter much more than anything.

Answer 3

When the surgeon mentioned a general anesthetic, he more than likely means they will give her something via an intravenous line, not that they will use gas. That will mean she is out entirely, so they don't have to use a local anesthetic. That eliminates the need to avoid epinephrine, which local anesthetics for dental work contain. Since she will recieve anesthetic, she will have to have a monitor in place for the entire procedure. Since they know going in that there is a heart condition, they will be watching her quite closely for anything that might come up. This procedure should be done in a hospital setting, so everything will be close at hand should the need come up. Unfortunately, the laws regarding counselling patients mean you have to disclose all the risks, even those which are highly unlikely. The truth is, there are always risks with anesthesia, and nobody can absolutely promise there won't be any. It's not likely to happen with the anesthetics used in a dental surgery- but you have to be informed all the same. Laughing gas is used by some dentists to get a patient to relax enough to be able to proceed with a procedure that stresses them- in her case I suppose that means inserting the IV needle. I had oral surgery done this way, using an IV to sedate me for the procedure. It's a very small needle, and I hardly noticed the prick. The anesthetic made me simply drift off to sleep, and I awoke about an hour later back in my bed again. My husband took me home about an hour after that, and I was just fine. I've assisted with iv sedation many times in my career, and I have never seen any problems from that even with very elderly or very young patients. Those are usually the ones most likely to have problems. There are no magic words to give you that will erase all your fears, but there is no reason to let you or your daughter get yourselves too upset. The fact remains that the teeth are impacted, and need to be removed. Leaving them in place puts your daughter at risk for developing an oral infection- and that is much more hazardous to her heart than the sedation will be. The only other option would be to use a local anesthetic, and do the procedure on one side or tooth at a time. That just drags out the misery, honestly. This way, the oral surgeon can get it all done at once, in a safe atmosphere, with the least amount of risk and trauma to your daughter possible. Yes, there are always risks, but you can't get much safer than having it done in the hospital where everything is readily available to deal with it. The benefits to her health far outweigh whatever risk the sedation poses. And honestly, that risk is not that high. The anesthetic doesn't last that long, she will be on a monitor, and if anything doesn't look right, it's easily reversed. So please, enjoy your holidays and don't focus so much on a minimal risk. Like as not, it will all go just fine. She will part company with the teeth, be miserable for about a week, and then move on just fine. This procedure is done all the time, even on patients with serious heart problems, and there's no reason to suspect it will go any differently for your daughter. If the oral surgeon thought the risk were that great, he wouldn't have even suggested it. And although he could have put the risks in a little better sense of proportion, most surgeons skills at procedures far exceed their patient sensitivity. Try to stay calm, and look for the best- enjoy your holidays and remember, it's a common procedure with very few actual complications.

Answer 4

When he meant general anesthesia, did he mean that your daughter would be put *completely* under, or did he refer to "conscious sedation", or IV sedation?

I do not have any kind of heart condition, but I did have my four impacted wisdom teeth removed by an oral surgeon. It was a relatively complicated case because I waited until I was older as well.

The dentist did not put me under the same type of anesthesia that happens when you have surgery in a hospital -- like to remove an appendix. Instead, he gave me an IV that contained a strong narcotic and a benzodiazapine called "Versed". This creates pain relief and amnesia for the procedure, but leaves the patient able to breathe on their own and respond to the dentist's requests to some degree.

It's also sometimes called "Twilight sleep".

I am not sure if this is appropriate for patients with a heart condition, but I have heard it is less risky for healthy patients than true general anesthesia where you are monitored and sometimes breathed for by an anesthesiologist.

It may also be that due to your daughter's heart condition he would rather have "general anestheisa" - being moniored by an anesthesiologist the whole time - instead of risking putting her even partially under outside of a hospital.

I would speak to your dentist about your concerns and ask if an anesthesiologist will be assisting in the case. If an anesthesiologist will be assisting or monitoring your daughter continiously during the procedure, or administering the anesthetic, you could then direct your concerns to him about the specific chemicals and procedures he will use and what is safest for your daughter.

ALL surgery has risks, even removing a splinter has risks. Doctors are required to tell you these risks in order to not be accused of malpractice, but they are relatively rare or people would be dropping dead a lot more often during surgery than they do and surgeons wouldn't be making so much money because people would be even more afraid to have surgery than they are now. Don't let the Christmas season be ruined by your anxiety.

To give you something to be happy about, within three days of my surgery I was able to travel over 1,000 miles to meet my fiance's grandparents -- in a car! As long as your daughter doesn't smoke or drink through a straw, and follows her other post-care instructions, she shouldn't be laid up in bed at New Year's!

Answer 5

My 16 year old daughter--severe heart murmur--had her wisdom teeth remove with a combination of demerol and versaid. (Don't know the spellings on these drugs, but she remembers nothing of the surgical procedure.)
The biggest scare reducer is a calm mom and all the TLC you can give her after--I found that Cream of Rice was about all she could eat after.
Good luck and make sure that everything you do is closely monitored by her family doctor.

Answer 6

First, you and your daughter need to calm down. Take a few deep breaths and think about it; every time you walk out of the door or cross the street there are risks. Considering the nervousness of your daughter, I think Nitrous Oxide (Laughing gas) would be the way to go. Having been born with a defective heart (even now healed) I would premedicate with an antibiotic. Enjoy Christmas and have a positive attitude. If necessary, you can have general anesthesia. I have atrial fibrillation and have had surgery with general anesthesia six times.

Answer 7

First of all calm down. This isn't brain surgery.
Now, call her cardiologist ASAP. Talk to him about your fears.
Nitrous Oxide (laughing gas) is great. It gives you an "I don't care" feeling. And she will be numb. Can he give her a sedative before hand? If she goes with the Gas tell her if she's stressed to breath deep through her nose.
She will be fine.

Answer 8

I only had three wisdom teeth. All of mine were also impacted and Abcessed. I had my regular Dentist take them out when I was 23 years old with about six shots of Novocaine. After this Dentist, who had treated me since I cut my first few teeth, began extracting my badly infected, deeply impacted wisdom
teeth, he said he wished he would have sent me to an Oral Surgeon. First of all, the Oral Surgeon specializes in cases just like this, so let's hope that helps to ease some of your concerns. I didn't even have the option of the 'laughing gas.' This should help your daughter tremendously because it will make her very goofy and help her to relax. If you or your daughter cannot have general anethesia or epi's, then why not give the 'Gas' a try without totally 'knocking her out?'
General Anesthesia can be a big concern for heart patients.
All doctors and surgeons HAVE to tell you to be prepared for the absolute worse case scenario and protect themselves from a potential lawsuit, so don't let the fact that the Oral Surgeon said, 'there are always risks' bother you all that much. If your daughter was having surgery to where she needed to be put to sleep, then I would begin to really worry. While this kind of surgery is bearable, it can still be painful afterwards, especially if you don't follow the post-op orders.
The fact that these teeth are impacted means that the teeth cannot be taken out cleanly in one piece. The Surgeon is going to have to cut into the gums and very likely remove each of these teeth in several pieces, just like mine. One of my teeth was taken out in six pieces, one in four pieces, and
the other one in two pieces because they were so far under
the gum line, and I remind you that with my teeth being badly
abcessed, the local anesthetic, Novocaine, only worked to a
certain degree without me feeling pain, but it did not make
me pass out. I was told to use Mercurechrome on my gums
(not available anymore), plus I rinsed with warm salt water several times daily, was given Percodan, and only ate soup,
mashed potatoes and foods that did not have to be chewed
for the first three or four days. My wisdom teeth turned out to
be a big pain and uncomfortable surgery, but it was not totally
unbearable. I've had lots of surgery since then that was much
worse and way more painful! One tip! Don't let the Surgeon give her Percodan...it is really bad stuff and it caused me to
have hallucinations and horrible nightmares while I was taking it. Ask for a different pain medication such as Vicodin ES (Vicodin 10/650). It contains synthetic codeine and lots of arthritis strength Tylenol in it and does wonders for pain of this nature. Even my Dad could take Vicodine with his heart being bad as it was for extreme pain.
Many people, including my two older, completely healthy 18 & 19 yr old children were given 'Gas,' or several shots of a local anesthesia, as opposed to being put to sleep, and had all four of their wisdom teeth taken out. Within about ten days, they hardly had any pain and were doing just fine, plus they said they remembered very little. I, however, remembered everything, including how long it took to have these 3 teeth extracted, the pain that could be numbed only to a certain degree, plus I was given Percodan pain pills every six hours. Even though it took me about a three weeks to really recover, my kids 'bounced back' at 18 & 19 years old, probably twice as fast as I 'bounced back.' I was only able to take one day off work, but the next day, my supervisor sent me home after he saw how pale I was and just how much I was hurting. He told me to go ahead and take another two days off, take my awful pain meds like I was supposed to take them, spend those days in bed and I still kept my job.
I truly think that if your daughter is given something to help relax her, perhaps some Valium or Versed, both are types of
relaxing medications or the 'laughing gas,' then shots of local anesthesia, and pain pills to take home with her (whatever she can tolerate because of her heart condition) for after-wards, and some ice packs for the swelling that she will probably tolerate this procedure without having to suffer that much. Doctors now have so many malpractice suits against them these days that the Dr's are compelled to let you know
about every little possible thing that could go wrong which does tend to scare people -- a lot! I think that perhaps the doctors go too far in saying that anything can happen, but in most of the cases, as long as the doctors or dentists don't over-sedate or over-medicate the patients, especially the ones that have other serious health problems, the patient will
usually come out of the procedure just fine -- very, very sore
for a few days, but fine overall.
Ask the Oral Surgeon what effects a Valium pill or a Versed injection and a local anesthetic to numb her would have on your daughter's heart or if it is even necessary, since she will be given 'laughing gas.' And be sure to consult with her Cardiologist before having this done. The Cardiologist can tell you what is safe and what is considered to be a high risk procedure.
My Dad had two major triple by-pass surgeries and there were many medications he could not take and lots of his surgeries after the by-passes had to be done under a local type of anesthesia, plus he was able to take Versed to calm him down. Now, you probably need a Valium for yourself until your daughter gets through this surgery! ;) Try not to worry and make sure you get prior consults before having this done to help put your mind at ease!! See? Gramma knows about this, too!!