Question - wisdom tooth removal and being "knocked out"

[D_K_night]

Hi there, OK let's just get this going:

Wisdom teeth removal, which many of you are intimately familiar with, or will be soon. The methods:

1) Freeze the gums via shot, remove your wisdom teeth(probably 2), and you're done within the hour or two.

2) The full IV treatment where you are totally "out" - you have the Anesthesiologist sitting there monitoring you, and the specialist performing the removal

3) You are handed two pills and water. The pills take effect quickly and put you into a "drunken" state - you feel no pain and the operation is performed in this manner. A waiver may be signed if you request all 4 teeth removed at once. You may be notified that you will not be "completely knocked out" for legal reasons(?)


Option 1 is straightforward and not much to talk about there. Please, no "MAN UP" replies please.

My questions center around the determination between Option 2 vs Option 3. For you health-care professionals and so on out there:

Some dentists seem very hesitant about granting you Option 2. Is this due to the cost(if so, can this not be simply passed over to the patient, as Anesthesiologists time is not free)? Is this due to putting someone out being inherently risky, and they'd rather avoid that? Or is Option 2 reserved for "complicated" extractions only?

I've had a friend vehemently insist that she cannot handle the pain nor the trauma, and they granted her the request to be completely knocked out for her wisdom teeth removal(Option 2).

So what's the determining factor at hand here? Or are the reasons nothing more simple than just "it just depends on your dentist"?

Thanks everyone.

[Rukentuts]

Is this due to putting someone out being inherently risky, and they'd rather avoid that? Or is Option 2 reserved for "complicated" extractions only?

I've had a friend vehemently insist that she cannot handle the pain nor the trauma, and they granted her the request to be completely knocked out for her wisdom teeth removal(Option 2).

So what's the determining factor at hand here? Or are the reasons nothing more simple than just "it just depends on your dentist"?

Thanks everyone.

Risk mostly. They don't want to be sued if something goes wrong.

However it is also more expensive because it requires an anesthesiologist on-site, but these costs are paid by the consumer. But if there is no access to an anesthesiologist, you can't have the surgery.

[frequency]

I had 1 of mine removed due to cracking it as a result of a bad filling, IV drip 100% completely out. I was told i had to be put under due to the depth / size of the tooth and me insane fear of dentists.
Total cost to me with no insurance was ~$400

[Deleted]

Hi there, OK let's just get this going:

Wisdom teeth removal, which many of you are intimately familiar with, or will be soon. The methods:

1) Freeze the gums via shot, remove your wisdom teeth(probably 2), and you're done within the hour or two.

2) The full IV treatment where you are totally "out" - you have the Anesthesiologist sitting there monitoring you, and the specialist performing the removal

3) You are handed two pills and water. The pills take effect quickly and put you into a "drunken" state - you feel no pain and the operation is performed in this manner. A waiver may be signed if you request all 4 teeth removed at once. You may be notified that you will not be "completely knocked out" for legal reasons(?)


Option 1 is straightforward and not much to talk about there. Please, no "MAN UP" replies please.

My questions center around the determination between Option 2 vs Option 3. For you health-care professionals and so on out there:

Some dentists seem very hesitant about granting you Option 2. Is this due to the cost(if so, can this not be simply passed over to the patient, as Anesthesiologists time is not free)? Is this due to putting someone out being inherently risky, and they'd rather avoid that? Or is Option 2 reserved for "complicated" extractions only?

I've had a friend vehemently insist that she cannot handle the pain nor the trauma, and they granted her the request to be completely knocked out for her wisdom teeth removal(Option 2).

So what's the determining factor at hand here? Or are the reasons nothing more simple than just "it just depends on your dentist"?

Thanks everyone.

Yes, if they put you under completely the level of risk rises considerably, not to mention it takes the patient a lot lot longer to wake up and "recover" enough of their wits to think straight.

[Rukentuts]

Total cost to me with no insurance was ~$400

I highly doubt that. It costs about $1000 to have a root canal.

[frequency]

I highly doubt that. It costs about $1000 to have a root canal.

I paid it out of pocket i was unemployed with no insurance @ the time, paying that $400 hurt what was left of my savings
They also knew i was unemployed and short on cash so they may have also given me a smaller bill than someone with insurance.
Like all medical procedures it depends on who is paying.

[Synithin]

I think honestly that it is because "being knocked out" adds a lot more complications to the surgery than is necessary. It is also extremely expensive having to have people monitoring, hooking the patient up to breathing equipment etc. The other main reason is properly fear of dentists, some people simply panic and it makes them impossible to extract the tooth on. Personally i have always had option 1, simply because it took around 15-20mins and i was done having that tooth extracted.

[Aldred]

I'd say cost, risk, and recovery time are the main reasons for not using general anesthesia. Although I'm sure they'll accommodate the patient's wishes wherever possible.

I opted for local anesthetic for mine partly because I don't really mind the dentist, but also because you can't drive or do anything like that for 24 hours afterwards and I wanted to be able to get home from the hospital by myself. You also can't eat for I think six hours beforehand and generally have to hang around longer at the hospital too.

[DeltrusDisc]

I was a number 1. I would do it again, too. It was painless and not a very long process at all.

Plus this is the same dentist I've seen all my life now, all 23 and a half years. ^_^

[Deleted]

I had all 4 of mine out because they were impacting. Option 2 for me. Free on the NHS.

[Talokami]

I think it depends on the dentist. To an extent they prefer you partially if not fully sedated because you're not going to flail around or fight them.

[Oerba Yun Fang]

From what I was told from my brother (he studied oral surgery for a while, ended up switching majors) they typically try to shy away from anesthesia simply because it always carries with it a certain degree of risk to the patient. Allergic reactions among other things are all possibilities so it's generally an "only if absolutely necessary" type of thing.

I've only had one wisdom tooth extracted (impacted lower-left wisdom tooth - the other three came in just fine, thankfully) and when I had that done I got option 1.

[D_K_night]

So the consensus looks to be, the risks with putting someone out - there's liabilities to go with that and so on.

However with the Anesthesiologist sitting there watching you - would that not be effective risk mitigation?

[h3lladvocate]

I have to get mine removed soon I fear (starting to feel some tenderness back there, not to mention the top of my rear molar is exposed *gulp*). Not looking forward to it, I am scared to death of the dentist. I think they've already said in the past they're gonna knock me out, since they are all likely impacted (top ones are for sure). I've had enough teeth pulled, I am sick of local, and frankly, scared of it. While I fear the general too, I've heard general is pretty damn safe these days...

[Oerba Yun Fang]

So the consensus looks to be, the risks with putting someone out - there's liabilities to go with that and so on.

However with the Anesthesiologist sitting there watching you - would that not be effective risk mitigation?

It helps but it's not a guarantee. There's still people who die during surgery from complications (granted not all are due to the anesthesia). Generally, any risk, no matter how remote, is considered in the world of medicine. There's always the possibility that that particular patient will be the one-in-whatever-number that has complications, and this can lead to all sorts of consequences if the proper steps weren't taken before hand (lawsuits, loss of license, etc.). They're taught to cover their asses no matter how unlikely the negative outcome may be.

And in the case of allergies, it's often an unknown, so that's even more reason to take precautions.

[Arkenaw]

I had all 4 of my removed with option two. I don't even remember being asked if I wanted anesthesia or not. The worst part was recovery in the weeks after.

[Asmekiel]

Have to get one removed next month. We really only have option 1 here, so there's little choice. Not that it really matters though, you don't feel a thing that way.
Since a year or so there are a few dentists that offer option 2, but it's not insured yet and costs a lot.

[Dreamless]

Risk mostly. They don't want to be sued if something goes wrong.

However it is also more expensive because it requires an anesthesiologist on-site, but these costs are paid by the consumer. But if there is no access to an anesthesiologist, you can't have the surgery.

The anaesthesia given for wisdom teeth removal is not general anaesthesia.

It's much, much more mild than general anaesthesia is, and has little to no risk associated with it.

I would highly suggest using that method. It definitely requires you get a lift home after the procedure, but makes the whole thing much more bearable.

I had all 4 wisdom teeth out simultaneously (which I also definitely suggest; the first few days are more of an annoyance, but it condenses it down to one trip, and it is not in any respects unmanageable. I didn't even end up using painkillers afterwards, just some extra strength ibuprofin. It really wasn't that painful at all after the procedure) with the knockout IV option. The subjective experience for me was what felt to me about 5 minutes of time, with a vague suggestion of my lips being pulled on and a little bit of pressure on my gums as I half woke-up halfway through it, but went back to sleep again very quickly.

[FourEyesMoniker]

There are two options where being put under is probably a better option. One, as others have said, is if someone is likely to be scared and fight the dentist. Another is if you have a particularly small mouth. The reason I say that is if you are awake and just under local, your mouth is going to be open for a very long time if they have any issues, with you constantly trying to close it and swallow and such. Being put under, you might have less stress on your jaw muscles, and less soreness from that alone.

When I had mine out, they did all four at once. Unfortunately, it also took longer than it might have otherwise, because on the two bottom ones, part of the roots broke off, and they had to do some extra work digging them out. Speaking of, if that kind of idea really freaks you out, you might want to be put under, as it is not uncommon.

In my case, a combination of a smaller than normal mouth and the longer time it took for them to dig out the roots left my jaw muscles sore for well over a week. But I had pretty much no pain from the actual teeth being pulled.

[Deleted]

I had option 2 with all 4 teeth removed and I think it was the right choice.

Yeah, you felt terrible for the rest of the day but that would have been the case no matter which option you chose.

At least you had it over and done with at that point and didn't have to waste more thought on it. It was also the easiest as you sleep through the whole endevour rather than having to watch people fumble around inside your mouth.