Tooth Extraction Enquiry

[Kendrew]

I'm having the remains of a broken tooth extracted in two days time and because its apparently going to be a bit tricky, I'm going to be sedated. On offer is,

- sedation by gas (nitrous oxide & oxygen)

- intravenous sedation ( midazolam)

The first option seems to have almost immediate recovery afterwards whereas the second option requires a few considerations and at least 24hrs for full recovery.

Am I right to assume therefore that the gas option will probably have the best recovery time, even with pred, propranolol and Atorvastatin added into the mix?

Any advice, greatly appreciated.

Thankyou

[PMRpro Ambassador]

I assume I had midazolam a couple of weeks ago for the ablation - no idea how long I was out, my mouth felt like the bottom of a budgies cage when I came round and it was definitely 24 hours before the dregs were out of my system. I was in hospital so it didn;t really matter but not sure I'd have fancied going home too soon after!

As soon as they stop giving the notrous oxide you should be "back" within a few minutes - it's the stuff used in childbirth (no personal experience of it though, I had c-sections)

prescottfamilydentistry.com...

oralsurgeryofutah.com/2017/...

[Kendrew in reply to PMRpro]

Thanks Pro. 👍

Informative advice that's given me the knowledge I needed to make the right choice for me.

As always...appreciate your time and help. 🙂

[SnazzyD]

gas and air during labour helped me relax and disassociate from the pain. It leaves the body in minutes once you stop inhaling it. Presumably you take it through the nose instead of a face mask for obvious reasons so you would need to breathe through the nose. Midazolam can take hours and hours to leave you and into the next day. Made me feel horrible, but we’re all different.

[Kendrew in reply to SnazzyD]

Thanks Snazzy for responding and offering your perspective.

[jessiem]

I’m having the same in a few weeks - so I’d be interested in how you get on. I think I’d go for the gas and air because of quicker recovery time. Good luck .

[Kendrew in reply to jessiem]

Thankyou jessiem

Unless I'm told of some contraindication I'm not aware of, I'll be taking the gas option now too.

Interesting that I initially thought I'd probably have the IV option until I sought some help here.

Hilights how necessary it is to always educate yourself as much as possible about any matter that requires us to make a choice or decision... and this forum is completely the right place to do that. We're so fortunate.

I'll definitely update my post after the procedure so look out for it.

[Hidden in reply to Kendrew]

Best wishes 💐I hope it goes well

x

[Kendrew in reply to Hidden]

Thankyou

[HeronNS]

Best wishes for successful procedure and not too much discomfort as you heal. Will you be getting an implant or is it a back tooth which may not matter?

[Kendrew in reply to HeronNS]

Thankyou. I think they'll do something called a bridge.... where an artificial tooth is attached to the teeth on either side.

Apparently leaving a gap may cause my other teeth to shift and cause more issues.

It would be done at a later date though and I need to discuss that in more detail first.

[HeronNS in reply to Kendrew]

I confess to curiosity as I had an extraction with immediate implant this summer. In my case the affected tooth was a middle upper front tooth so was glad the implant could be done at the same time. Still have the temporary crown, but expecting permanent one early in February. At the same time I'm getting a retainer to stop my lower teeth from moving any more - possibly result of losing a molar years ago. At the time no one said anything about possibility of other teeth moving, and as no one can see it, and I have wisdom teeth so didn't need the one lost, we just left the gap. (I'd briefly had a root canal and gold crown, but turned out the tooth was cracked and there was constant low grade infection....) It was only when I was hanging around one of the dental waiting rooms I've visited this year that I read about teeth moving, so I'm glad for your sake that your gap will be attended to promptly!

It was a bit disconcerting when my dentist blurted out the day I had scan to measure for the crown that my teeth are "great - they have so much character"! Somehow having teeth with character doesn't sound all that great.

Anyway I hope your dental adventure proceeds smoothly! 🍀😁

[HeronNS in reply to Kendrew]

Oh, and by the way, I only had local anaesthetic for everything. Had been offered sedation (an injection) for gum graft but at last minute said I'd manage without, and I did. Before going into clinic I gave myself a few drops of Rescue Remedy (Bach Flowers).

I like it when the person doing procedure chats you through it, telling you what's going on. Periodontist was very quiet so I didn't know what she was doing or how long it would take, other than what had been told beforehand. However the man who did the extraction/implant told me everything that was going on, showed me (broken) extracted tooth, explained every move, showed me the titanium rod that is the implant.... Even the images he was working with. All quite interesting and distracting.

[Kendrew in reply to HeronNS]

Sounds really quite interesting but a little more 'involved' than mine is going to be! Hope my procedure has as good an outcome as yours happily did.

Characterful teeth??? Hmm..... not come across that one before! 😂

Thankyou for responding Heron

[Stills]

I had sedation and gas for a recent procedure, although very low level sedation, I was my usual self with minutes afterwards and no side effects, although I’m not on any med except otc pain relief. Good luck

[Kendrew in reply to Stills]

Thankyou.

[Pixix]

I’m very interested, as seeing dentist tomorrow to discuss an extraction on a tooth where they are expecting it to shatter & there will be lots of pieces to ‘dig’ out. Hospital wait to do it is 11 months, & I have 7th infection & just want tooth gone. Now I now what to pick, if need that choice, very timely! Hope all goes well for you. I have bad toothache now, but dreading the procedure. Thinking of increasing pred from 2mg to 5 mg, as I currently have a flare, slight vertigo & an injured knee & hip from a fall. I call it ‘London bus syndrome’. I wasn’t thinking of increasing pred, but am now. I guess you aren’t increasing? Sorry if this is too personal, but do you take propanolol to control tremors, please? I’ve just picked up my first tablets & I have to increase weekly. It’s likely I will have to take 16 tablets a day to get control. I’m not happy with this, but now have significant arm & hand tremors in left, & it’s started in the right side, too! Good luck! S x

[Kendrew in reply to Pixix]

Hi Pixix

You're situation sounds a little like mine regarding the tooth extraction. I don't have any pain thankfully, despite an infection that required some antibiotics.

I'm sorry your situation is a little more troublesome with other health issues to consider.

Try not to be fearful of the procedure...it sounds worse than it will actually be and I know that the dental practitioners will ensure we don't feel any pain and that we'll be as relaxed as possible with the gas. I'm expecting my gum to feel sore afterwards but I know this shouldnt last for too long.

I won't be taking any extra prednisolone myself but your situation is different and you must do whatever is right for you.

As for my Propranolol....I don't mind you asking at all.

I don't take it for tremors.... from time to time I experience episodes of ectopic beats (extra heart beats) Everyone has them but mine are particularly noticeable and have caused me some anxiety in the past, until they were checked out by the cardiologist and diagnosed as harmless. They're probably best described as palpitations.

The Propranolol just calms them down.

I take 40mg daily, so a relatively low dose.

I hope you have a positive outcome from your appointment tomorrow too, and good luck with whatever is decided.

[Pixix in reply to Kendrew]

Thanks very much. Yes, definite similarities, I think. The pain was OK until the swelling started on outside of gum. Last time I had a tooth out it took the dentist 40 minutes, by which time he was red & sweating profusely! He shot across the room shouting ‘got it’, then realised the roots had grown up into the cheek bone, & he’d pulled part of my cheek bone out! I know it sounds as if I’m exaggerating, but it’s exactly as it happened! It’s a bottom tooth this time, so no cheeks to worry about! I have symptoms of adrenal problems back again, so will talk to the dentist about an increase, or not. Thanks for the propranolol bit, I’ve yet to look up the drug & see side effects etc, as only just picked up the tablets. Hope all goes well, S x

[Kendrew in reply to Pixix]

I personally haven't experienced any real side effects from the propanolol. The first few days I felt a little woozy but that disappeared after a day or two.

[Pixix in reply to Kendrew]

Thanks, that’s good to know.

[Gimme]

Is the sedation your choice, or the dentist's? I know that some people are really nervous about dentistry and need the sedation to be able to have treatment at all, so I wouldn't blame anyone from making that choice if they need it, but do you think that you really need the sedation? Personally, so long as I am going to be made profoundly numb, I prefer to be awake, even for complex dental procedures. I stay calm using meditation techniques. I recognise that some people might not be able to do that, so I'm just suggesting that as a third option to consider.

[Kendrew in reply to Gimme]

Thankyou. I appreciate your thoughts and comments. I'm quite a tough old bird with most things, but as a child and teenager I had some really horrible experiences at the dentist.

My mother had bad gums & my father, bad teeth and unfortunately I inherited both! So I was always needing fillings! Back in the 60's, dental treatment wasn't as 'kind' or advanced as it is now, so all I can remember is the extreme fear that arose from knowing I was about to experience extreme pain as the dentist drilled out the bad stuff..... and it was 'extreme pain'. At times I thought I would faint.

So unfortunately, although I'm not particularly fearful of the procedure, I don't want to be too aware of everything that's going on and feel happier with a little help to relax me.

I won't be asleep, just 'chilled out'!

Thankyou for your input and alternative suggestion though.

[scottygirl73]

Hope all goes well,i had root of tooth taken out but only had injections to freeze mouth, it was awful 8 jags ltr he said i might have to go to dental hsptl try once more another jag.I cried like a Baby all way through procedure my Husband was with me so glad he was.xxx

[Rugger]

Wishing you well for the extraction. I share your childhood experiences of dentristy and it has taken me decades to feel anything like 'comfortable' with being in the chair!

A year ago I had the remains of a broken tooth extracted without any sedation - just numbing, of course. The dentist took his time very gently loosening the tooth in its socket and I was never more relieved when he said to the nurse "It's free"! It healed well too.

I took 5mg extra prednisolone on the day, as had been suggested by a dentist before, for an extraction soon after I was diagnosed with PMR.

I try to recite poems in my head when I'm in that kind of stressful situation - my kind of meditation!

[Kendrew in reply to Rugger]

Thankyou.

Sounds reassuring...... and a good strategy you had to stay calm!

Thankyou for taking the time to respond.

[knoone]

I had a tooth extracted last Friday and had gas. It worked well and I felt back to moral before I left the dentist office.

[Kendrew in reply to knoone]

👍👍Thankyou

[brenda1207]

I just had a front tooth extraction done today and Bone grafted for a future implant. I had nitrous oxide and the usual deadening and it was sufficient to relax me and make me comfortable.

[Kendrew in reply to brenda1207]

Thankyou for those reassuring words. I appreciate you taking the time to respond.