Tooth extractions - general anaesthetic - for orthodontic treatment

[mrsmike]

DS1 is 16 and needs 4 teeth extracted as part of his orthodontic treatment - before he can have a fixed brace fitted. 3 times now I have taken him to the v v nice dentist to have this done and 3 times he has jumped out of chair at last minute. It has turned in to big phobia for him. I am wondering if he could be referred for a general anaesthetic but orthodontist says no as it is only for cosmetic reasons. Has anyone had GA for orthodontic treatment or know if it's possible? thanks

[NotQuiteCockney]

GA is really really bad for you. Seriously, they're very dangerous, they kill lots of people, and they're saying 'no' for a good reason. (Even local anaesthetic is bad for you, tbh, and kills a few people.)

When is he bolting (before injection? after?)? Have you spoken to him about it? There are some v good techniques for dealing with phobias out there. Or you could teach him self-hypnosis, or get him some hypnosis tapes for his ipod, to listen to while they do it?

[expatinscotland]

i'd go for IV sedation and local before GA.

i've had a total of 5 teeth extracted - two of them wisdom teeth that grew in straight but got decayed, one impacted wisdom tooth and two crowned molar that got decay in what little remained of the tooth - and like NQC i'd only have GA if absolutely necessary.

[mrsmike]

Has bolted 2x before injection and 1x after injection. When orthodontist said they don't refer for cosmetic reasons, plastic surgery came to mind ...
He would be v sceptical about self hypnosis etc - actually he had teeth out with GA about 10 yrs ago - I suppose I am thinking of it as a necessary evil - I mean the risks are very tiny aren't they?

[CarGirl]

do they not have anyone in the are that does them with gas, there is usually one in a PCT?

[whooosh]

My sister is extremely phobic and has just arranged to have treatment in Germany.
She needs 4 root extractions and two further extrections plus a whole host of other stuff,which in Germany they will do under GA (5hrs!).
Apparently (according to a UK dentist)they cannot legally do anything other than extractions under GA in this country.There has to be a very good medical reason to use GA.

Heavy sedation is fantastic and combined with hypnosis,even better.
Many places use IV sedation for phobic patients.

[mrsmike]

Thanks, what is IV sedation - does it take place at regular dentists or is it hospital treatment? Are you awake?

[Niecie]

I have had sedatives before now for serious root canal stuff and once in hospital to have impacted wisdom teeth out - I sympathise with the phobia. I probably would have jumped out of the chair too if it weren't for the fact I was given something.

It was amazing stuff as you feel like you've been asleep even though you haven't - you can respond to requests.

Not all dentists do it as it requires extra training so you may need to find one who specialises. If you look at the NHS website (sorry can't find the address quickly but you should be able to google it) it will give a list of local dentists and also those who will sedate.

I had two teeth out for cosmetic purposes as a teenager and I reckon they are part of the reason I have a phobia of dentists now so anything that could have avoided that would have saved me years of angst.

[expatinscotland]

it's just sedative delivered through a drip/cannula.

some people drift off to sleep, but usually, to be frank, you're too stoned to care if they cut your whole head off.

[NotQuiteCockney]

Oh, yes, gas and air might work.

Could you push self-hypnosis as relaxation tape? He must be very nervous to bolt.

Relaxation techniques are useful for lots of different things, I find, so they'd help him in other parts of his life.

The risks from a GA are fairly significant. Even if it goes well, you feel really bad afterwards.

[NotQuiteCockney]

Or even valium might help?

[gscrym]

DS was put under last year to have 4 teeth removed (he was 5 at the time). It was the only way we could get it done. I think he was out for about 10 minutes in total. Was woozy and upset but fine within an hour.

I got knocked out for getting a mouth full of dental stuff done about 15 years ago. Any treatment I've had recently has been local anasthetic but quite lengthy due to my fear of dentists.

[mrsmike]

Ha!
Sounds fab. I want some.
Thanks, will investigate.
They have not offered any of these choices and make us feel rather like nuisances because its cosmetic and not medical.

[CarGirl]

sometimes can't you get valium on pescription for this kind of thing, before the injections, again you feel like you don't care.

[CarGirl]

sometimes can't you get valium on pescription for this kind of thing, before the injections, again you feel like you don't care.

[expatinscotland]

the GP can prescribe a couple of Valium.

[NotQuiteCockney]

Valium is really addictive. But you might be able to get one, iyswim.

[expatinscotland]

Valium isn't the devil's work.

It has its place.

I've used it several times for extreme insomnia and have never become addicted.

A tablet or two was routinely prescribed to women who needed a colposcopy and were a nervous wreck when I worked in a women's clinic and no one ever got addicted just from there.

IV sedatives are generally addictive substances, stuff like fentanyl, as are pre-ops, and again, when used in such an isolated circumstance they are not going to lead to addiction in a normal, healthy person.

[NotQuiteCockney]

It's fine to use that way, EIS, I've used it for medical stuff, too, and been fine. It's just not something to use for a few weeks, afaik.

[expatinscotland]

Oh, no, I agree, and I think if you went to a GP and explained that it was for a phobia they'd only give you one or two.

I know someone who has an extreme fear of flying and needs to fly and was prescribed 4, 2 for the flight over (Glasgow to London to Johannesburg) and 2 for the flight back.