To request to be put to sleep having tooth extracted?

[Neverbroken]

Okay so here’s the deal I have an impacted wisdom tooth and next to it a tooth that’s pretty much in half. Paracetamol, clove oil, salt water rinses nothing is touching it. I didn’t sleep a wink lastnight and went to the dentist today he numbed me and was going to take the tooth out but then said they didn’t have the equipment necessary to do so because of the impacted one.During giving me the injection I nearly jumped out of his chair with pain and fear. He had to stop. I have the dental hospital in the morning AIBU to ask to be put to sleep and can they if I’m 19 weeks pregnant?

Generalising, having a GA at 19 weeks is high risk to both a baby and mother. Sedation is also higher risk for pregnant women & at 19 weeks would usually be avoided. Pregnant women clearly can have GAs but the potential benefit has to outweigh the risk (eg, untreated appendicitis has a much higher risk of complications to mother and foetus than having the operation). If the tooth were so infected it was causing sepsis or a serious problem with eating/nutrition then the balance of risk may make a GA necessary, but really they’d need to have had a good go under local before GA would be sensible. Hope it goes ok tomorrow.

you would be crazy to request a general anaesthetic in my opinion. They are really dangerous.

I had my 4 impacted wisdom teeth removed in hospital under general. TBH they are so big I think not is sensible.

You can ask but waits are long, 6 months in h's case as they are not top priority funny enough, he was on ibroprofen the whole time and multiple antibiotics prescriptions. The dentist did such private but they wanted £900

Didn’t realise they were High risk, I will ask for the gas and numbing gel to the gums before injection. Thank you guys for the advice x

1. General anaesthetics are not "really dangerous". You are in more danger driving to the hospital than you are during a general anaesthetic.

1. General anaesthesia is generally only given to pregnant women requiring urgent / emergency surgery as there is no evidence that anaesthesia is safe for the fetus - obviously it would be unethical to do large scale clinical trials on pregnant women. If it can be avoided it usually is. If an anaesthetic must be given it is usually timed to occur within the second trimester as the sensitive organogenesis processes occur during the first and premature labour may be triggered in the third. That said, if you need emergency surgery while pregnant, you get a GA and you personally are really at no more risk of complication than a non pregnant patient.

1. I don't tend to sedate pregnant patients as due to a variety of reasons there is a higher risk of aspiration of gastric acid with associated lung issues. I either give them a full GA and protect the lungs or use regional techniques.

1. For a severely painful and impacted wisdom tooth - I would suggest having it done under local anaesthetic if at all possible, but failing that, time a removal under GA during the second trimester. I have anaesthetised pregnant women for dental extractions during the second trimester for similar reasons - unable to tolerate under local and unable to cope with dental issues for the remainder of pregnancy.

There is an increased miscarriage rate following GA in pregnancy, but it is not clear whether this is related to the instrumentation of the abdomen causing uterine irritability (for gallbladder / appendix surgery), or the surgical problem requiring treatment causing it. Most anaesthetic agents decrease uterine muscle tone rather than stimulating it.

(anaesthetist)

Oh and the use of nitrous oxide in pregnancy is controversial. It inhibits methionine synthase and in animal studies at least is teratogenic (linked with fetal abnormality). Studies following up pregnant women who have received it during pregnancy haven't shown anything (but again it's unethical to do them in large numbers) and the general advice is to avoid it, particularly in the first trimester.

Obviously it's fine in labour, although chronic exposure to HCP may be implicated in higher rates of pregnancy loss in the first trimester and lower birth weights.

I had a GA to have my impacted wisdom teeth removed a few months ago. Dentist said the older you are (I’m 45) the harder they are to get out and the more they hurt. He said teenagers’ wisdom teeth almost fall out with a little tug but for an older adult they can be very tight and a real struggle to remove.

No waiting list here so I had it done a few days later. Marvelous experience! A bit of mild discomfort on day 3 but other than that no pain whatsoever. Healed beautifully. Went back 10 days later for a follow-up and the dentist was so pleased with his handiwork that he took pictures to use at the university where he teaches once a week. I was terrified beforehand but it was the best decision for me.

I'm not sure if this will work for you being pregnant butI had two teeth out today.
My dentist gave me triazgalam to take 60-90 minutes before. It took all the stress away (I've been putting this off for two years).

Triagalam

for some reason my laptop things it needs a g.

Oh FFS TRIAZALAM!!

It's obviously not cleared my system yet.

I’m rather shocked that there appears to be all but a blanket ban on GA while pregnant. Isn’t it the woman’s choice whether or not she is prepared to take that risk? Paternalistic nonsense.

@herculepoirot there isn’t a blanket ban. GA for an elective procedure is avoided because it’s better to give a GA when you are in optimal health (which for a variety of reasons is not the case in pregnancy).

However often there is a need to operate regardless and so we do. If it can wait until the second trimester and mum is happy to wait then we wait, but we give GAs to pregnant women frequently in all trimesters.

@herculepoirot2 sometimes people aren't given procedures under GA when they're obese due to the health risk.

Medical professionals assess our health for a variety of things and say which is the best way forward.

It's called twilight sleep. It's like an IV valium and you are able to answer questions but completely unable to feel pain, or even care about what they are doing.

I've had 2 root canals done with this (and because they can do it all in one go it's much quicker and less painful) and my son had 5 teeth extracted when he was 10 - They put him under, I went into the waiting room and had just sat down, when the nurse came back to say he was ready to go home! Less than 4 minutes.

Apparently because the patient is relaxed , and they can just get one with it there is much less trauma.

Properly done, a local anaesthetic and the following treatment are normally painless. Though it can be hard to ensure no pain if there's already a serious infection. I've had some extractions though none were impacted and they were all fine.

But to do it right requires the dentist to have the skills and knowledge, and to listen to the patient and give a shit. Call me cynical, but I doubt many good dentists are still doing NHS treatment. (And there are bad private dentists too.) If you can afford it I recommend finding a good private dentist. Mine got me through my decade-long dental phobia (that's why my teeth got so rotten in the first place.)

HicDraconis

Provided the choice is actually available to have needed treatment, I have no problem with medics avoiding GA where possible because of pregnancy. Ultimately I think the choice should rest with the woman.

kaytee87

The best way forward is an informed discussion with the patient and a decision made with the patient.

Hope it goes well for you OP. Would you be able to request a LA and sedation? You will be conscious but literally won't experience or remember a thing with the sedation. You'll come to quicker as well. They had to take mine out in bits and I was completely oblivious!

I had impacted ones under local. I didn't feel pain but lots of pressure as it came out in bits and my head had to be held tightly by the dental assistant. The only problem was when I stood up after too soon and nearly collapsed, so take your time or ask for 5 minutes to just get yourself together.

Something I did during was wear headphones and listened to some very heavy metal music so I could feel like some sort of bad ass. I swear it really helped!

I was put to sleep to pull out my wisdom teeth and I am so happy for it. It was so pleasant compared to what other say. It was like a blink of the eye and it was done because I was asleep. I have heard bad stories from others who were awake. I would be a little worried though if your pregnant and would speak to doctor first about that.

They did it under LA a lot of it though and were really kind, talked me through everything they were doing which I was grateful for I think they could see how scared I was. They took both out the impacted wisdom and the one in half, Aldo asked them to numb my gum before they gave me anaesthesic. So now just a little swollen and sore but glad the original pain is gone.

Glad it went well and notvto traumatic for you.