Widsom tooth removal, anaesthetic options, help please!!

[mummyflood]

I need to have an impacted, horizontal wisdom tooth removed and was referred to local orthodontic dept by my dentist.

The consultant explained the procedure involved in reasonably graphic detail, i.e. some bone needs to be removed, tooth will have to be broken to remove, stitches, etc. Said it will take 30 mins minimum, and that he intends to do it under local anaesthetic I asked about the possibility of sedation, to be told that the hospital no longer offers the IV option, but that he could ''give me a couple of tablets'' That's exactly how he said it - no explanation of what or how.

I expressed my panic concerns at this point - various elements to this, eg needle phobia, previous local anaesthetic failed (more needles) don't fancy the thought of 30 mins plus, aware of everything going on - a routine wisdom extraction at my own dentist a couple of years ago was bad enough!! but he basically seemed to dig his heels in more and more, kept repeating that ''they are the experts, they do this every day'' and was really insistent that a local on its own would be fine.

He completedly brushed over the ''couple of tablets'' which I now understand from my own dentist would be valium or similar, and I would need to be issued with a prescription so that I could take them at intervals including the night before, something which was not explained or discussed at the time, he obviously doesn't intend to go down that route despite anything I had to say, and that this method can be quite unreliable and basically 'hit and miss'. I also have been told that this method is basically a similar principle to a pre-med before a general anaesthetic. I have had 3 of these in the last few years and they have had no effect whatsoever on me. So I therefore would think that there is a good chance that the oral sedation would not be very effective in this case ??.

My own dentist has now referred me to a neighbouring health authority, who do offer IV sedation if appropriate, but unfortunately I didn't realise that the overseeing consultant is the same one. It's really a combination of the man himself and the thought of a local anaesthetic only which is filling me with dread, to the point of symptoms of stress and panic, and I was wondering if anyone else had been in a situation like this and successfully got a second opinion and given their anaesthetic of choice, or may I be up against a ''closing of ranks'' situation?

Sorry for lengthy post, I ''talk'' a lot when in panic mode!! Thanks to anyone who can help.

My DH got his removed under local and OMG never again, it was brutal! He was black and blue for a week afterwards, he was naseuous with pain for days and days. We so regretted not insisting on the full anaesthetic so fight your corner!

The only civilised way of removing wisdom teeth is under a genral anaesthetic. Insist on it.

He has made it clear that I will definitely not get a GA, ''mallet to crack a walnut'' was what he said. I don't do very well with them, always throw up despite being given anti-emetics. But to be honest, the way I feel about having this done under a local only, I would be prepared to run that risk if need be!!

Change dentists/doctor/go private would be my advice.

DS (18) had his wisdom teeth on both sides taken out in July under GA and he was fine. He had pain for a couple of days but no side effects, no bruising etc. I paid privately for it, though.

I'm currently waiting on hospital appointment for a GA to remove my bottom impacted wisdom tooth.

Had my two top ones removed at dentist surgery with a local, was fine.

This fecker however, my dentist attempted it with a local, but I had to stop him, if was horrific and i am not a wimp at the dentist.

I currently have a cracked, half out tooth
sitting there, painful & not good.

Your one sounds like a big job, no way would i let anyone near it without being unconscious, sod that!

I'm not trying to dismiss your fears or dissuade you from pushing further for sedation, but just to say I had EXACTLY the same procedure done a year ago. i.e. horizontally impacted wisdom tooth, broken into pieces, stitches etc. and did have it with 'just' local anaesthetic. I am also not good with needles and did in fact faint shortly after they gave me the anaesthetic injection. Not fun as I then came round (always a horrible sensation!) and realised I still had to undergo the tooth removal! Actually that was the worst part of it... obviously it wasn't pleasant, but I did cope, and it took ~25 mins in total, and I was able to walk out of the clinic, unaccompanied if a bit shaky.

Realise that doesn't answer your question and of course everyone reacts differently to the same procedure, but hope it might be helpful to hear of an oK-ish experience and make you a bit less panicky.

Hope it goes smoothly for you in the end, however you sort the anaesthesia.

I've just had mine taken out this afternoon with local only (chose not to have sedation as I'm breastfeeding). It was fine - the not-so-nice bits only lasted about 2 minutes, and I used breathing exercises and visualising myself somewhere else to get through those bits.

My friend has had Valium and said it was awesome

Can you really not see another consultant? Is it a small hospital?

It won't be a barrel of fun, but mine was all over within 20 mins. I think if you can manage your fear, it will be better than you think I really wouldn't have a GA, especially if you know it makes you feel awful.

Thanks everyone for the comments. I am reassured by those of you who have had this done successfully under local, hubby thinks I will not get anywhere and will end up either having to agree to a local or hang on until the inevitable (so I have been told by the consultant when I asked if I could think it through) emergency procedure when I develop an abscess or serious infection.

I am seeing a different consultant at the different hospital on Tuesday, but it turns out from the letter that he is part of the original guys 'team', which came as a total shock as didn't know they could work for more than one health authority?? I am keeping an open mind (ish) and am hoping that he will be a LOT more 'patient friendly' than the other guy. One of the main things that got to me originally was, when I realised he wasn't listening or taking on board any of my concerns, I said ''can I think it through'' and his response was ''no, you don't have a choice. You know what will happen, you will be admitted as an emergency and will be in agony before and afterwards''. He said this with a smile on his face, in a jovial manner, but after everything I had said, I didn't really find it amusing.

Will see how it goes on Tuesday I suppose.

My top left one was impacted and in a bugger of a place. I was sedated as there was no way they could get to it to pull out without me completely out of it - would have broken my jaw trying.

bottom right I had out a couple of months ago. by local. I didnt realise it wouldnt be sedation until I was in the chair. Took the poor dentist ten tries to get the injection in my mouth - everytime he came near me I shut my mouth. Once done though, it was smooth, quick and easy (apart from the blood loss afterwards, looking like a vampire)

Good luck.

Do you have a nice GP? Please ask him/her for a small supply of valium. It is a perfectly reasonable request. It really does take the edge off panic and the local anaesthetic will take care of the pain. I had mine done with IV sedation in the States. The dentist there positively encouraged it. Bruising afterwards is standard and I don't think it reflects the kind of anaesthesia used (could be wrong--not a doctor).

Mycatcoco- didn't realise that was a possibility!! I will definitely follow that up if needs be, our GP is usually pretty good.

I know it's not an exact science, but can anyone tell me how ''out of it'' valium or similar actually takes you, i.e. how much awareness do you have once in the chair/undergoing the procedure, especially if anyone has had oral sedation and separately local anaesthetic only to compare?

I am one of those annoying patients who likes to be as informed as possible, and this stuff is what the original consultant so obviously didn't want to discuss, all he could say was how routine this is to him - but hey, not to me it's not. So thanks guys!!

You will be "aware" but will not give a ! I used it to get through a brain scan. It was like having a couple of glasses of wine. Just makes you very mellow. I am sure your GP will prescribe it as a one off. They just don't like to give it out regularly as it's highly addictive. Go for it.

I hope you do manage to get IV sedation .

With the valium I think the dentist needs to know you've taken it /are planning to take it and may object to treating you ( something about you not being able to make informed decisions ) if he finds you've taken it .

I hate to tell you this as your situation sounds dreadful and you have all my sympathy .

I had mine taken out with just local anaesthetic, but I didn't have much choice (in another country). The dentist used breathing techniques to calm me and reminded me of them continually throughout the procedure. I was in the chair for 90 minutes for all four wisdom teeth, but the last one broke off and there was a lot of furtling around which wasn't nice. It was manageable though and I had a very quick recovery (two days). I was already familiar with breathing techniques though having used them during birth successfully and I had a very empathetic team who kept stopping to check I was OK.

I have been sedated for another medical procedure and tbh I hated it. I kept sinking into a happy sedated state and then sort of becoming just about aware of what was happening to me and just as I was getting frightened I would sink back into the sedation. I don't remember much, just patchy images but that seems worse that I can't remember anything and it has left me quite unhappy about the whole thing.

But everyone reacts to these things differently and the NHS is quite different from the dentists I saw abroad. If you want sedation push for it, its quite a physical procedure I swear the tiny dentist climbed into my mouth at one point and if you are worried about it its going to make the whole thing worse. I was desperate to have my wisdom teeth out as they were causing me so much pain and I had reached the point where I would have pulled them out by myself!

Good luck, I hope you get what you want.

Hmm, lots more to think about. R2, all four out with a local in one sitting!! I know what you mean about it being quite physical, that's the impression I got from the description of the procedure described by the original consultant, and I had a top one out at my own dentist a few years ago which was quite physical enough for me, even though it was apparently a straightforward one.

Tea, I hope you are ok today. It's a good sign that you were able to mumsnet on the same day

Well all I can do is see what is said on Tuesday, and plead my case as best I can. Anyone know a good hypnotist

I'm feeling pretty good today actually - despite bloody DS waking every two hours last night because of his teething pain!

It was a bit achey/sore yesterday evening and at 3am, which was just before I was due to take my next painkiller, but today it hasn't hurt at all. Still on soft food, but hopefully later today or tomorrow I can start chewing again

Good luck for Tuesday, let us know how you get on