Tooth Extraction: Oral and Maxillofacial Surgery

[PhilDawson8270]

I don't usually post this kind of thing, nor really comment much on this kind of thing so I feel a bit of a fraud posting on this topic, but I'm hoping for some encouragement, and information from experience.

Background:
Long term fear of dentists which I believe came from my parents, as my immediate family all have this same fear. At 15 the dentist found that my mouth was overcrowded. The solution then was to remove a couple, and reshape my jaw to better fit teeth in later. I declined at this point.

At 17 I needed a root canal which wasn't a pleasant experience due to severe pain from lack of anaesthetic.

This reinforced my fear of dentists. Shamefully, 12 years of poor dental hygiene (I hate to admit this), and after biting a fork got me worried about my teeth.

This brings us to now, well 6 or so months ago.

I found a wonderful, friendly, patient dentist. Who managed to repair nearly all of my teeth, thankfully all my front ones. The back I have 6 or 7 that are broken at the gum line, from a mixture of overcrowding, and poor hygiene.

It took 2 visits for all the fillings, but each time relatively fine. A little short on anaesthetic, meaning that the teeth were sensitive when they were drilled, but I could simply raise my hand and she would give me more.

At the 2nd visit I was told that the broken teeth really need to come out as they aren't functional, and a serious risk of infection (I have just had an abscess drained too as it did get infected waiting for treatment). Being comfortable with the dentist I agreed, and was referred to my local Hospital's Oral and Maxillofacial surgery department.

I have been to the consultation, from the X-Rays alone they seem to think it's all fairly straightforward, and would do it all in 1 session under local anaesthetic.

Now, I have been back to the dentist for a check up, as until this is sorted I'm on 3 monthly check ups. I must say it was very nice, and relaxing for the dentist to say that electric brush, and regular cleaning means my teeth all look healthy, and gums are looking normal again. So it is nice to know that I haven't totally destroyed what I have got left.

But my appointment is on Tuesday 15th November, but now the anxiety has started. It is like the fear I had when I was a young adult again where severe toothache was preferable. But now, I am older and wise enough to know this really needs to be done.

But I am not as comfortable with 6/7 tooth extractions under local as I thought I was now it is getting close. I have tried to get through to the department but they seem impossible to get hold of, and the appointment line is the only one I can reach. As I would really like to know if it is too late to request some form of sedation, gas and air for example.

So the short version:
6/7 extractions at the gumline, that may need gum removing to access
What to expect? What does it feel like? Do they take long to come out?
Can I request something like gas and air on the day?

My biggest worry is that I usually have a high tolerance to local anaesthetic at the dentist, meaning I get them to give more when they start drilling. But, with an extraction, the first chance I will get is when they grab and pull on the tooth. I am worried that this will hurt, a LOT before I get chance for more local anaesthetic. Do they even use the same anaesthetic as a regular dentist?

So, any experiences from patients or NHS staff is greatly appreciated.

Apologies for the long thread.

 

[ColinJ]

I understand exactly how you feel Phil! If you search for posts made by me featuring the word 'dentist' you will see what my dental history was and that I have now found a dentist who is sorting my problems out.

I'll give you a detailed breakdown of what I had done and how I felt; hopefully that will help to put your mind at rest.

I had 2 broken, rotten teeth which eventually forced me to face my fears and make the initial appointment. I made a point of explaining to the dentist how scared I was. He was very kind and said that nothing would be done to me without warning, everything would be explained to me first, and I was in charge of what was happening and could stop it at any time.

I thought the rotten teeth would be the first to be dealt with but the dentist wisely thought that it would be better to build up to the extractions and I had 2 sessions for simple remedial fillings first to put my mind at rest. I had the option of gas and air but we decided that we would see how I got on without it. I was ok!

The dentist used a gel to numb my gums so I couldn't feel the needle going in with the main anaesthetic. He gave it a while to kick in and then probed my gums with a metal implement and asked if I could feel it. I could, so he gave more anaesthetic and that did the trick.

He talked me through what was going to happen and we agreed that I could stop him at any time by raising a hand.

I didn't want to see what he was doing so I kept my eyes closed throughout. I also didn't want to hear what was going on so I put some loud music on my phone and wore earbuds [if you use a phone, remember to put it in 'airplane mode' so it doesn't ring and startle you during proceedings!]. The music did drown out external sounds, but I was a bit taken aback when having the first filling done by how much vibration came through my skull. I was ready for that second time round.

Both of the extractions were done on the 3rd appointment. One of the teeth was broken at the gum line and I was worried about how that would be taken out. I am on Warfarin so I would bleed a lot more than most people if the gum was cut. I had to sign a release form to give permission for that, but the dentist managed to get both of the teeth out without cutting the gums.

I was impressed by how he got the stumps out without any major problems. I felt no pain at all and nothing other than the inevitable pressure that is put on the head. I won't lie and say that it was a pleasant experience, but it was not at all traumatic. I think after the anaesthetic took effect, the actual extractions took about 15-20 minutes in total.

I had very minor bleeding afterwards and just chomped down on some sutures which I was given. The bleeding stopped after an hour or two. For someone who was not on anti-coagulants, it would have probably bled for less than half that time.

When the anaesthetic wore off after a few hours, I did develop quite a bit of discomfort. More of a throbbing ache than anything too serious. I took 8 paracetamol in the first 24 hours and that kept the pain under control. I think I only needed 1 or 2 the next day and none after that.

The wounds in the gums took a week or so to really start to heal. I had to be careful eating and drinking, and brushing my teeth but was otherwise ok. I avoided eating troublesome foods at that time - things like nuts which break up into lots of small, hard bits which could get into the gums.

I think you ought to be able to discuss your treatment in advance to reassure you that you can have gas and air if you feel that you need it. Another suggestion - why not ask if you can have the first 3 extractions done with an option to postpone the others for a week or two if you feel it is becoming too much for you? OTOH, you would then have to go through it all a second time so it might be better just to get the whole lot done at once?

Anyway ... Good luck!

 

[PhilDawson8270]

I understand exactly how you feel Phil! If you search for posts made by me featuring the word 'dentist' you will see what my dental history was and that I have now found a dentist who is sorting my problems out.

I'll give you a detailed breakdown of what I had done and how I felt; hopefully that will help to put your mind at rest.

I had 2 broken, rotten teeth which eventually forced me to face my fears and make the initial appointment. I made a point of explaining to the dentist how scared I was. He was very kind and said that nothing would be done to me without warning, everything would be explained to me first, and I was in charge of what was happening and could stop it at any time.

I thought the rotten teeth would be the first to be dealt with but the dentist wisely thought that it would be better to build up to the extractions and I had 2 sessions for simple remedial fillings first to put my mind at rest. I had the option of gas and air but we decided that we would see how I got on without it. I was ok!

The dentist used a gel to numb my gums so I couldn't feel the needle going in with the main anaesthetic. He gave it a while to kick in and then probed my gums with a metal implement and asked if I could feel it. I could, so he gave more anaesthetic and that did the trick.

He talked me through what was going to happen and we agreed that I could stop him at any time by raising a hand.

I didn't want to see what he was doing so I kept my eyes closed throughout. I also didn't want to hear what was going on so I put some loud music on my phone and wore earbuds [if you use a phone, remember to put it in 'airplane mode' so it doesn't ring and startle you during proceedings!]. The music did drown out external sounds, but I was a bit taken aback when having the first filling done by how much vibration came through my skull. I was ready for that second time round.

Both of the extractions were done on the 3rd appointment. One of the teeth was broken at the gum line and I was worried about how that would be taken out. I am on Warfarin so I would bleed a lot more than most people if the gum was cut. I had to sign a release form to give permission for that, but the dentist managed to get both of the teeth out without cutting the gums.

I was impressed by how he got the stumps out without any major problems. I felt no pain at all and nothing other than the inevitable pressure that is put on the head. I won't lie and say that it was a pleasant experience, but it was not at all traumatic. I think after the anaesthetic took effect, the actual extractions took about 15-20 minutes in total.

I had very minor bleeding afterwards and just chomped down on some sutures which I was given. The bleeding stopped after an hour or two. For someone who was not on anti-coagulants, it would have probably bled for less than half that time.

When the anaesthetic wore off after a few hours, I did develop quite a bit of discomfort. More of a throbbing ache than anything too serious. I took 8 paracetamol in the first 24 hours and that kept the pain under control. I think I only needed 1 or 2 the next day and none after that.

The wounds in the gums took a week or so to really start to heal. I had to be careful eating and drinking, and brushing my teeth but was otherwise ok. I avoided eating troublesome foods at that time - things like nuts which break up into lots of small, hard bits which could get into the gums.

I think you ought to be able to discuss your treatment in advance to reassure you that you can have gas and air if you feel that you need it. Another suggestion - why not ask if you can have the first 3 extractions done with an option to postpone the others for a week or two if you feel it is becoming too much for you? OTOH, you would then have to go through it all a second time so it might be better just to get the whole lot done at once?

Anyway ... Good luck!

Many thanks for this in depth reply, and it's good (well not really good, but you know what I mean) that I'm not alone. Unfortunately it's not my dentist doing the extractions but a dental surgeon at the hospital. So that is adding a little bit of an unknown. I felt fine about it at the time, and didn't question sedation for example. Since it is in a hospital, there's a 6 week wait for appointments after consultation, so it would be quite a wait for the next lot. And if it's unpleasant I think I'd rather not have to return if that makes sense?

Is the pressure obvious what they're doing? Or is it a similar feeling to pushing down onto a tooth/biting something hard?

 

[oldfatfool]

Surprised they are doing it under a local tbh. I was in hospital last week for a tooth out and a cyst removing from my upper jaw that involved cutting the gum and was told i had no option but a GA. Good luck whatever you decide.

 

[PhilDawson8270]

Surprised they are doing it under a local tbh. I was in hospital last week for a tooth out and a cyst removing from my upper jaw that involved cutting the gum and was told i had no option but a GA. Good luck whatever you decide.

The fact it is all local, is the only positive thing. As surely that means they expect it to be fairly straight forward?

 

[Racing roadkill]

I've had all of my Wisdom teeth extracted by my dentists, over the years, always under local anaesthetic . Two of them had impacted roots. I stocked up on Ibuprofen / paracetamol, which I took as soon as the anaesthetic wore off, and for the day after the extractions. I've not had any problems following the procedure. Just relax, get it over with, it'll be fine. Good luck.

 

[ColinJ]

I can see why the hospital aspect of it makes it more worrying and I can see why you want to get it all done at once!

I would have thought the dental surgeon ought to at least give the option of gas and air. I don't know if you are allowed to travel alone afterwards if you have it? It might be that you would need to be accompanied. (Ask?)

As for the pressure ... It was pretty obvious that it was taking a fair effort to get the stumps out. Nothing was hurting and the music was doing its job of distracting me. I didn't enjoy the sensation of having my head pushed back into the chair but it was not painful which is the main thing that had concerned me.

I would describe the experience as tolerably unpleasant but not traumatic. My fear of dentists came from an awful experience as a child, but this was nothing like that.

I think techniques, attitudes and equipment have moved on a lot in the past 50 years! I am never going to like going to the dentist but I have got to the stage now where I don't think about it until the night before, and don't worry about it until I am actually walking in the door of the dental practice. For a dental-phobe like me, that is REAL progress!

It is such a relief once the work has been done. I had a chat with the dentist afterwards and he said how nasty the stumps had been inside, and how much better I would feel once the gums had healed. He was right!

 

[oldfatfool]

The fact it is all local, is the only positive thing. As surely that means they expect it to be fairly straight forward?

Hope so, i asked for local but told no. It may have been due to the risk of them cutting into my sinus and that the cyst had already disolved/displaced a good amount of bone

 

[pclay]

I had the offer of having my 4 wisdom teeth removed about 5 years ago. I went to hospital and they said I would have a general anaesthetic. I asked what they thought, and they actually disagreed with my dentists referral. I declined to have them removed.

3 years later I had one wisdom tooth removed under local anaesthetic. The tugging felt like I was having my jaw broken, but it only lasted about 5 minutes. I was fine afterwards.

I am surprised you are have 6 teeth removed under local. You could ask for a general anaesthetic.

 

[Yellow Saddle]

You will be fine and will be able to ask for at least, gas, on the day. At least.

You will have dragon breath for days afterwards. It can melt ice on windscreens and make flowers wilt instantaneously. It's like a superpower. Enjoy it.

 

[Shortandcrisp]

My experience is that having teeth removed is less painful and more steIghtforward than having a filling. There won't be any pain in the nerve, all you'll feel is the dentist pulling your head to one side.
As Colin said, there's some pain once the anaesthetic wears off, but nothing too intense and easily sorted with paracetamol.
One tip I will give is to take some paracetamol before a trip to the dentist. Always seemed to lesson the pain of injections and calm me down a little.

 

[vickster]

@midlife is expert in matters of gnashers IIRC

 

[raleighnut]

I've had all of my Wisdom teeth extracted by my dentists, over the years, always under local anaesthetic . Two of them had impacted roots. I stocked up on Ibuprofen / paracetamol, which I took as soon as the anaesthetic wore off, and for the day after the extractions. I've not had any problems following the procedure. Just relax, get it over with, it'll be fine. Good luck.

The trick is to take painkillers before the anaesthetic 'wears off', don't wait for the pain to start.

 

[keithmac]

I'm lucky enough to have all 4 wisdom teeth partially erupted (39 years old), the dentists take an x-ray every year or so but never mention having them removed.

It's a necessary evil going to the dentist for me, never will feel comfortable but make the best of it!.

Good luck with the op and it will go smoothly for you I'm sure .

 

[Dan Morinary]

I went to emergency dentist, had a tooth removed. This has led to a new problem, the tooth next to it has cracked. I'm putting off getting it sorted for purely financial reasons. Find that shocking considering both my wife and I work!
Don't be worrying about it Phil, I think Colin's description above is spot on. Tolerably unpleasant. The benefits are worth it. Just don't go for a pint afterwards, like my mate did after 6 extractions, wasn't the best plan! Good luck.