I need to have a wisdom tooth pulled

[Tracywag]

I have let it go way too long, but now am in severe pain. I am terrified of any surgery since being diagnosed with apnea. They can use a local anesthesia, but I'm afraid I will panic if on my back like that and feel as if I can't breath. What if they find they can't get to it? They can't change and use a general on me in the office.

What I would like is for a surgery to happen in the hospital, fully under with everyone prepared 'just in case'. While they are there, fix my deviated septum (and a few other procedures that I am avoiding because of my fear of dieing). Seriously, can I ask for the tooth extraction be done at a surgical facility? Would I need my primary doc to ask? My sleep doc? How do I handle the insurance part? (I have very good medical and very poor dental insurance).

My apnea is still well controlled (will be three years this summer) with ResMed S8 and mirage full face mask. I rarely use the hybrid anymore, and haven't kept up with if there are any new masks that are worth checking.

Tracy

[Tcamillemars]

I had my back bottom molar pulled last summer. It was painless during the procedure, and wasn't nearly as bad as I had imagined. Pain pills afterwards took care of the pain. Hardest part was learning to eat without my tooth. You'll get by with a local just fine. Just breathe through your nose, close your eyes and think of doing something pleasant. Dental procedures aren't nearly as bad now as they were even a few years ago.

[Tracywag]

I don't generally breath through my nose though. I'm a confirmed mouth breather (probably due to the deviated septum, although I sometimes have function in both nostrils). Thanks for the reassuraces though, I'm not normally this wimpy and need to get over it.

[old64mb]

I have let it go way too long, but now am in severe pain. I am terrified of any surgery since being diagnosed with apnea. They can use a local anesthesia, but I'm afraid I will panic if on my back like that and feel as if I can't breath. What if they find they can't get to it? They can't change and use a general on me in the office.

What I would like is for a surgery to happen in the hospital, fully under with everyone prepared 'just in case'. While they are there, fix my deviated septum (and a few other procedures that I am avoiding because of my fear of dieing). Seriously, can I ask for the tooth extraction be done at a surgical facility? Would I need my primary doc to ask? My sleep doc? How do I handle the insurance part? (I have very good medical and very poor dental insurance)

1. If it ends up being an impacted (grew in wrong) tooth, your DDS will almost certainly send you to an oral surgeon, who can in fact use general if he he feels he has the need (he has an MD as well as a DDS) and who does in fact generally perform surgery in a more 'surgical facility' type place. I'm sure that he could give you anxiety medication if you need that too (which it sounds like it might be the case).

2. No real need for primary doc or sleep doc to be involved; you might be able bypass your DDS and just book an oral surgeon directly, although that'd be slightly rude if you have a good relationship with your DDS - most are quite competent at pulling teeth, and know when they need to pass it up a level.

3. Drawback to oral surgeon is that they have two doctorates, so they're pricey. Mine required a full mouth x-ray before he'd pull, so all in it was about $200 for the x-ray/consult and $300ish for the extraction. All for 30 seconds of work - he literally yanked it out with no resistance. A DDS may do it for half or less than that price. Medical insurance won't cover it. Even good dental probably wouldn't pay for all of it, and lousy dental may pay for none or just a fixed dollar reimbursement that won't cover even the DDS price - even if it's in network.

4. Regarding anesthesia, with apnea you are so much better off doing a local if you can for any procedure. Just breathe through nose - and ask in advance if you can take a decongestant or such before to help, since that sounds like it'll be half the problem for you. You'll be so numb you won't notice anything for hours post surgery, let alone during it. The oral surgeon could do a general if you really want, I'm sure, but it would a. require someone to take you home afterwards (local doesn't) b. complicate things with OSA and c. probably add mucho, mucho dinero to the bill. I strongly doubt medical insurance would cover that either.

5. If it's an upper wisdom tooth and only one tooth...honestly, they'll prescribe you vicodin or such but you probably won't need it. My old roomie is now a dentist, and before I had mine out I talked with him and he laughed at me for being a wimp with my overpreparation. He was right - make sure you have ibuprofen (and lots of it) available, and make sure one of your docs knows that you'll be adding that or more powerful stuff to your drug cocktail so that it's ok...but I think I ended up on 200-300 mg of ibu every 4 hours and I didn't feel a thing. Lower wisdom teeth are slightly more complicated, but even then with only one tooth going out it's honestly not that big a deal.

Good luck!

[coloradogal]

You’ll do fine with a local , it’s not like it use to be. My dentist uses a medication on a Q-tip that numbs my gum before he injects the local, so it’s almost painless. Even if the Dentist chooses to use a mild sedation, it shouldn’t affect your apnea, there are drugs that will immediately reverse the effect of a sedative or any narcotic if necessary. I just had knee surgery with deep sedation, with no problems.

[Debjax]

Ok, I'm a dental phobic, and while I can now go to the dentist for cleanings and fillings without drugs, I have to see an oral surgeon for any type of extraction because they have to put me under. The last wisdom tooth I had done, the oral surgeon put me under, did the tooth and I was awake within 20 minutes. The sedation they use these days is much lighter and is more of a twilight sleep than full anaesthesia. Taks the CPAP without the humdifier, if you have to hang out for awhile (probably an hour or so), you'll be 'dozy' and the CPAP would be advisable.

Insurance will not generally cover it, some dentals do for impacted teeth, but most don't to my knowledge. Depending on your fear level, it may be worth it to you. For me, it is a simple matter of they knock me out or they don't pull the tooth...

[MidnightOwl]

My dentist sent me to an oral sugeon to have a tooth pulled last year. It was done in an office with local anesthetic and it was painless and fast, faster than if my dentist had done it. You can get anxiety meds before hand. Many people do.

Double check with your dentist or oral surgeon about using the cpap for the first few days afterwards. I couldn't get a straight answer when I did so, as I recall, I used it once and didn't use it the other time. I think the concern is the pressure on the wound. Also, if CPAP dries out your mouth that will definately be a problem after extraction.