OT: Wisdom Teeth & IV sedation

Dentist would like my wisdom teeth removed. Referred me to an Oral Surgeon who agreed. I suffer from anxiety, and expressed my concern over the sedation. The Oral Surgeon said he'd like me to take 10mg Valium an hour prior (which seems like a lot), and once there I'd get an IV of versed, propofol and fentanyl during the procedure. This seems like a lot of drugs, and with the sleep apnea (which I mentioned) makes me nervous I'd stop breathing. It seems propofol has a narrow window too and its possible to slip into general anesthesia. The internet is full of scary information regarding IV sedation and even the wisdom teeth removal procedure itself!

Should I be worried that these drugs would be administered in an outpatient setting (oral surgeon's office) and not in a hospital? Is it normal to get all those drugs to remove four teeth, or am I getting all of those drugs because I mentioned anxiety?

Having watched my husband (age 44 at the time) and daughter (age 17) go through wisdom teeth removal, I can't imagine doing it WITHOUT those drugs. This is a tough surgery.

You should sit down with the oral surgeon and explain your concerns. The surgeon should show you the crash cart and tell you exactly what they will do in the office to monitor your airway and oxygen levels and what they will do if there is a problem.

You should alos ask about using CPAP immediately afterward when you get home. You will be groggy and need to sleep. Can you wear your mask without causing additional pain? Will the air pressure affect the gums and bleeding? Are you going to be able to seal your mouth for a nasal mask with a mouth packed with guaze and a swelling jaw?

Oral surgeons must encounter this regularly and the surgeon should be able to answer your questions. If you have concerns, get a second opinion and be sure to check in with your sleep specialist as well.

Try to keep in mind that lots of people with undiagnosed OSA come through this fairly routine surgery just fine. You have a heightened awareness and it's good to be cautious, but with an experienced oral surgeon you should be OK.

That's what is sometimes referred to as "twilight sedation." The combo is used frequently for procedures that you as the patient don't really want to be there for. Colonoscopies come to mind.

Don't worry about breathing. The versed/fentanyl won't stop your breathing. But propofol requires mechanical ventilation, so I wonder why they use that for an oral procedure. For tooth extraction, I thought they'd put you out with the fentanyl/versed then numb your gums with a local. That would keep you breating and minimize recovery issues.

So long as your Oral Sturgeon is aware of your apnea, you shouldn't have any problem.

But as Jan says, your mouth will likely be stuffed with cotton afterwards, so your CPAP mask might not work. Best to run this by your sleep doc, too.

Only advice I've got... is pay attention to where your straps lay... as to where the tooth is coming out.

I had a tooth pulled once and couldn't use the machine the first night as the straps lay right over where the tooth was pulled.