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My wife is a dentist. She told me that you really should have your wisdom teeth removed in two general instances: * The teeth are growing in a strange orientat

My wife is a dentist. She told me that you really should have your wisdom teeth removed in two general instances: * The teeth are growing in a strange orientation. * You have cavities on them and your jaw shape is such that you can't brush them properly. --- The major problem with the molars is that they are notoriously difficult to keep clean. They all eventually become abscessed (on a long enough timeline). Might as well remove them. So removing wisdom teeth is not really a scam, it's something you will need sooner or later unless you're really anal about keeping your wisdom teeth clean. Can you brush all the way back there? How about behind the wisdom tooth? I have also noticed a trend here in the US that dentists put you under general anesthetic for this procedure. When in reality, unless you -really- need surgery, it's just overkill. For example, when I had my wisdom teeth removed in Bolivia, I was entirely awake, they only used local lidocaine (or similar) using a syringe, and they pull them out using hand tools and levers. Some antibiotics for a couple of days, and I was on my way.

ajdlinux 11y ago
When I had my wisdom teeth removed in Australia - they were impacting and causing me some very real grief - I had them taken out under local lidocaine. My dentist was of the view that general was overkill and would simply be more expensive for very limited gain. In Australia I know it's fairly common to have general anaesthetic for wisdom teeth, but I'm not sure we're quite as into preemptive removal as the US seems to be by the looks of this article?
- deleted 11y ago
  [deleted]
- acveilleux 11y ago
  I had my wisdom teeth removed (in Canada) under local anesthesia. Two of them didn't strictly have to go and were pulled out in a couple minutes, the remaining two were impacted and pushing against the next molar. I can remember no pain during the procedure so lidocaine was quite sufficient. I can see why general anesthetic might be desired, the amount of force required to break the tooth is downright disturbing. I remember wondering if the surgeon ever slips with that punch and that the sound of breaking teeth in the absence of any other feeling was eery.
- vacri 11y ago
  (in Australia) I had to have a tooth removed due to a botched root canal that led to an abcess in the bone. The oral surgeon gave me the option of local or general - I went for general, in case he really needed to poke around. He was clearly good at what he did - ripped out the tooth, cleaned out the abcess, and stitched me up without the need for so much as an aspirin afterwards. Only the vaguest sense of pain, and then only if I tried to find it. Also interesting in this life event was that it was done by the same surgeon at a separate private hospital. It was covered by private medical insurance, but the hospital took a $500 contingency payment up-front. The next week for my follow-up, I asked if there were any unusual costs, because I hadn't got my 'contingency' money back. He (quietly) hit the roof that this was an unnecessary payment and I never should have paid in the first place. He told me that I should demand the money back. This was at 5:30pm. 9:02 the next day, as I'm gearing up to do phone battle, I get a call from the hospital's finance department asking where to send the refund - apparently in the intervening hours, this surgeon had torn the financial controller of the hospital a new one at the unethical behaviour. Colour me pleasantly surprised!
- noir_lord 11y ago
  Had mine out via local as well in the UK I had one crack and one filled that wouldn't stay filled, exposed nerve etc. 20 minutes one side, came straight out, 45 the other fought ever step of the way, relief was immediate, couple of weeks and all mended. Not sure why you'd need to go under or have nitrous.
  - nommm-nommm 11y ago
    >Not sure why you'd need to go under or have nitrous. Many people (myself included) have anxiety around dental work. Just like going into an MRI might be fine for you but people with even a mild claustrophobia may find it unbearable. The other thing is not everyone's procedure is as simple as yours. Your tooth was exposed, thus easy to extract. Your teeth were not fully impacted, for example. This - https://www.youtube.com/watch?v=SNLuyFaOQoo https://www.youtube.com/watch?v=SNLuyFaOQoo - shows the procedure for removing impacted wisdom teeth.
    - noir_lord 11y ago
      Granted the edge cases require it but anaesthesia is dangerous. Wouldn't call my second one simple, dentist asked if she could preserve it and send it to local uni as her words "that's the largest root structure I've ever seen", at one point I didn't think she could get enough force on it, had to get a different tool. Lovely woman and amazing dentist.
      - nommm-nommm 11y ago
        Of course sedation is dangerous. Sedation and nitrous both have dangers but so does avoiding dental work because of patient anxiety. So does a patient moving during the procedure due to anxiety or being uncooperate. Its all a cost benefit analysis, like everything in medicine, and each patient and case is different. Nitrous is fairly safe and very effective and should probably be suggested more as an alternative to sedation. You could open up my abdomen and take out my kidney while I was awake and it would not bother me as long as I didn't feel it. Go near my mouth or eyes though and I have unbearable anxiety. I'd let all my teeth rot out of my face before undergoing tooth extraction awake, its that bad. This is a fairly common fear. Even without anxiety my oral surgeon strongly recommended at least nitrous due to the procedure being performed. Your procedure was simple enough for a dentist to perform, and didn't require an oral surgeon, so pretty simple.
sdfin 11y ago
My wisdom teeth at the jaw were removed with a brief surgery and the anesthesia was local. I find it strange that in the US full anaesthesia is the default. I see that many doctors do extra studies and interventions so that they can charge for it to the medical insurance. For example, every time I go to a new dentist (covered by the insurance) they always want to do a 'dental cleaning', as that is something extra they can charge, and the medical insurance always authorize it when they have a new patient.
- djcapelis 11y ago
  > I find it strange that in the US full anaesthesia is the default. I don't think is the default. They offer it amongst a range of options, but it's expensive usually on the order of a few hundred dollars extra. I think most people do local + nitrous. The few people who serve really upper middle class areas might offer it by default, but it's generally just not the case for most of the US. I could be wrong though, I don't have actual data, just my own experiences.
  - Avshalom 11y ago
    Yeah I still see general anesthetic advertised as a point of differentiation. I don't know how common it is but I don't think it's near the default yet.
- nommm-nommm 11y ago
  >I find it strange that in the US full anaesthesia is the default It is not the default. Patients are advised of their choices based on their situation. Many people get only local anesthesia.
Outdoorsman 11y ago
I had mine extracted years ago...my case was the latter--very difficult to clean, even for a trained dental hygienist... The process was not at all pleasant...I refused general anesthetic, so had lidocaine and a couple of minutes of nitrous oxide... By the time the dentist was finished we were both in a noticeable sweat... I was put in mind of a cartoon I once saw of a dentist in the late 1800s with his foot up on the patient's chest, trying for all the leverage he could get... I developed a "dry socket" (clot broke loose) and walked the floor all night, in intense pain, waiting to get an appointment the following morning...he simply packed the hole with a piece of gauze soaked in oil of cloves...the relief was immediate... Since that experience I've kept a bottle of oil of cloves in my medicine chest...the stuff is magic, and sold over the counter....I've used it for minor toothaches over the years with great results (until I could see a dentist)...can't recommend it highly enough...
- Natsu 11y ago
  I honestly haven't heard anything yet that makes me regret having mine removed under general anesthesia, except possibly a few of the horror stories about anesthesia in general (which mostly appear to apply to those older or in worse health at the time).
  - benjohnson 11y ago
    My melodramatic fear: The the brain impulses and patterns that comprise your soul are snuffed out during general anesthesia. The new soul that takes rood in your brain will have access to your old memories but is a new set of patterns that only approximate the previous soul. This new soul, of course, will claim to be you in order to preserve itself. Unless primed with the memory of this idea, the new soul won't know any better.
    - kzhahou 11y ago
      On the bright side, that could be the first day of the rest of your life! How about it? Ready to shake things up and get a fresh start?
    - 11y ago
vacri 11y ago
> unless you're really anal about keeping your wisdom teeth clean. Can you brush all the way back there? That's going to require a really long toothbrush...
ams6110 11y ago
A water pik or similar is good to clean around back teeth (and gums) that are difficult to brush/floss.
Gibbon1 11y ago
Mine all came in straight. I had them removed one by one when they developed cavities. Minus waiting for the Novocain to kick in each one took the oral surgeon about 30 seconds to get out including packing the gauze. Bonus I got a bottle of Vicodin that I didn't need out of the deal. Also: General anesthesia? That's often an excuse for the dentist to be a rough on you as convenient for them. No thanks.
erickhill 11y ago
I had two of mine taken out when I was in the Air Force. I was 21 years old and this was around 1991 or so. I /was/ put under (demoral + valium IV drip). My jaw is rather small (I have always had tight teeth, which makes flossing even a chore now), so they had to chip jaw fragments out of the way for the extractions. There simply was nowhere for new teeth to go. In any case, I remember coming out of anesthesia and the doctor leaning over me, his bloody gloves now removed, and asking me how I was feeling. I was about to respond when, after a moment's pause to catch my breath, I suddenly awoke to a very large male nurse giving me chest compressions. The doctor yelled, "He's back! He's back!" and he made the man stop. I groggily looked about and noticed a female nurse cowering in the corner. She was sobbing uncontrollably and soon ran out of the room (maybe not the best nurse, but I guess she had never 'lost' someone before). I asked, fuzzy mouthed, what happened? Apparently they pulled my IV out too soon and my forced dehydration and starvation made me faint once the fluids stopped. One of the possible side effects of fainting is a loss of heart beat. They told me "I had been dead" (which was inaccurate) "for about 90 seconds." What they meant was my heart had stopped beating for that long. People always ask, so I'm obliged to say: I saw no tunnel of light or flashing of my life before my eyes. It was simply total sleep-like darkness with absolutely no concept of time passing. It was as if I had made a long hard blink, and been told later 90 seconds had elapsed. For all I knew, two seconds had passed, much like a deep solid sleep: It's not until you look at the clock that you know how much time has passed. I had the other two wisdom teeth taken out at a dental school in Dallas. That was whole other ordeal. But I didn't "die" that time, at least.
- beachstartup 11y ago
  i've fainted before. you're right, the time just 'blinks' out of existence. it's different than sleep. i'm not quite so sure 'dead' isn't a good way to describe it, because that's probably what it feels like to be dead, and what it felt like before you were born.

ajdlinux 11y ago

When I had my wisdom teeth removed in Australia - they were impacting and causing me some very real grief - I had them taken out under local lidocaine. My dentist was of the view that general was overkill and would simply be more expensive for very limited gain. In Australia I know it's fairly common to have general anaesthetic for wisdom teeth, but I'm not sure we're quite as into preemptive removal as the US seems to be by the looks of this article?

deleted 11y ago
[deleted]
acveilleux 11y ago
I had my wisdom teeth removed (in Canada) under local anesthesia. Two of them didn't strictly have to go and were pulled out in a couple minutes, the remaining two were impacted and pushing against the next molar. I can remember no pain during the procedure so lidocaine was quite sufficient. I can see why general anesthetic might be desired, the amount of force required to break the tooth is downright disturbing. I remember wondering if the surgeon ever slips with that punch and that the sound of breaking teeth in the absence of any other feeling was eery.
vacri 11y ago
(in Australia) I had to have a tooth removed due to a botched root canal that led to an abcess in the bone. The oral surgeon gave me the option of local or general - I went for general, in case he really needed to poke around. He was clearly good at what he did - ripped out the tooth, cleaned out the abcess, and stitched me up without the need for so much as an aspirin afterwards. Only the vaguest sense of pain, and then only if I tried to find it. Also interesting in this life event was that it was done by the same surgeon at a separate private hospital. It was covered by private medical insurance, but the hospital took a $500 contingency payment up-front. The next week for my follow-up, I asked if there were any unusual costs, because I hadn't got my 'contingency' money back. He (quietly) hit the roof that this was an unnecessary payment and I never should have paid in the first place. He told me that I should demand the money back. This was at 5:30pm. 9:02 the next day, as I'm gearing up to do phone battle, I get a call from the hospital's finance department asking where to send the refund - apparently in the intervening hours, this surgeon had torn the financial controller of the hospital a new one at the unethical behaviour. Colour me pleasantly surprised!
noir_lord 11y ago
Had mine out via local as well in the UK I had one crack and one filled that wouldn't stay filled, exposed nerve etc. 20 minutes one side, came straight out, 45 the other fought ever step of the way, relief was immediate, couple of weeks and all mended. Not sure why you'd need to go under or have nitrous.
- nommm-nommm 11y ago
  >Not sure why you'd need to go under or have nitrous. Many people (myself included) have anxiety around dental work. Just like going into an MRI might be fine for you but people with even a mild claustrophobia may find it unbearable. The other thing is not everyone's procedure is as simple as yours. Your tooth was exposed, thus easy to extract. Your teeth were not fully impacted, for example. This - https://www.youtube.com/watch?v=SNLuyFaOQoo https://www.youtube.com/watch?v=SNLuyFaOQoo - shows the procedure for removing impacted wisdom teeth.
  - noir_lord 11y ago
    Granted the edge cases require it but anaesthesia is dangerous. Wouldn't call my second one simple, dentist asked if she could preserve it and send it to local uni as her words "that's the largest root structure I've ever seen", at one point I didn't think she could get enough force on it, had to get a different tool. Lovely woman and amazing dentist.
    - nommm-nommm 11y ago
      Of course sedation is dangerous. Sedation and nitrous both have dangers but so does avoiding dental work because of patient anxiety. So does a patient moving during the procedure due to anxiety or being uncooperate. Its all a cost benefit analysis, like everything in medicine, and each patient and case is different. Nitrous is fairly safe and very effective and should probably be suggested more as an alternative to sedation. You could open up my abdomen and take out my kidney while I was awake and it would not bother me as long as I didn't feel it. Go near my mouth or eyes though and I have unbearable anxiety. I'd let all my teeth rot out of my face before undergoing tooth extraction awake, its that bad. This is a fairly common fear. Even without anxiety my oral surgeon strongly recommended at least nitrous due to the procedure being performed. Your procedure was simple enough for a dentist to perform, and didn't require an oral surgeon, so pretty simple.

sdfin 11y ago

My wisdom teeth at the jaw were removed with a brief surgery and the anesthesia was local. I find it strange that in the US full anaesthesia is the default. I see that many doctors do extra studies and interventions so that they can charge for it to the medical insurance. For example, every time I go to a new dentist (covered by the insurance) they always want to do a 'dental cleaning', as that is something extra they can charge, and the medical insurance always authorize it when they have a new patient.

djcapelis 11y ago
> I find it strange that in the US full anaesthesia is the default. I don't think is the default. They offer it amongst a range of options, but it's expensive usually on the order of a few hundred dollars extra. I think most people do local + nitrous. The few people who serve really upper middle class areas might offer it by default, but it's generally just not the case for most of the US. I could be wrong though, I don't have actual data, just my own experiences.
- Avshalom 11y ago
  Yeah I still see general anesthetic advertised as a point of differentiation. I don't know how common it is but I don't think it's near the default yet.
nommm-nommm 11y ago
>I find it strange that in the US full anaesthesia is the default It is not the default. Patients are advised of their choices based on their situation. Many people get only local anesthesia.

Outdoorsman 11y ago

I had mine extracted years ago...my case was the latter--very difficult to clean, even for a trained dental hygienist... The process was not at all pleasant...I refused general anesthetic, so had lidocaine and a couple of minutes of nitrous oxide... By the time the dentist was finished we were both in a noticeable sweat... I was put in mind of a cartoon I once saw of a dentist in the late 1800s with his foot up on the patient's chest, trying for all the leverage he could get... I developed a "dry socket" (clot broke loose) and walked the floor all night, in intense pain, waiting to get an appointment the following morning...he simply packed the hole with a piece of gauze soaked in oil of cloves...the relief was immediate... Since that experience I've kept a bottle of oil of cloves in my medicine chest...the stuff is magic, and sold over the counter....I've used it for minor toothaches over the years with great results (until I could see a dentist)...can't recommend it highly enough...

Natsu 11y ago
I honestly haven't heard anything yet that makes me regret having mine removed under general anesthesia, except possibly a few of the horror stories about anesthesia in general (which mostly appear to apply to those older or in worse health at the time).
- benjohnson 11y ago
  My melodramatic fear: The the brain impulses and patterns that comprise your soul are snuffed out during general anesthesia. The new soul that takes rood in your brain will have access to your old memories but is a new set of patterns that only approximate the previous soul. This new soul, of course, will claim to be you in order to preserve itself. Unless primed with the memory of this idea, the new soul won't know any better.
  - kzhahou 11y ago
    On the bright side, that could be the first day of the rest of your life! How about it? Ready to shake things up and get a fresh start?
  - 11y ago

vacri 11y ago

> unless you're really anal about keeping your wisdom teeth clean. Can you brush all the way back there? That's going to require a really long toothbrush...

ams6110 11y ago

A water pik or similar is good to clean around back teeth (and gums) that are difficult to brush/floss.

Gibbon1 11y ago

Mine all came in straight. I had them removed one by one when they developed cavities. Minus waiting for the Novocain to kick in each one took the oral surgeon about 30 seconds to get out including packing the gauze. Bonus I got a bottle of Vicodin that I didn't need out of the deal. Also: General anesthesia? That's often an excuse for the dentist to be a rough on you as convenient for them. No thanks.

erickhill 11y ago

I had two of mine taken out when I was in the Air Force. I was 21 years old and this was around 1991 or so. I /was/ put under (demoral + valium IV drip). My jaw is rather small (I have always had tight teeth, which makes flossing even a chore now), so they had to chip jaw fragments out of the way for the extractions. There simply was nowhere for new teeth to go. In any case, I remember coming out of anesthesia and the doctor leaning over me, his bloody gloves now removed, and asking me how I was feeling. I was about to respond when, after a moment's pause to catch my breath, I suddenly awoke to a very large male nurse giving me chest compressions. The doctor yelled, "He's back! He's back!" and he made the man stop. I groggily looked about and noticed a female nurse cowering in the corner. She was sobbing uncontrollably and soon ran out of the room (maybe not the best nurse, but I guess she had never 'lost' someone before). I asked, fuzzy mouthed, what happened? Apparently they pulled my IV out too soon and my forced dehydration and starvation made me faint once the fluids stopped. One of the possible side effects of fainting is a loss of heart beat. They told me "I had been dead" (which was inaccurate) "for about 90 seconds." What they meant was my heart had stopped beating for that long. People always ask, so I'm obliged to say: I saw no tunnel of light or flashing of my life before my eyes. It was simply total sleep-like darkness with absolutely no concept of time passing. It was as if I had made a long hard blink, and been told later 90 seconds had elapsed. For all I knew, two seconds had passed, much like a deep solid sleep: It's not until you look at the clock that you know how much time has passed. I had the other two wisdom teeth taken out at a dental school in Dallas. That was whole other ordeal. But I didn't "die" that time, at least.

beachstartup 11y ago
i've fainted before. you're right, the time just 'blinks' out of existence. it's different than sleep. i'm not quite so sure 'dead' isn't a good way to describe it, because that's probably what it feels like to be dead, and what it felt like before you were born.