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My guess would be that GA is an order of magnitude more dangerous than most routine dentist procedures like root canals or teeth extraction. Most people would r

by BigJono 10y ago

My guess would be that GA is an order of magnitude more dangerous than most routine dentist procedures like root canals or teeth extraction. Most people would rather suffer through the pain than add extra risk to the operation.

willismichael 10y ago
I'm with you, in that I avoid anaesthesia when possible, but be careful making sweeping statements about "most people" without having some data to back it up. My off-hand guess is that "most people" would prefer GA.
justin66 10y ago
> Most people would rather suffer through the pain than add extra risk to the operation. That might be true when people are making decisions about their kids. I question whether it's true of people making decisions for themselves.
detaro 10y ago
Is avoiding pain really a good reason for GA? At least in my dental procedures (and I've had quite a few for my age), the operations itself where uncomfortable, but the painful part was afterwards, when the anesthetics wore off.
- Aaargh20318 10y ago
  Depends on the type of pain. The pain afterwards I can manage, the pain during is of a completely different magnitude. But even if they could guarantee it would be 100% painless, I would opt for GA every time. The problem is being operated upon while fully aware of what is happening. We don't even treat animals that badly. If you bring your dog to the vet to have tooth fixed they put him under, but a human has to suffer through the experience ?
  - blktiger 10y ago
    GA can be extremely dangerous for some people. I know someone who has had several knee surgeries without GA because they don't handle GA well enough to make it worth the risks (death, for example). There are very good reasons why a lot of procedures are done without GA.
    - rscho 10y ago
      It is highly likely that even if your relative is very sick, the odds of him/her dying due to general anesthesia are pretty low. The amount of people for whom GA itself is "extremely dangerous" is extremely small. Anesthesiologists optimize. Their job is to counsel you on what they think is best, to lower the odds of complication. We often have to put people under who are very, very sick due to surgical constraints. A crushing majority of the time, nothing bad happens. It's all a question of lowering the probability.
LordKano 10y ago
I suspect the opposite. A few years ago I had to have a gastroscopy and the doctor was baffled that I refused GA.
TeMPOraL 10y ago
Motivations vary wildly. My mother actually had root canal treatments with no anesthetics whatsoever, solely to save money on anesthetics. OTOH my SO now saves money to get all her teeth fixed under GA, because of her fear of dentists.
Aaargh20318 10y ago
That is only looking at the physical part though. It doesn't take into account the psychological damage that is done. I'm pretty sure I've got a form of PTSD as a result of my childhood dentist experience and I suspect my anxiety issues are at least somewhat related to it.
rscho 10y ago
GA may be "an order of magnitude" more dangerous if you are already very sick or have it administered by a non-specialist. In the hands of someone who knows what he is doing, the risks are orders of magnitude lower than even crossing the street to go to work every day. There are two main real reasons why a dentist prefers to go without GA: - no need: most dental procedures are minor, and well-conducted local anesthesia is sufficient. Unfortunately, dentists often underestimate the pain and anxiety generated by some of their actions. - not alone anymore: if you want anesthesia, you have no other alternative than getting a specialist, who will have to be paid. Furthermore, the anesthesia provider will interfere in care decisions if required, making him a pain for the dentist. So yeah, mainly money...
- SamReidHughes 10y ago
  Are you saying this with awareness of claims like this? http://www.medicalnewstoday.com/articles/294966.php http://www.medicalnewstoday.com/articles/294966.php
  - credit_guy 10y ago
    Is that difference statistically significant? For those who don't have time to click the link, they looked at 53 kids who received GA and 53 who didn't. The average IQ of the first group was 5-6 points below the second. Now the stdev of one IQ is 15, so the stdev of the average of 53 is 15/sqrt(53)=2.06. The stdev of the difference of two such averages is then 2.06*sqrt(2)=2.91. A 5-point difference is then a 1.72 sigma event and a 6-point move a 2.06 sigma event, and the probabilities of more extreme events are 4.3% and 2%. I guess that's statistically significant, but not by much.
    - SamReidHughes 10y ago
      Look, I didn't read the paper, and it's not the only one.

by BigJono 10y ago

willismichael 10y ago

I'm with you, in that I avoid anaesthesia when possible, but be careful making sweeping statements about "most people" without having some data to back it up. My off-hand guess is that "most people" would prefer GA.

justin66 10y ago

> Most people would rather suffer through the pain than add extra risk to the operation. That might be true when people are making decisions about their kids. I question whether it's true of people making decisions for themselves.

detaro 10y ago

Is avoiding pain really a good reason for GA? At least in my dental procedures (and I've had quite a few for my age), the operations itself where uncomfortable, but the painful part was afterwards, when the anesthetics wore off.

Aaargh20318 10y ago
Depends on the type of pain. The pain afterwards I can manage, the pain during is of a completely different magnitude. But even if they could guarantee it would be 100% painless, I would opt for GA every time. The problem is being operated upon while fully aware of what is happening. We don't even treat animals that badly. If you bring your dog to the vet to have tooth fixed they put him under, but a human has to suffer through the experience ?
- blktiger 10y ago
  GA can be extremely dangerous for some people. I know someone who has had several knee surgeries without GA because they don't handle GA well enough to make it worth the risks (death, for example). There are very good reasons why a lot of procedures are done without GA.
  - rscho 10y ago
    It is highly likely that even if your relative is very sick, the odds of him/her dying due to general anesthesia are pretty low. The amount of people for whom GA itself is "extremely dangerous" is extremely small. Anesthesiologists optimize. Their job is to counsel you on what they think is best, to lower the odds of complication. We often have to put people under who are very, very sick due to surgical constraints. A crushing majority of the time, nothing bad happens. It's all a question of lowering the probability.

LordKano 10y ago

I suspect the opposite. A few years ago I had to have a gastroscopy and the doctor was baffled that I refused GA.

TeMPOraL 10y ago

Motivations vary wildly. My mother actually had root canal treatments with no anesthetics whatsoever, solely to save money on anesthetics. OTOH my SO now saves money to get all her teeth fixed under GA, because of her fear of dentists.

Aaargh20318 10y ago

That is only looking at the physical part though. It doesn't take into account the psychological damage that is done. I'm pretty sure I've got a form of PTSD as a result of my childhood dentist experience and I suspect my anxiety issues are at least somewhat related to it.

rscho 10y ago

GA may be "an order of magnitude" more dangerous if you are already very sick or have it administered by a non-specialist. In the hands of someone who knows what he is doing, the risks are orders of magnitude lower than even crossing the street to go to work every day. There are two main real reasons why a dentist prefers to go without GA: - no need: most dental procedures are minor, and well-conducted local anesthesia is sufficient. Unfortunately, dentists often underestimate the pain and anxiety generated by some of their actions. - not alone anymore: if you want anesthesia, you have no other alternative than getting a specialist, who will have to be paid. Furthermore, the anesthesia provider will interfere in care decisions if required, making him a pain for the dentist. So yeah, mainly money...

SamReidHughes 10y ago
Are you saying this with awareness of claims like this? http://www.medicalnewstoday.com/articles/294966.php http://www.medicalnewstoday.com/articles/294966.php
- credit_guy 10y ago
  Is that difference statistically significant? For those who don't have time to click the link, they looked at 53 kids who received GA and 53 who didn't. The average IQ of the first group was 5-6 points below the second. Now the stdev of one IQ is 15, so the stdev of the average of 53 is 15/sqrt(53)=2.06. The stdev of the difference of two such averages is then 2.06*sqrt(2)=2.91. A 5-point difference is then a 1.72 sigma event and a 6-point move a 2.06 sigma event, and the probabilities of more extreme events are 4.3% and 2%. I guess that's statistically significant, but not by much.
  - SamReidHughes 10y ago
    Look, I didn't read the paper, and it's not the only one.