4 ms·

I had a cavity filled without local anesthesia as a poor backpacker in Thailand. It hurt. Not as bad as I thought it would, but I’ve never felt the need to turn

by yojo 3y ago

I had a cavity filled without local anesthesia as a poor backpacker in Thailand. It hurt. Not as bad as I thought it would, but I’ve never felt the need to turn down local since. I also had my wisdom teeth out under local. The pain was bearable, but it is a much more violent procedure than I would have guessed. Given that general comes with a non-zero risk of death, I’d still do local again on that one. Plus it’s kind of a trip to watch someone wrench a tooth out of your mouth.

toast0 3y ago
> I also had my wisdom teeth out under local. Me too, but it makes a big difference how far erupted they are. Mine were basically half way out, and were starting to cause problems, so pull them all. The top ones came out with like one yank each, but the bottom ones took a lot of tugging. The dentist said that was pretty normal, top teeth are barely hanging on.
- brandall10 3y ago
  Mine were just beginning to come in and for some reason my dentist felt it was okay to remove them... trying to pull them was a joke, so he used a tiny reciprocating saw to cut each tooth into pieces. Took 3 hours, and given the amount of local used it would have been better to do general. Worst pain I ever felt was when the anesthetic wore off 30 minutes post procedure.
  - vkou 3y ago
    > for some reason my dentist felt it was okay to remove them That reason is probably 'he stands to make a lot of money for getting to them before any other dentist'.
    - brandall10 3y ago
      The funny thing is he had been my dentist for 3 years to that point, and because of this my family moved on to someone else. And there were potential repercussions beyond as my face was crazy swollen for a couple weeks and dozens of teachers/students wanted to know WTF happened... like if I was in a car wreck and broke my jaw or something.
  - bombolo 3y ago
    I'm sure the local butcher would have costed you less.
distances 3y ago
Is general anesthesia then offered somewhere as an option for wisdom tooth removal? That sounds massively excessive for what usually is just pulling a teeth out.
- Barrin92 3y ago
  In the US apparently. I'm German and I also found it completely wild when I heard it. Over here they give you barely anything if they fix a cavity and for wisdom teeth you get local anesthetics, and afterwards they tell you to take an ibuprofen and an ice pack when you have some pain. People in the States even told me they got opioids from a dentist.
  - formerly_proven 3y ago
    GA isn't uncommon there for wisdom teeth removal, either, standard insurance just doesn't pay for it so it's reserved for privately insured people.
  - dtech 3y ago
    North-western Europe generally does a lot less for pain management than US and the rest of Europe. It's a big complaint of expats. I've heard it explained as a cultural remnant "pain belongs with life, suck it up" from protestantism.
    - bombolo 3y ago
      Well mother theresa wasn't big in anesthetics as well.
  - yojo 3y ago
    Can confirm re:opioids, the dentist prescribed Vicodin (acetaminophen + hydrocodone) post surgery. It seemed pretty excessive.
- irjustin 3y ago
  Yes very common actually. Getting your wisdom teeth extracted at ~16 is also extremely common - a sort of rite of passage. > That sounds massively excessive for what usually is just pulling a teeth out. So with above in mind, the wisdom teeth are typically still inside the jaw's bone at that age so extraction is a full on surgery at that point. Drilling through bone and then the tooth is not for the feint of heart - so that's why it's so common to do general. It does raise the question. Should wisdom teeth be extracted so early when it's not truly necessary yet? Personally, having lived abroad now where a large percentage of people around me still have their wisdom teeth - I've seen the pain and problems having wisdom teeth can have and how expensive it is if you do have a problem. Doesn't seem worth not extracting at a younger age when you have "more freedom".
rscho 3y ago
For an uncomplicated case, I think the difference in risk between local and general is so tiny it cannot be reliably measured, when performed by competent pros in the western world.
- yojo 3y ago
  The most reliable number I can find for patients without comorbidity is ~.4/100k[0] (so about 1/250,000). A study specific to dental anesthesia produced a similar number (3 per 1,000,000)[1]. I couldn't find any mortality numbers for local anesthesia, but it would pretty much require an allergic reaction, and I know from past experience I don't have that allergy. So yes the increased risk for general is very low, but not unmeasurably so. [0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3147285/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3147285/ [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5535496/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5535496/
cafard 3y ago
The sound effects were impressive.
chris37879 3y ago
I went under for my removal and I vaguely have a memory of waking up during one of the wrenching sessions, and the doctor saying something like “sorry, this one’s being a bit difficult, up his anaaaaaaaaa” and then I woke up at home in a comfy recliner.

by yojo 3y ago

toast0 3y ago

> I also had my wisdom teeth out under local. Me too, but it makes a big difference how far erupted they are. Mine were basically half way out, and were starting to cause problems, so pull them all. The top ones came out with like one yank each, but the bottom ones took a lot of tugging. The dentist said that was pretty normal, top teeth are barely hanging on.

brandall10 3y ago
Mine were just beginning to come in and for some reason my dentist felt it was okay to remove them... trying to pull them was a joke, so he used a tiny reciprocating saw to cut each tooth into pieces. Took 3 hours, and given the amount of local used it would have been better to do general. Worst pain I ever felt was when the anesthetic wore off 30 minutes post procedure.
- vkou 3y ago
  > for some reason my dentist felt it was okay to remove them That reason is probably 'he stands to make a lot of money for getting to them before any other dentist'.
  - brandall10 3y ago
    The funny thing is he had been my dentist for 3 years to that point, and because of this my family moved on to someone else. And there were potential repercussions beyond as my face was crazy swollen for a couple weeks and dozens of teachers/students wanted to know WTF happened... like if I was in a car wreck and broke my jaw or something.
- bombolo 3y ago
  I'm sure the local butcher would have costed you less.

distances 3y ago

Is general anesthesia then offered somewhere as an option for wisdom tooth removal? That sounds massively excessive for what usually is just pulling a teeth out.

Barrin92 3y ago
In the US apparently. I'm German and I also found it completely wild when I heard it. Over here they give you barely anything if they fix a cavity and for wisdom teeth you get local anesthetics, and afterwards they tell you to take an ibuprofen and an ice pack when you have some pain. People in the States even told me they got opioids from a dentist.
- formerly_proven 3y ago
  GA isn't uncommon there for wisdom teeth removal, either, standard insurance just doesn't pay for it so it's reserved for privately insured people.
- dtech 3y ago
  North-western Europe generally does a lot less for pain management than US and the rest of Europe. It's a big complaint of expats. I've heard it explained as a cultural remnant "pain belongs with life, suck it up" from protestantism.
  - bombolo 3y ago
    Well mother theresa wasn't big in anesthetics as well.
- yojo 3y ago
  Can confirm re:opioids, the dentist prescribed Vicodin (acetaminophen + hydrocodone) post surgery. It seemed pretty excessive.
irjustin 3y ago
Yes very common actually. Getting your wisdom teeth extracted at ~16 is also extremely common - a sort of rite of passage. > That sounds massively excessive for what usually is just pulling a teeth out. So with above in mind, the wisdom teeth are typically still inside the jaw's bone at that age so extraction is a full on surgery at that point. Drilling through bone and then the tooth is not for the feint of heart - so that's why it's so common to do general. It does raise the question. Should wisdom teeth be extracted so early when it's not truly necessary yet? Personally, having lived abroad now where a large percentage of people around me still have their wisdom teeth - I've seen the pain and problems having wisdom teeth can have and how expensive it is if you do have a problem. Doesn't seem worth not extracting at a younger age when you have "more freedom".

rscho 3y ago

For an uncomplicated case, I think the difference in risk between local and general is so tiny it cannot be reliably measured, when performed by competent pros in the western world.

yojo 3y ago
The most reliable number I can find for patients without comorbidity is ~.4/100k[0] (so about 1/250,000). A study specific to dental anesthesia produced a similar number (3 per 1,000,000)[1]. I couldn't find any mortality numbers for local anesthesia, but it would pretty much require an allergic reaction, and I know from past experience I don't have that allergy. So yes the increased risk for general is very low, but not unmeasurably so. [0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3147285/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3147285/ [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5535496/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5535496/

cafard 3y ago

The sound effects were impressive.

chris37879 3y ago

I went under for my removal and I vaguely have a memory of waking up during one of the wrenching sessions, and the doctor saying something like “sorry, this one’s being a bit difficult, up his anaaaaaaaaa” and then I woke up at home in a comfy recliner.