wisdom tooth question

October 19, 2008 8:49 PM

wisdom teeth removal questions - laughing gas only? is two separate removals a bad idea?

I need to get all 4 of my wisdom teeth removed - only one is out enough to be functional, so of couse this one has a cavity. This is the easiest/cheapest of the removals, the other 3 are either "impacted" or "deeply impacted" and thus more expensive/painful to remove. There's no pain really in any of them which is why i was told to get them removed in july and am only dealing with this now.

My insurance only pays 1000$/year of anything, which I've already used up almost half of this year. The oral surgeon's receptionist told me that with the first non-impacted tooth, usually laughing gas alone is just enough, but they highly reccomend an IV drip for the anything impacted. It would save me about $800 if I got the easy tooth removed now and the other three done in Jan with the IV, but I am a little hesitant to think that any tooth removal could be done without being completely out of it, and paying for the IV twice makes it not really worth it. I'm not broke, so an extra 800$ won't kill me if it's better to do it all at once, but I can think of so many other things I'd rather do with my money.

So my questions are: Has anyone had a wisdom tooth removed with just novocain/laughing gas, what's it like? Is it generally just a bad idea to split up the procedure like this, will I be making myself miserable to have to go through recovery twice?

posted by illegiblemess to health & fitness (35 comments total)

Mine were all (four) removed this year, using only local anesthesia. During the operation, pain was minimal. The dominant sensation is one of pressure, as the teeth are drilled, broken, and twisted out.Luckily it doesn't take too long - it was probably about a 25 minute operation each time (upper and lower) I had it done.
posted by unmake at 9:10 PM on October 19, 2008

My experience was much the same as unmake -- it would have been great to have been out (or high as a kite) but not because of pain: have a tooth wrenched from your mouth is an incredibly weird feeling.
posted by nathan_teske at 9:16 PM on October 19, 2008

I had all four of my wisdom teeth removed about two months ago and like your situation, I had 3 impacted teeth and one relatively easy-to-remove tooth (complete with cavity). I opted to remove them all at the same time, which I am very, VERY grateful I did. Heal time broke down to a lost couple of days high as a kite on pain meds, another 4 or so days being careful of how and what I ate, and then another two weeks of being mildly annoyed that I had to... uh- suck food particles out of my tooth sockets. Not bad in retrospect.

The idea of doing that again, however, is not pleasant and I think my "next January" would slip into "when the tooth begins to painful rot in my jaw". If you can afford it, take the hit once and be done with it.

I chose to be completely sedated- which is the IV, I assume- so I can't personally speak about the gas option. I've had friends do it and while they had no pain, they mentioned that the sound/pressure was troubling.
posted by cheap paper at 9:26 PM on October 19, 2008 [1 favorite has favorites]

I had all four done at once with the IV drip, and I really can't imagine doing it any other way (I've had non-wisdom teeth extracted under laughing gas before). I went in, chatted with the oral surgeon while he setup the IV, and the last thing I remember was me saying to him "I don't think this conversation is going to go on much longer, is it?" Recovery wasn't too bad--I had it done on a Friday and was back at work on Monday pretty close to my usual self, but I wouldn't want to go through that twice.

I guess the real question is, how much discomfort/pain/recovery time is $800 worth to you?

Also, it's almost November. Since you're not having pain and have put it off this long already, could you push the whole thing to January and just do it in one go?
posted by zachlipton at 9:30 PM on October 19, 2008

When I was in high school I had two out. They used novacaine only, but my mom got me a prescription for a couple of capsules of valium to take a couple of hours before the appointment.

I was so stoned they could have removed my jaw and I wouldn't have cared. I don't recall it being a particularly horrible experience.
posted by Class Goat at 9:42 PM on October 19, 2008

I had all four removed last year using only local anesthesia. None were impacted, though. The only pain I had was when the surgeon stuck the bigger needle in the roof of my mouth (as opposed to the smaller needles near each tooth). Even then, the main was minimal and for only a second.

I agree with unmake that you mostly feel pressure. It is weird when they are pulling as hard as they can to yank the tooth out. I wouldn't call it troubling, though -- more like cool. I was actually kind of disappointed that I couldn't see more of what they were doing in my mouth.

I only had one procedure and it lasted 20 to 30 minutes, but about half of that time was waiting for the anesthetic to take effect. For me, I think IV sedation would have been unnecessary. I may have a high tolerance for pain, however. I had a bone marrow biopsy with local anesthetic only and I've had fillings done without any anesthetic.

My sister had laughing gas and she was sick for a day or two after the procedure. This was one reason why I opted to forego anything other than local. The others being that I didn't want to get a ride or lose a day due to the sedative, and I felt it wouldn't be that painful. I took 2 non-prescription Tylenol after I got home and that was it. I actually even went to work in the afternoon (my procedure was in the morning).

I would not want to do the procedure twice because of the things you have to do during recovery: avoid certain foods and drinks, brush gently, rinse with salt water, etc. I wouldn't say recovery was horrible or anything -- more like an annoyance that I wanted to get over with.

I'd recommend doing it all at once, but if you think it's worth the $800, go ahead and split it up. The end result will be the same.

P.S. Remember to ask for the teeth when it's over. I forgot to ask, so I had nothing to exchange with the tooth fairy that night.
posted by mathlete at 9:53 PM on October 19, 2008

I had my front two teeth removed under local, then had the jawbone above them chiseled for 15 minutes also under local (right before they drilled two stainless steel sockets into it..). It sucked bigtime, but I survived. Just get Percocet for the next day. :)

Just remember that if you eat the night before the procedure they don't generally retain the option of going to IV.
posted by kcm at 9:55 PM on October 19, 2008

I also only had local anesthesia - I'd have LOVED to have had nitrous (I had that for another extraction and it was GREAT), but they told me that nobody does that anymore! Dang it, I feel gypped now! Anyway, yeah, they gave me a couple weeks' worth of Vicodin, and, honestly, the first 24 hours after the novocaine wore off were the worst. The procedure itself was fine being awake and aware and completely numb. I'd also vote for getting them all done at once - it's not like it's FUN, and I'd have a hard time making myself go back to do it again.
posted by hfbellefille at 9:56 PM on October 19, 2008

I would have preferred to have been unconscious for mine. The Novocain worked on the pain, but the sound and sensation of four deep-rooted teeth being ripped from your head is pretty gross.
posted by knowles at 10:01 PM on October 19, 2008

I had all four impacted and two infected on top of that (my jaw geometry borders on non-Euclidean). I had the IV drip and had them all done in one go.

I can't say I recommend any approach, sadly, other than just getting the fuckers out and toughing out whatever happens afterwards with plenty of happy narcotic painkillers. You, however, probably do not share my jaw issues.

Oh. I do NOT recommend getting them out the day after Christmas, however. My mother's probably earned a few extra days in Purgatory by setting up that appointment and convincing me that it was a good idea.
posted by fairytale of los angeles at 10:02 PM on October 19, 2008

I just got one of my wisdom teeth out on Friday. I actually didn't realise that is what the dentist was going to do until I sat down in the chair (I've been booking so many dental appointments for my family that I lost track of what was happening at each appointment). I had no gas, just the freezing and the big needle (novocain?). I had no pain at all during the procedure (okay, a bearable twinge when he injected the novocain "inside the tooth" as he described it). Really, no pain. No pressure during the removal, I am amazed at how almost pleasant the procedure was. I had heard horror stories about wisdom teeth extraction and since I have a really small mouth with close set teeth I held on to mine until I was in my thirties and one got a cavity in it. I walked out of the dental office and spent the rest of the day running errands/working, just popping an advil every four hours just in case there was going to be pain after the freezing wore off (there wasn't). I've worked all weekend with no after-effects either. I had a filling and a deep cleaning (on some teeth) done at the same time. The whole procedure took an hour (but then another 30 mins of chatting with the dentist after) and cost me $300 all in. The only negative part of it was that I was playing with my frozen lip on the walk home and somehow bit it and now it has a little sore spot that is healing. I think it comes down to the fact that I have lucked out with an amazing (and affordable) dentist.
posted by saucysault at 10:05 PM on October 19, 2008

All four of mine were impacted, and the procedure took an hour - I had the IV and I'm very glad I did. I can't imagine having two recoveries. My recommendation would be to do whatever it takes to get it all done at once. As for asking for the teeth: I asked. They looked at me like I was a little crazy. I was picturing four perfect teeth, like the archetypal "tooth" image with four curved roots. Apparently they were pulverized into shards and dust, so no teeth for me.
posted by peep at 10:06 PM on October 19, 2008 [1 favorite has favorites]

My sister just got her wisdom teeth removed- all four, all impacted, and with Novocaine only. I don't remember what she said about the experience (it wasn't too bad, I guess). Most of the lower half of her face was numb for several hours after the procedure. (This freaked her out a whole lot.) The next day most of the feeling in her face was back, but a couple spots, like the inside of her ears, remained numb for a bit longer. I hear Novocaine has different effects from person to person, so YMMV.

I went under completely for my wisdom teeth. It was good- I didn't remember much of anything from the time they started the IV drip and I didn't have to deal with numbness afterwards. (My sister had trouble drinking, eating, and taking pain meds because of the numbness; I probably hurt a little more, but I'd rather go with pain than numbness.) On the other hand, my sister was up and acting pretty much normal the day after. I spent the weekend in bed and got sick and had to go home on my first day back at school.

Pain was not a big issue for either of us. We both were given prescriptions, but neither of us needed anything more than regular doses of ibuprofen. The biggest annoyance with recovery was definitely having holes in our mouths. Cheap paper expressed it nicely- food always gets in them, which is a huge pain. I wouldn't want to go through that sort of recovery more than once. Having a weirdly-swollen face wasn't bundles of joy and happiness either, so that's probably another thing you'll want to avoid going through more than once.

Because the wisdom tooth with the cavity isn't impacted, would you have to go through widom-teeth-removal recovery or regular-teeth-recovery? I had some teeth pulled before I got braces on, and that recovery was a breeze, comparatively. (I guess it would come down to whether you'll have a large hole that will need stitches when that tooth comes out- if not, it would be a short recovery, I think. You'd have to talk to an orthodontist or something about that.) If you're going to go through the whole weeks-long recovery, may as well only do it once.
posted by Baethan at 10:07 PM on October 19, 2008

I've had two on opposite sides removed with local anesthesia. They were done on different days, to let me eat using the other side during recovery. Wasn't really painful - just standard dentist stuff.
posted by ghost of a past number at 10:09 PM on October 19, 2008

Since the teeth aren't causing you any pain, I vote for waiting until January and then getting the whole lot done in one go. Minimizes the cost and recovery time. I also vote for the IV, but that's because I'm one of those people who would rather be knocked out and not know what is going on, dental work scares me.

FWIW I still have 3 wisdom teeth which need to be removed, all are impacted or partly impacted, and one has a cavity in it. It has had a cavity in it for over a year, and I have been putting off the surgery because I'm so scared (and I had several other expensive dental things done this year too). The cavity doesn't cause me any pain, hence my feeling that if I can wait 1 year +, you can probably wait pain-free til January in order to get the most dental insurance benefit.
posted by Joh at 10:20 PM on October 19, 2008 [1 favorite has favorites]

I had teeth out with only local anesthesia, and then got all 4 wisdom teeth out this past summer with an IV drip. One was slightly impacted.

I would strongly recommend doing all 4 at once with an IV drip, especially since three of them are impacted. I had a long recovery time even though my teeth were quite accessible, and I would not want to have to do it twice.
posted by Picklegnome at 10:31 PM on October 19, 2008

I had my wisdom teeth taken out over the course of two procedures (the two bottom ones, then about five years later, the two top ones). All four of my teeth were impacted. (As my surgeon so delicately put it, the top teeth were "all the way up in my eyeballs.") For the bottom ones, recovery really sucked. I was in pain and out of commission for a week. I was really dreading getting the top ones out, but the recovery was a snap! I went out for a short car trip later in the day (as a passenger!) and I was feeling almost 100% 2 days later. My oral surgeon told me that recovery for the top teeth is usually a lot smoother for people. So I would say that your recovery time/pain level is probably somewhat dependent upon which teeth you're getting removed, and that might be something you want to consider.

As for the no anasthesia thing, I can't help you out there... I was out both times, although I somehow still managed to cry the whole way through both surgeries (I'm told).
posted by rebel_rebel at 10:50 PM on October 19, 2008

I had an upper wisdom tooth taken out under local anaesthetic, and it wasn't a big deal. No pain, took about 10 - 15 minutes, some pretty gross noises and a sensation of pressure. Almost no pain on recovery except for a slight ache lasting a few hours. The salt-water gargling thing was pretty tedious, and I ate only soft foods for a couple of days.

Personally I'm pretty mean, so I'd definitely rather save $800 at the cost of a few days extra nuisance. All depends on your finances and your preferences though. If you love to tear into a juicy steak every day, best to do them all at once.
posted by TheophileEscargot at 11:31 PM on October 19, 2008

I feel I should note that tooth removal (yaknow, getting teeth pulled) is not at all like having a surgeon open up your gums to take out impacted wisdom teeth. Unless you have extremely low tolerance for pain, having a normal tooth taken out (even if it is a wisdom tooth, I would assume) does not require laughing gas, much less being put to sleep entirely. If your wisdom tooth with a cavity is not at all impacted, you could probably have that done at any time.
posted by Baethan at 11:37 PM on October 19, 2008

I had all 4 of mine taken out at once, I had the IV and was knocked out, then got an infection later on. I have to say, I've never done drugs before, but waking up after getting my wisdom teeth out was the bestest feeling in the world. I mean, until I fully woke up and the pain kicked in. But I was glad to get it all over with at once. It was a piece of cake.
posted by blue_beetle at 11:43 PM on October 19, 2008

Another vote for getting them all done at once with local anesthetic. I had all four teeth taken out earlier this year, two of which were impacted.

The most painful part of the procedure was the novocane injection itself. The most uncomfortable part was the sound of the third tooth being snapped out of my jaw. My recovery time was a bit longer than some here- there was pain for about a day (easily managed with Vicodin), soreness for two or three more, and I stayed away from anything involving chewing for a total of five days.

You mentioned cost being a factor, and electing to go with the local anesthetic did save quite a bit of coin. The whole thing ended up setting me back a little over $500.
posted by Uncle Ira at 12:03 AM on October 20, 2008

I had all four taken out a year and a half ago under local anesthesia. The Novocaine didn't work so well to begin with, and by the time my oral surgeon got to the fourth tooth, it had pretty much worn off. It wasn't fun at all. On the one hand, I've come out of boxing classes in almost as much pain; on the other hand, now it's easy to sympathize with my parents' generation for being squeamish about the Dentist. I highly recommend the IV.

Recovery wasn't bad: home for three days, eating mostly liquids for another four, eating and brushing very gingerly for another couple weeks. Very little pain, but it's tedious.
posted by wtdoor at 3:06 AM on October 20, 2008

I just had the left two wisdom teeth pulled last Wednesday. Novocaine only, and none were impacted, so it was more uncomfortable than painful. Mine have been out for years and it's only because of a gaping cavity in the bottom one that I had to have them out at all.

The needle in the roof of the mouth hurt like hell, but only for a second or two. The worst part for me was actually the little string of the stitches that wound up laying against the back of my mouth, making me gag from time to time, and I trimmed that (which I doubt is advisable). I've barely touched the vicodins they prescribed, which feel like overkill, sticking with the prescription strength ibuprofin they gave me instead.

As for the other two, well, they don't hurt me and I'm a firm adherent of "if it ain't broke, don't fix it".
posted by JaredSeth at 3:52 AM on October 20, 2008

I'll toss in my vote for doing all 4 underlocal at the same time. That's how I did it, and other than the strangeness others have mentioned of weird pressure and hearing cracking noises, there was no pain during and minimal after. And no recovery time. I drove myself home after the procedure and was fine. I chewed on some teabags as instructed (I'm not sure if this helped anything, but I did as I was told), and no problems since then.

Why split the discomfort into two sessions?
posted by genefinder at 5:00 AM on October 20, 2008

I also vote for doing all 4 at once. However, I do have a warning against waiting until January to do it. I put mine off for a year from when the dentist recommended it, and by that point they had growing in crazy directions and started moving my other teeth around. I never needed orthodontia as a kid, but 10 years after having my wisdom teeth out my bottom teeth are still noticeably crooked.
posted by hydropsyche at 5:21 AM on October 20, 2008

I had all 4 taken out with very little IV sedation and no nitrous and did fine; the main factor was that I had an experienced oral surgeon doing it. I also required nothing more than naproxen for pain afterwards-just make sure you follow directions and take your pain meds before you start to hurt.
posted by TedW at 5:58 AM on October 20, 2008

4 out at same time, all impacted, IV drip out cold. I would NOT recommend any other way. Oh and get the valium or coedine or whatever else they're prescribing ahead of time so that you can pop them on the way home (you shouldn't drive).
posted by allkindsoftime at 7:18 AM on October 20, 2008

I *loved* the IV sedation. I definitely would not have wanted to know what was going on as my impacted teeth were being removed.
posted by All.star at 9:09 AM on October 20, 2008

4 impacted, had them out one side and then the other. I didn't mind going through it twice - one side of my face swollen and in pain at a time was quite enough, thanks.

Novocaine only, both times. It hurt a little bit as the oral surgeon was doing the numbing. During the procedure I only felt pressure and digging, no pain at all, and I heard some cracking as they broke teeth to pull them out. I can't imagine opting for an IV - it would creep me out to be completely out of it just so they could dig out a tooth (and I hate hate hate pain - I'll pop a pain pill without 2 seconds thought).

Take the vicodin they give you before it starts to hurt. And it will hurt afterwards. Have a couple of ice packs ready, and ice cubes to suck on if you feel you need them - I totally did.

I took home the teeth - all cracked up and sooo gross looking - it was really kind of neat, and I still have them!
posted by KAS at 9:29 AM on October 20, 2008

I had all four taken out at the same time with nitrous oxide and I think novocain (there were definitely two things used). Personally I would not want to be put all the way under, but I've had so much done to my teeth that I don't get too squeamish. The nitrous oxide was very calming. I was glad to have it all done at the same time, but here's what I learned:

-Plan to take three or four days off work. As others have said, the first two or three days were the worst: some bleeding, pain if your meds wear off, etc. You may not need that long but my jaw was swollen for a few days. Get your meds in advance if possible, so you don't have to wait or go to the drugstore after you've had your teeth pulled. I wish I could have returned to normal as soon as others have written.

-When you go for follow up, make sure your dentist thoroughly rinses out/suctions your mouth to get rid of any food particles that have collected or tucked in your gums, since you can't brush fully. Otherwise you will have bad breath.

-Before the procedure, ask about additional charges like lab fees. As he was pulling my teeth the dental surgeon said he was sending off gum tissue samples to check for something (don't remember what since I was on laughing gas). I got invoiced for this--by the tooth--from some lab and had to pay for it. I called my primary referring dentist to complain. He said it wasn't unusual but would make a note that the guy didn't tell me in advance that I would have to pay more money. It sounded like a crock to me.

I don't know how much of my experience was due to the surgeon or what, but those are my pointers. Whatever you choose, best wishes for a speedy recovery!
posted by luckyveronica at 9:34 AM on October 20, 2008

Definitely do it all in one go. That is what I did, and yes, it sucks, but it only sucks once. My friend had his done in two sittings, and bitched to no end about it. (The same friend wasn't 'out' when they took his out: he said it feels strange when they pull them out, but it's not a big deal.)
posted by chunking express at 10:47 AM on October 20, 2008

From everyone I've known who's had their wisdom teeth removed, the experience varies wildly depending on the condition of your teeth and pure luck. I was lucky. I had all four out at once, under IV sedation, and it was no big deal. I put it off for three years prior to the surgery and eventually they got so painful that I couldn't sleep at all for a week. Compared to the pain I had before the surgery, the recovery was nothing. Two days, maybe.

My husband had severely impacted teeth and he also put it off until he woke up suddenly one night in excruciating pain. He had an emergency removal of 4 wisdom teeth, cost us $2000, and had a painful week-long recovery. So, I would say the most important thing is not to wait until your teeth are really messed up. Eventually, you won't be able to wait any longer, and that's going to be the worst time to figure it out. Get em all out, under IV, ASAP.
posted by threeturtles at 11:57 AM on October 20, 2008

take happy pill, go for the gas (if you like it some people don't It's not like smokin weed. don't hold your breath. the more you breath the better it works.) then you won't feel the Novocain (those needles hurt BAD) as it goes in. once you're numb the doc can Get er done & you can go home & sleep off the drugs. Get someone to drive you home as you will be stupid stoned.
posted by patnok at 12:39 PM on October 20, 2008

After reading all the replices, I am definitely leading more towards getting them all at once based on this. Also, IV is definitely necessary for me for the impacted ones, especially since 2 of them are entirely under my gum, I don't want to be at all aware of my gum being sliced open. Thanks everyone!
posted by illegiblemess at 6:29 PM on October 20, 2008

I had them all done at once many years ago, with, if I remember correctly, a demerol injection in the vein on the back of my hand.

It was almost pleasant, at least until the medication wore off.
posted by stavrosthewonderchicken at 1:30 AM on October 21, 2008