Extracting Wisdom

June 7, 2004 2:26 PM

Extracting Wisdom: I've been putting it dodging it for years, but it's looking (and feeling) like I'm going to have to get my wisdom teeth pulled. I do have insurance, but I have to go to a specific provider - a provider I've never actually been to before. Any advice on questions I should ask or things I should look for? Is one oral surgeon as good as another or should I shop around and/or pay extra if needed?
posted by aladfar to health & fitness (24 comments total)

things I should look for?

I got nitrous when mine came out. Whee!
posted by gimonca at 2:29 PM on June 7, 2004

I don't know how to judge an oral surgeon but my guy, when I finally went, just knocked me out cold. It was a beautiful thing. I had put it off for years, but when the thing finally happened, I went in there, sat in the chair, rolled up my sleeve, got stuck with something powerful and woke up an undetermined time later feeling better than I ever had in my life. As far as I knew, I had never even opened my mouth. (There was the small matter of my stumbling oh-so-high into the waiting room, spitting bloody gauze and raving to the nervous and appalled waitees about how much fun they were in for. They had to come corral me and take me away. But definitely go for the major drug/unconsciousness thing.)
posted by CunningLinguist at 2:36 PM on June 7, 2004

Ditto what CunningLinguist says on the general anaesthesia. That is the way to do it, especially if you're having all four of them pulled in one visit.

If you know the name of the oral surgeon you have to use, why not ask your regular dentist for his/her reference on the guy? Dentistry is an insular little group. They tend to know of each other unless you're in a really large city. And they tend not to hold back on their opinions of their colleague's skills.
posted by contessa at 2:48 PM on June 7, 2004

Oh, yes, you want to be knocked flat-on-your-ass unconscious.

I got nitrous, and then an IV cocktail of valium, swelling suppressants, and other stuff that sent me to nighty-night land. I never had a smidge of pain or swelling even though they had to crack two teeth in half to get them out.

Definitely worth paying for if your insurance won't cover it.
posted by ROU_Xenophobe at 2:53 PM on June 7, 2004

I just got mine done the Friday before last, at 31 years old.

I was getting three out - one partially, and one fully impacted.

They gave me two Xanax, one for the night before and one for an hour before surgery. I was very relaxed going in.

If they will let you, bring headphones and a music player.

They gave me an IV, and then I woke up on my couch at home.

Definitely get put under.

Ask for Oxycodone for the week after.
posted by tomierna at 3:00 PM on June 7, 2004

Definitely have someone to drive you there and back, and make sure you're well stocked with the correct foods --- jello, applesauce, etc.
posted by nathan_teske at 3:00 PM on June 7, 2004

I had nitrous, but was conscious when I had mine out. Didn't bother me a bit. I do second nathan's recommendation of having someone drive you, regardless of whether you get general anaesthesia or not.
posted by DevilsAdvocate at 3:12 PM on June 7, 2004

My biggest question would be about after-care. How many visits will the surgeon schedule for followup? What if there are complications? If your insurance doesn't cover any "fix-ups", will the surgeon cover any required procedures as a result of infection, etc.?
posted by nprigoda at 3:33 PM on June 7, 2004

I had mine pulled, got the gas, and got me some pretty wicked painkillers.

Problem was, I was living in the only first-floor room of my fraternity house-- and the drugs so suppressed my ability to reason that I wound up lying face-down, naked, with the door to my room wide-open. Photographs and permanent magic markers involved.

So find someone you trust to take care of you post-surgery.
posted by trharlan at 3:34 PM on June 7, 2004

I did not get the drugs...... Get the drugs!!!!
posted by xammerboy at 3:37 PM on June 7, 2004

I had two wisdom teeth extracted about eight months ago, age 36ish, and I'll have another two out this summer iffenwhen I finally get around to it.

My dentist gave me a local. One of the teeth came out easily. The other was quite a chore, involving a lot of cutting my gums, twisting and breaking, wrenching, picking, and other gore. (The worst part was when the cauterizing scapel wasn't correctly grounded, electrifying my head. Took fucking forever for the guy to figure out what the problem was. Zap! Is that working? Zap! Now?)

In both cases the after-pain was minimal. I didn't use more than a Tylenol. The gums were tender for quite a while, and the stitches were scratchy, but it was otherwise peachy.

So in my opinion, you just might be able to do it without a general, and there might not be pain afterward. Wouldn't that be nice!

Flipside, of course, is that I may have a freaky high level of pain tolerance. I don't think I do, but the proof seems other.
posted by five fresh fish at 4:15 PM on June 7, 2004

I need to get my own out. I like the idea of a general but all my friends in Australia have advised against it. Something about dentists being rougher on unconscious patients since they can't provide any feedback. My sister-in-law claims her jaw pain was much worse after having some removed under general than when she had the others done under local. Unfortunately this has led to me picturing a doctor kneeling over my unconscious body and yanking at my teeth with a pair of pliers every time I envision the procedure... which is why I haven't had it done yet.
posted by web-goddess at 5:08 PM on June 7, 2004

A friend of mine had his out in Hungary, where they apparently never use general anaesthesia, for fear of it causing later health problems. (Though I couldn't say exactly what these problems would be, or whether there is any documentation other than Hungarian law to back it up. Or maybe it's just that the anaesthesia is too expensive and they don't want people feeling trod upon. But that's probably not it, 'cause he went to the rich American guy who takes care of all the foreigners...) In any case, it seems like general is far less popular in other parts of the world (judging also by web-goddess' remarks). My hypothesis is that Americans are pussies; the pain of local likely isn't nearly as bad as imagined. Of course, I say this as someone who still has his wisdom teeth, but has also done plenty of very painful things that people tend to shirk at the thought of.

I guess all this amounts to is a very vague YMMV, but you only have to worry about it once. (Or twice.)
posted by kaibutsu at 5:26 PM on June 7, 2004

i found ice to be an extremely effective painkiller. coupled with your narcotic of choice, generously applying ice will keep both the swelling (no chipmunk cheeks!) as well as the pain down.
posted by lumiere at 5:37 PM on June 7, 2004

There was nothing ever quite as traumatizing as my dentist pulling out these ginormous locking pliers and squeezing the tooth until it exploded. And I saw everything reflected in his face-shield. Get knocked out.
posted by casarkos at 5:46 PM on June 7, 2004

I got knocked out and actually got mine out in the hospital because I was 14 or so and covered under my parents' insurance. If you get knocked out cold make sure you have a ride home from wherever you are. Have your friend plan to stop by the pharmacy on the way home to get a painkiller prescription. Make a bunch of peppermint tea to keep your mouth from tasting like blood for a few days. When you're done with the teabags, put them in the freezer for a bit, then chew on them later, it's soothing to your mouth. Rent a zillion movies, even if you've already seen them, because you'll likely feel like crap for a day or possibly more. Take all the anti-biotics you get and whatever you do, DON'T SMOKE or drink through a straw soas to avoid the dreaded dry socket. I've had tons of friends who have had their wisdom teeth out, and it's usually an annoying but rarely supertraumatic process as long as you're well prepared.
posted by jessamyn at 5:51 PM on June 7, 2004

After care:

Since I was feeling no pain, I thought that salty was a good idea for foods. I didn't try the (above) suggested peppermint tea, but what I found soothing, and what was probably rather antiseptic was drinking hot chicken broth. I made mine out of half canned chicken stock and half water, plus two of the chicken broth cubes.

Soft foods are very important. I suggest yogurts and broths. Shakes are nice too - get some ovaltine, some ice cream, some milk and a bananna. Yum!

My oral surgeon had me back once (just last Friday) and said that my sockets were very clean and were healing well.

I still have a tiny amount of pain - more of an ache, as though I'd been clenching my teeth for a while and just decided to let up.

My stitches all fell out as of yesterday, and I have only the tiniest bit of numbness on one side.

Numbness is a common side effect, especially on the lowers, since the nerves are so close to the wisdom teeth. Mine's probably just because they shot me full of local a little too deep on that side.

Lastly, don't expect to do *anything* the first few days afterward. Seriously. I'm a programmer by trade and I couldn't focus *at all* because of the residuals of the general, and because of the initial getting-to-know-the-narcotics.
posted by tomierna at 6:29 PM on June 7, 2004

I got knocked out on Halloween when I was seventeen. Whee! So fun! I was FLIPPING out at first because I don't do well with needles but when they finally got me sedated it was great.

They gave me codeine and when I got home my best friends came over in their halloween costumes. Apparently one was dressed as a ghost but in my drug addled memory she was dressed as the mom from the Wonder Years. Heh. I heart painkillers.

But, oh yeah, my mouth felt SO MUCH BETTER when it was done -- there is this constant low grade pain you probably aren't even really aware of and then you feel fantasmo!

It was a Friday and I went back to school on Monday, no problem.
posted by sugarfish at 6:39 PM on June 7, 2004

I just had novocaine and all 4 were out in less than an hour. Three years ago I had two teeth removed for braces, and that was worse than the wisdom teeth coming out.

The dentist got mine out before things got out of hand, so I had a sore mouth for a couple of days, but nothing the tylenol 3 couldn't cope with. The only aftercare was a visit to make sure that the stitches had come out as they were supposed to. All in all, it really wasn't a big trauma.

Friends of mine who went under general had more pain and a longer healing time, I don't know why, but there you go. I think perhaps some kind of tranquilizer would be a good middle ground.

Now when I got my tongue tie cut...let me tell you! That was some bad shiznit.
posted by Salmonberry at 7:26 PM on June 7, 2004

If you've ever seen the MASH episode where Col. Flagg refuses to take anesthesia, that was my predicament. My clearance at the time required that I have someone from the security office present if I was going under any anesthesia. Unfortunately, the security schmuck didn't show up, so I opted to do it under local.

There wasn't too much pain, but the cracking and crunching noises being conducted from my jaw all around inside my head made up for that. (The two lower teeth were impacted and basically growing horizontally.) Afterwards, the lower incisions wouldn't stop seeping. I had to spend most of the night with teabags clenched in my ravaged gums.

If you can't get a general, get NO or something that will leave you oblivious to the procedure.
posted by joaquim at 7:28 PM on June 7, 2004

I think whether or not the teeth are impacted really is the big question. Makes all the difference.
posted by Salmonberry at 8:19 PM on June 7, 2004

Two words to strike fear into your heart:
Dry Socket.
I had one and it was a very painful, horrifying two-week ordeal (bascially the craters stop healing and start putrefying.)

I'd recommend buying two nice, soft, cloth-covered ice-packs at Walgreens before you get the surgery, as well as stocking up on applesauce and painkillers. I found the ice helped the pain more than the pills, but having several icepacks was a necessity, so I could sleep with one and then get up in the middle of the night and trade it for a fresh cold one.

I'd also recommend stocking up on movies and reading material ahead of time. Plan to take it really easy the first few days, even if you feel great. Dry Socket doesn't set in until a few days post-surgery-- it's well worth a few lazy days in bed sipping smoothies and watching soap operas to avoid the drama of a dry socket.

Good luck!
posted by bonheur at 9:09 PM on June 7, 2004

If your wisdom teeth have come in all the way normally and need to be removed so they don't screw up the positioning of the rest of your teeth eventually, it shouldn't matter.

I had all four of my wisdom teeth out under local anesthetic without any aftercare painkillers two days before thanksgiving six or so years ago. I ate cold pizza the next day and thanksgiving dinner the day after that no problem.
posted by Apoch at 10:20 PM on June 7, 2004

I got knocked out, but woke up a bit during the proceedure. That must have been when they cut a nerve to my tounge. No way to fix that. Luckily, its not so bad as it affects my speech or movement or anything, but a quarter of my tounge is permanently numb. This wouldn't have happened if I hadn't been knocked out - I would have screamed soon enough to stop it.
posted by rainbaby at 5:46 AM on June 8, 2004