sleep dentistry, yes or no?

Discussion in 'Archived Threads 2001-2004' started by Christ Reynolds, Mar 11, 2003.

  1. Christ Reynolds

    Christ Reynolds Producer

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    i have some dental work i need to have done, and i was wondering if anyone has had experience with this. are there any procedures that they can do with a conscious patient that they cant with an unconscious one? my responsiveness to novocaine has been very unreliable, and my last visit to the dentist was pretty painful. ive been putting off the work for a while, but i really should look into things i can do. anyone have more info? thanks

    CJ
     
  2. Patrick Sun

    Patrick Sun Moderator
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    Will local anesthesia not be enough to hold back the pain of the procedure? Are we talking root canal? The only time I took the gas was when I got my wisdom teeth ripped out of my skull.
     
  3. Bob Movies

    Bob Movies Stunt Coordinator

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    I'm up for the wisdom teeth removal next month... Any advice on coping Patrick?
     
  4. Bill Kane

    Bill Kane Screenwriter

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    Speaking as one who has had 6 molars removed over the years, including several I let go thru neglect to peridontal disease, there should be no reason to experience pain in the dental surgeon's chair. Of course, dreading the procedure only adds mental anguish beforehand, something to be avoided -- the dread and the postponement.

    Novacaine, or whatever anesthetic may be comparable, ought to be sufficient. I will stop him at the outset and ask for more if I feel I can't go on!

    In the more major extractions, I was prescribed 800mg of ibuprofen (Motrin) an hour beforehand, to have some pain reliever in the system following the procedure and going home. Also offered are various codeine/Tylenol3 pain killers, tho I never felt enough after-pain to use them.

    Point is, a no-pain visit to the dentist can and should be "normal" and expected.

    Same with my one root canal.

    YMMV

    bill
     
  5. Luis S

    Luis S Supporting Actor

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    I just had two wisdom teeth removed myself last week. One was impacted and driving me crazy! The doctor applied a topical anesthetic,followed by a couple of injections and some laughing gas to seal the deal. Didnt feel a thing.The only thing was the pain and soreness after the anesthetic wore off. Make sure they give you some good pain killers. They gave me Percosets,didnt do a thing for me but come pretty recomended. Be careful though it supposed to be pretty wicked stuff. I tell ya I hadnt been to a dentist in a LONG time,so I was pretty nervous. But now Im ready to go back and get the other two that gotta go done

    They offered to put me under as well but it seemed to have alot more risks involved so I passed.See if they can combine anesthetic treatments like they did for me.It worked real well with absolutely no pain.Let us know what happens...

    Good luck,
    Luis S
     
  6. BrettB

    BrettB Producer

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    As happens so often I'm thinking of a Seinfeld episode. Make sure to take note whether or not your shirt is tucked in. [​IMG]
     
  7. Christ Reynolds

    Christ Reynolds Producer

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  8. Luis S

    Luis S Supporting Actor

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    Christ Reynolds,

    Well as it was explained to me as I recall there were numerous risks such as permanent damage to your heart or nervous system,an allergic reaction of some kind,and even death in rare cases . Not to mention the side effects weren't looking to hot. Drowsiness,vomiting,nausea, and a few I cant remember.Not to mention you'd HAVE to miss work for almost a week. This was going to be administered intravenously (sp?) So after signing all the documents that cover their behinds if I croak and sitting in the chair awaiting dreamland I changed my mind. I figured what the hell if its that painful then next time Ill go to sleep,but I thought it may be over doing it for getting some teeth pulled.Sure enough no pain and I felt much better afterwords.

    Now I can completely understand your hesitation to see a dentist.Hell Im embarrassed to say it but its been YEARS since I've seen one. And the first time back in years is to have teeth pulled! So I was pretty nervous as you can imagine.And I cant agree with you more about dentists with poor bedside manner. Its the biggest reason I think so many don't get their regular visits during the year.Luckily my doctor was friendly,polite,and very comforting. He didn't talk down to me, explained exactly what was going on and what's gonna happen. Ask around, friends and family, And see if you can find someone who will treat you that doesn't act like a jerk. I think that's what's going to make or break your experience.

    Hope this helps!
    Luis S
     
  9. Luis S

    Luis S Supporting Actor

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    Oh and also regarding the Novocaine. I think effectiveness varies according to technique. If it isn't injected properly its no use. I didn't even feel the needle touch the gum when I went! Worked great. As far as immunity goes,I doubt that's a concern. Like I mentioned,they prescribed me Percosets and it did NOTHING for me. Now I don't know if you've heard of it,but its supposed to be some of the strongest stuff out there,kinda like zanax. And yet nothing, didn't help me one iota. But the Novocaine did. So that makes me suspect how and where its injected is crucial. Get a good doctor and talk with him about it. You shouldn't have to worry about feeling a thing. [​IMG]

    Luis S
     
  10. EdR

    EdR Second Unit

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    I had 4 wisdom teeth pulled in one visit and I elected to be knocked out. It was incredibly smooth and easy proceedure, fall asleep one minute, wake up the next all done. I'm glad i was asleep because there were some complications and they needed to cut some of the teeth to get them out...I don't imagine that would have been fun to experience.

    In general, I am quite insensitive to novacaine, I've learned over the years that I need more than most people. My latest (and best) dentist agrees with me and now administers more automatically.

    My first and only (crossing fingers) root canal was painless, just uncomfortable from having to lay there for 2 hours.
     
  11. ian_graven

    ian_graven Extra

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    I to am immune to novicane as is my mother.
    Ask your dentist about Marcane(sp?), similar to novicane but much stronger. This is the only thing that will numb me properly.

    However, I have an upcoming root canal and i think i will chose to be put under because they marcane Keeps me numb for up to 3 days.
     
  12. Chuck C

    Chuck C Cinematographer

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    kinda reminds me of the time they had to give me 5 shots of nov. for one cavity! They kept hitting the nerve while drilling, so they added a shot, then pain, then shot and so on...by no.5 (injected in a different place) no more pain! My face was goo for a week.

    I'm going in for wisdom teth extraction in a couple months, and threads like these are reassuring. thanks all.
     
  13. Luis S

    Luis S Supporting Actor

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    When they took my wisdom teeth out they had to cut some gum as well as tooth.I felt a very slight sting as they cut the gum away,but it was barely noticeable.And when they cut a little bit of tooth?Forget it,all I felt was vibration similar to an electric toothbrush. I was given about three injections of nvocaine in all, worked real well for me. I guess the short of it is :

    Dont be nervous
    Talk to your dentists about all your options for anesthetic
    And lastly just concentrate on the the new piece of AV gear your going to treat yourself to afterwards for all your "suffering"(least thats what I told the wife [​IMG] ). [​IMG]

    With that you should have a pretty pleasent experience. Hey I cant wait to go and get the others done! As twisted as that sounds [​IMG]

    Luis S
     
  14. Julian Reville

    Julian Reville Screenwriter

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    I'm working too much: I swear I read this title as sheep dentistry , and I was thinking, "well, being ruminants, they don't have upper incisors..."
     
  15. Ryan Tsang

    Ryan Tsang Second Unit

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    Hi guys,

    First of all, I'd like to apologize to Christ Reynolds on behalf of this amazing profession for having had to put up the jerk. There are plenty of dentists who would love to take care of you. Dental school teaches us to be great technicians, but leaves us out to lunch on communication skills.

    On local anaesthetic:
    Novocain is no longer in use. Has been almost completely replaced by others over the last 20 years. No one I know uses it. So, it's ok to say "Novocain" to refer to anaesthetic, but don't think that's what going into your body. The most popular LA's are lidocaine, articaine, mepivicaine, and prilocaine. Marcaine is a long-lasting LA as Ian mentioned, but the offices I've worked in never had it.

    On injection:
    Lower teeth are more difficult to freeze than upper teeth. The reason is: 1)we can deposit the LA closer to the root of upper teeth 2) bone in the upper jaw is thinner, so it's easier for the LA to diffuse through it. 3) the anatomy of the lower jaw differs in people, so despite our best efforts, the optimum location for one person is not for another. 4) lower molars can have a "network" of nerves from it, not one "easy-to-locate" cable of a nerve.
    Different people have different tolerances as well, and the number of different experiences on this thread mimics exactly what I see every day.
    Pain threshold, anxiety level, and past experience also has a profound effect on how individuals experience the injection. I've had 10yr olds not bat an eyelash and 40yr olds go white-knuckled on the same injection, at the same site, using the same kind of needle, with the same amount of care and attention.

    roof of mouth, under upper front lip, back of lower jaw are the tougher spots. Upper premolars and molars are by far the least painful. Feels like a pinch at worse.



    On "sleep dentistry" and communication,
    I don't do laughing gas (nitrous oxide) because I don't have the additional training, so I won't comment on that. The value of conscious sedation (don't confuse with general anaesthesia), is that the patient does not remember what went on. They don't feel the vibrations or hear sounds, but we still need to give the injection. I always try my best to educate the patient and try to understand what exactly they fear. 90% of the time, I think anxiety can be managed thru communication. If the dentist is truly genuine and empathic, his/her tone of voice and body language will show it, and patient will sense that. Only then can a trust can be developed and most of the time, the patient learns to let go.


    On conscious sedation without "the gas":
    I prescibe Valium or Ativan, which will put the patient into light sedation and usually relaxes them enough to get them past the injection or extraction. I ask the patient to take a pill or two an hour before the appointment and get somebody to drive them home. Ask your dentist.


    On pain killers:
    Luis mentioned Percocet. I've never Rx'ed it. It is a narcotic combo drug. Hollywood already glamorizes Vicodin (Any Given Sunday, The Ring, Eminem) and Percocet is even more powerful.


    Christ Reynolds:
    What are you planning to have done? If it's confidential then you can email me. The fact that you are resorting to an HT forum to answer you dental question doesn't say much about your dentist.
     
  16. Clinton McClure

    Clinton McClure Casual Enthusiast
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    To have teeth extracted, the only way I'll go now is to go to an oral surgeon and but put under. I can stand any kind of pain except when it's in my mouth.
     
  17. Luis S

    Luis S Supporting Actor

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    [​IMG] to Ryan Tsang for sharing his expertise! You sound like someone Id trust with my teeth any day![​IMG]

    Ryan,you are so right about communication between the dentist and his/her patient. My doctor was exactly as you described "truly genuine and empathic" Like I said this in my opinion is why it went so well. If not for that I probably would have been to nervous and had a terrible experience.

    Percocet does have quite the reputation.Thats true.I expected to be in la-la land for as long as I took them. Its just so damn strange though,they had ZERO effectiveness on me! I think next time Ill go with a Tylenol/Codine. It helps me alot with my migraines. Unless of course Ryan you have any recommendations?

    Keep the experiences and info coming. This is a good thread to read for anyone getting work done on their teeth.[​IMG]

    Luis S
     

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