Dental advice?
Jan. 12th, 2015 12:48 pmThe kidlet gets all four wisdom teeth removed next month, and at least two of them are impacted.
I can tell them my experience, but I'm hoping things have improved somewhat in the 25 years since I had mine out.
Does anyone want to share recent experiences or tips?
edited 2019 to retroactively correct the kidlet's gender pronouns
I can tell them my experience, but I'm hoping things have improved somewhat in the 25 years since I had mine out.
Does anyone want to share recent experiences or tips?
edited 2019 to retroactively correct the kidlet's gender pronouns
(no subject)
Date: 1/12/15 07:12 pm (UTC)They gave me prophylactic antibiotics and a super-strong painkiller, the latter of which made me so sick to my stomach that my mom switched me to 800mg of ibuprofen after two doses. I had to go back a week later to get the sockets flushed out because there's just no real way to keep them entirely clean, no matter how fastidiously you eat or how carefully you rinse (unless, I guess, you have a device with the pressure of their water jets), and some time after that to get the stitches removed from the two where they'd had to do incisions and break the teeth and extract them in pieces. But after that, no problems! And I'd been pretty miserable before having them out, because they didn't fit in there and the crowding was giving me headaches that caused me to miss quite a lot of classes (second semester of my freshman year of college).
I'd do it again in a heartbeat. (If there were something surgical that could fix my TMJ, for example, and the experience would be just like having my wisdom teeth out? Hell yes. Except I'd skip the prescription painkillers and go straight for the non-nauseating stuff.) Hope the kidlet has an easy experience!
(no subject)
Date: 1/12/15 07:16 pm (UTC)(no subject)
Date: 1/12/15 07:16 pm (UTC)(no subject)
Date: 1/12/15 07:22 pm (UTC)For the first one, I had a super-strong painkiller but was off it after the first day (no bad reactions, just it made me loopy as fuck), and ibuprofen was fine. I did have bone aches in my jaw for the week after the second two, and took the loopy stuff to sleep.
Opiates are apparently likely to constipate, which is a good thing to know up front.
(no subject)
Date: 1/12/15 07:28 pm (UTC)And Fox, I was one of those unfortunate people who did not get sedated. I nearly cried years later when I found out it was an option! :D Thank goodness, I was only getting two done at the time (no insurance so that's what I could afford). One was partially impacted and one was completely impacted. Novocaine and nitrous oxide is all I got. There are some things you don't want to be awake for. The sound of your tooth being cracked into pieces is one of them. And also, the gas made me so woozy I had trouble telling them the novocaine was wearing off. So...much...fun. :/
(no subject)
Date: 1/12/15 07:35 pm (UTC)The vicodin or percocet or whatever it was they gave me for pain made me wretchedly sick, that was truly the worst part of the whole thing.
The best part was the two days of milkshakes.
(no subject)
Date: 1/12/15 07:35 pm (UTC)I would advise taking all the pills she's prescribed even if it doesn't hurt. If she is prone to allergies or any sinus problems at all, I'd add some sudafed to her daily pills. (They helped me.) The least bit of sinus pressure will make things worse. Yes, sudafed will dry her mouth a little, but a wide-mouth bottle of water (wide so she doesn't have to make the sucking motion) should fix that. Or a regular glass if at home.
Good luck! It should be fine.
(no subject)
Date: 1/12/15 07:49 pm (UTC)If your kid gets sedation and/or opiates afterward, most important advice: Eat something as soon as you're allowed to. All those drugs can make you incredibly nauseated and you don't want to be puking on top of everything else.
(no subject)
Date: 1/12/15 08:10 pm (UTC)The next thing I remember is being in the parking lot of the local CVS with my mother picking up my post-surgery painkillers. No idea how I got there, no memory of wtf I was supposed to do to take care of the wounds. But by god I remembered the nurse making assumptions about my mental acuity!
I think I took percocet for two days afterwards, and slept a lot, and then went down to tylenol for a few days longer, because I'm a wimp; I probably didn't need the tylenol, but I have no interest in toughing it out. I had persistent soreness in my jaw for the next six months, but I have jaw tension anyway, so that might not be a problem for your kidlet; when I asked my dentist about it, he wasn't worried and said it was probably just lingering inflammation from the pressure they had to put on the joint to pry out my teeth (see above and deeply rooted), if it was bothering me I could take ibuprofen for a few weeks and see if that helped. Which it did.
(no subject)
Date: 1/12/15 08:11 pm (UTC)Also my main tip for dental work of any kind: ask if you can take ibuprofen BEFOREHAND, and if so, do so. (I usually pop an advil just before heading to the dentist office.) You're way better off keeping the swelling down before it even starts, and IME this can reduce the amount of swelling and pain (and necessary painkillers) after the fact.
Yes to sedation/anaesthesia, yes yes.
Also, load up on probiotics and yogurt with active cultures and eat tons while on the antibiotics, if you have to take them.
(no subject)
Date: 1/12/15 08:28 pm (UTC)I would strongly advise having someone present to advocate for her throughout the whole thing (preferably someone who knows her medical history, especially if she has unusual drug reactions of any kind*). Dentists are not trustworthy, and people who are vulnerable/in pain/drugged are not in a good position to confront arrogant medical personnel.
Ask her if she wants to be sedated or not. Many of your commenters said they didn't want to be awake for it; I would have found being knocked out even more terrifying. I took anxiety meds and painkillers beforehand, had a family member on hand, and listened to music the whole time. It sucked, but I wanted that sense of control - that I could have called a halt if I needed to. If your kidlet does not have anxiety issues or medical trauma, sedation might be easier, but it should be her call. Back her up if the dentist tries to pressure her into something she's not okay with.
*Watch for unpleasant reactions to anything she hasn't encountered before. The dentist is likely to assume meds will work exactly as planned; this is not necessarily the case, and sometimes dentists will be very resistent to facts that contradict their expectations. (Thus the advocate.)
The aftermath can be worse than the procedure. Try to avoid dry sockets if you can.
Sorry to be a downer! I hope her surgery goes smoothly and painlessly and involves no complications, and none of what I've said turns out to be relevant at all.
(no subject)
Date: 1/12/15 08:28 pm (UTC)(no subject)
Date: 1/12/15 08:29 pm (UTC)(no subject)
Date: 1/12/15 08:43 pm (UTC)But if she goes with lidocaine instead of sedation, the thing I did learn about recently is this vibrating wand, a bit like a long tuning fork, that they can press up right against your jawbone so that the vibrations help counter the pain of the injection. I have a horrible time with -caine family local anaesthetics-- I need twice the recommended dose, it takes twice as long to start working as it's supposed to, and the lidocaine shot is always the most painful part of any procedure, and often the one that takes the longest to heal. I've had minor fillings done with no anaesthetic at all because drilling is less painful than the shot. But my periodontist uses the bone-shaker thing, and it really helps-- it doesn't make the shot painless, not nearly, but it lowers the pain enough to make it bearable. Without it, I would pretty much need sedation for anything that you can't just do without medication. (And I generally have a high pain threshold and no trouble with injections. But when they're in the gums they just feel like a blunt awl.)
All that being said, if she has two impacted teeth they'll probably want to sedate her.
Oh! And the other thing she and her dentist might need to look out for-- if her teeth are really crowding her mouth now, and if the extraction involves a lot of deep incisions, it's possible for the scar tissue to build up enough around the remaining back molars to make it impossible to brush or floss behind them. This happened to me, and led after ten years to a botched root canal which led immediately to a decade of horrible TMJ issues while what was left of the tooth quietly rotted in place. (The TMJ got better overnight when the tooth was finally removed, but if my dentist, when I was sixteen and fully healed from the extraction, had done the half-hour procedure my periodontist did last year and pared away the excess tissue to begin with, I might have been spared a lot of difficulty.)
But that said, most wisdom tooth extractions don't lead to that level of scarring. My second set was far enough back in the jaw that I overheard the surgeon, as I was coming out from sedation, saying that if he'd known how hard it was going to be to get them out he'd have gone in from behind with incisions below my ears.
Um. Maybe the most important thing I can say is that the kidlet's wisdom tooth situation CANNOT POSSIBLY be as bad as mine.
(no subject)
Date: 1/12/15 08:46 pm (UTC)(no subject)
Date: 1/12/15 08:46 pm (UTC)(no subject)
Date: 1/12/15 08:48 pm (UTC)(no subject)
Date: 1/12/15 08:53 pm (UTC)(no subject)
Date: 1/12/15 08:56 pm (UTC)What I meant was that the pain pills they sent me home with made me sick. I was fine after the procedure. And fine again once I stopped taking the pills.
(no subject)
Date: 1/12/15 09:20 pm (UTC)I went for full sedation because I really did not want that experience. They put the IV in through a vein in my left hand. I actually didn't stay 100% under the entire time, I surfaced enough to be aware of them working for a bit -- it felt like I was, myself, a construction zone with all the grinding etc. -- vbut for what it's worth, while it was uncomfortable I still wasn't in any actual pain (I believe they did apply local in addition to the sedation) and I did go back under after that. It was mostly odd, rather than traumatic.
They insisted I would be woozy and out of it and might forget everything. I was wobbly and a little iffy for about five minutes; by the time I'd gotten back to the car some twenty minutes, I was pretty much snapped entirely out of it. I mean, I didn't feel GREAT, someone had just taken knives to mouth and dug stuff out, but I could've driven if I'd had to. This is not typical, I gather, and much faster than usual snapback is probably why I surfaced in the first place.
As I recall, they packed the sockets with something to help with the clotting and to keep particles out out. I remember them being very very clear that I should be careful not to dislodge the clots because that would be an enormous pain in the ass; so nothing crunchy, no straws of any kind, and to be thorough but GENTLE in rinsing the area. I seem to recall gentle saline rinses were a thing I did as part of that, but I could be conflating with other dental stuff.
If your kid doesn't have chronic pain issues then she probably won't have the pain management issue I had; they gave me a standard hydrocodone scrip to deal with the pain with instructions to take every 4 hours, as needed. It only barely kept the pain controlled and by the end of 4 hours the pain would be breaking through badly -- which made sleeping fun. I did not get a single uninterrupted night's sleep while I was healing up; I'd wake up from the pain and have to wait for the pill to kick in before I could get back to sleep.
This was almost certainly because the hydrocodone was actually dealing with more than just the dental pain but also my undiagnosed and unmedicated joint pain. If your kid does have chronic pain issues of any kind, or problems with any particular classes of painkiller, y'all want to talk with the doctor about that ahead of time to make sure that she'll be able to control the pain.
As others have noted, people who aren't habituated to narcotics often deal with nausea from them. If they give her narcotics, there are anti-nausea meds that can be prescribed with them and having some on hand would probably be a good idea.
I hope it goes well for kidlet!
(no subject)
Date: 1/12/15 09:32 pm (UTC)(no subject)
Date: 1/12/15 09:44 pm (UTC)(no subject)
Date: 1/12/15 10:06 pm (UTC)(no subject)
Date: 1/12/15 10:06 pm (UTC)ETA: On the plus side, I had a jaw like Silvester Stallone for several weeks afterwards. It was actually pretty funny. ;-)
(no subject)
Date: 1/12/15 10:16 pm (UTC)(To be honest, the week after the surgery I vaguely remember watching Angel S1, while Mum gave me pills every so many hours and eating a lot of mushed food. Mum insisted of cooking regular meals and putting the end result through a blender so I had meals with piles of green mush, white mush and brown mush, but at least it all tasted like food. If I was doing it again, I might have had a few more protein shakes/meal replacements as an easier option -- but I loved an excuse for icecream and jelly/jello.)
I don't have any trouble with painkillers of any sort, but my dental surgeon was smart enough to recommend a mix of ibuprofen/advil and paracetamol-based (um, it's the tylonel brand over there, but I can't remember what the US drug name) codiene painkillers. Since they're different drug families you can double-dose and take them together without just taking one strong one that can upset stomachs.
Lots of mouthwash, fight the urge to brush those sore gums, and factor in a week lying about in bed -- but all in all, it's an easy recovery.
(no subject)
Date: 1/12/15 11:07 pm (UTC)I would not have wanted to be awake, but I don't like the dentist much.
(no subject)
Date: 1/13/15 12:33 am (UTC)(no subject)
Date: 1/13/15 12:56 am (UTC)OBEY THESE LIKE THE WORD OF GOD.
Dry socket is too much pain to live, worse then migraine or gallstones. Avoid. AVOID.
Upper teeth recovery isn't bad; lower can take a lot longer, several days before you can open your mouth very much at all. Have a wide variety of soft foods available, including protein sources, because they get boring. Yogurt, scrambled eggs, ice cream, soup, pasta, etc.
(no subject)
Date: 1/13/15 03:28 am (UTC)Use a painkiller that works on her - I got Tylenol 3 which basically had no effect on me and was in pain until I switched to ibuprofen.
My dentist gave me a water syringe - great for clearing food out of the holes before they heal - it takes a while for the holes to close over. (http://www.dhphomedelivery.com/productcart/pc/catalog/NeedlesSyringes-12cc_412_curved_tip-800.jpg)
(no subject)
Date: 1/13/15 03:39 am (UTC)I remember sitting down in the chair and then the memories start again as I'm getting into the car next to my mother. I was pretty much poured into the couch for the next three days and subsisted mostly on yogurt and soups. My advice would be to stock up on soft foods, sweats and queue up tv shows you don't mind watching in a drugged haze.
(no subject)
Date: 1/13/15 03:44 am (UTC)I think I maybe had a liquid diet for the first day, and then just chewed very carefully for a few days after that. It was pretty uneventful, and I hope hers is equally easy.
(no subject)
Date: 1/13/15 03:59 am (UTC)The spouse was in the waiting room while the assistant came out and said, "Ms. Baxter? Lisa is awake and doing fine ... Mr. Grayeb? Jim is awake and doing fine ... Mr. Res? -- er, you'd better come with me ..."
(no subject)
Date: 1/13/15 04:38 am (UTC)And then was basically fine by the next day. I wasn't really eating anything, but I went to a friend's birthday party, and no one could even tell that I was recovering. A little drained, and not like it was nothing, but definitely no big deal.
There's a huge variety in what wisdom teeth extraction is like. Sometimes they're fairly easy extractions, and a dentist can do it like any other. Sometimes they're complicated impactions, and an oral surgeon needs to use every careful trick in the book. There's a huge spectrum of where the procedure might fall. Plus, then people's bodies vary in how they react and recover, too, so there's variations in the other dimension, too.
I hope she has an easy time with it! Good luck :)
(no subject)
Date: 1/13/15 05:20 am (UTC)Good luck to the kidlet :)
(no subject)
Date: 1/13/15 05:39 am (UTC)(no subject)
Date: 1/13/15 05:41 am (UTC)(no subject)
Date: 1/13/15 06:39 am (UTC)(no subject)
Date: 1/13/15 08:14 am (UTC)I had local anaesthetic only, no sedation. It was more harrowing than a regular trip to the dentist and uncomfortable, but there was no pain. I remember a lot of tugging and wrestling with one tooth and it definitely came out in pieces, but I don't remember the dramatic crack some commenters have reported.
I spat out the cotton plugs an hour later when I got home. They gave me mouthwash, which I used not quite as often as recommended, antibiotics (which gave me thrush) and painkillers equivalent to Tylenol 3. After the first day or two I only needed regular ibuprofen and not much of that.
There was very little swelling. I was chewing soft foods within a week. I had some soft stitches, which felt funny but didn't hurt. They all came out by themselves, still no pain, and some of them I must have swallowed (ugh). By the time I went for the follow-up appointment two weeks later they were all gone.
All in all it was unpleasant, but really only traumatic to my wallet.
(no subject)
Date: 1/13/15 01:33 pm (UTC)I opted for twilight sedation, due to the aforementioned pallor and swearing, which was definitely the best plan for me. I did start to come out of it at the end and I remember the surgeon saying that there were still some fragments he was struggling to get. He must have given me a local as well, because I felt a lot of tugging but no pain. Then it was over and I immediately spent thirty minutes huddled under heated blankets because I had a reaction to the sedation that made me desperately ridiculously cold. Also fun! It took forty-five minutes to remove my one tooth, because it was so fabulously stuck, which is why I came out of the sedation before it was over.
I got the good drugs (tylenol 3) and antibiotics the size of horse pills. I slept most of that day and subsisted on chocolate milk and yoghurt for several days because my jaw locked up completely, due to super special snowflake joint problems. I also have ridiculous texture issues where mashed up food makes me gag. Perfect for dental procedures!
If anyone talks me into another extraction ever again, I'm loading up on protein replacement drinks. I lost several pounds in the aftermath. Mostly because just as I was finally starting to feel better after five days, I got dry socket. Yay me?
And because I'm super special, I got dry socket again two months later. The dental nurse felt so bad for me at that stage.
I'm pretty confident there's no way kidlet will have anything like my experience. But if dry socket happens, reassure kidlet that it can happen no matter how careful you are. Taking the precautions is worth it to try to prevent it, because dry socket sucks beyond the telling of it, but some people just get unlucky even though they're being careful.
(no subject)
Date: 1/13/15 04:48 pm (UTC)I had out 2 lower partly-impacted wisdom teeth (which was all the wisdom teeth I had--never grew any uppers), with local anesthetic and nitrous or "twilight" sedation--and I fell asleep and pretty much stayed that way, though I do recall being dimly aware of tugging and tapping and the burning smell of the friction cutting tool.
Once i woke up, I felt a little dopey but basically fine, allowed myself to be taken home and watched TV while gently biting a used teabag against the extraction sites (the tannic acid aids clotting). I had prescriptions for oxycodone (strong painkiller, enough for a couple days after) and hydrocodone (moderately-strong, enough for a week's use). The day of the procedure and the first day after, I felt fine, just a little localized tenderness, and I only used ice and iburofen to keep down swelling. Day 2 post-procedure, the pain hit. Apparently that progression is pretty common--when I called the oral-surgeon's office to report it, the nurse mentioned that it can take 24-48 hours for some patients to completely metabolize the anesthetic, so many people feel their worst on days 2-3 post-procedure. I took some oxycodone, which did away with the pain entirely, but made me so woozy and light-headed besides nauseous that they weren't worth it, and I switched to hydrocodone, which worked acceptably; I still felt pain, but it was not enough to be distracting, just sort of...informational (body says: "remember you had surgery a couple days ago and still have holes in your jaw; don't get too frisky"). I used the hydro for about 24 hours, then went back to mostly ibuprofen for a few more days. I had had the procedure on a Friday, felt worst on Sunday, went back to work Monday, was actually useful at work on Tuesday. Ate mushy foods only for a few days, then ordinary but not hard/crunchy foods that would hurt if a piece poked a tender spot, for a few weeks further.
I felt well enough to go to an SCA event the next weekend and eat most of the medieval feast. (I had some stronger pain in the evening at the event, but it was probably half a migraine.)
I was not prescribed antibiotics, but had hygiene instructions. I didn't get any infection but did get a persistent yucky rotting taste--which of course I couldn't dispel by vigorous cleaning (warm salt rinse didn't seem to do anything), since brushing the extraction sites, vigorous swishing, or use of Listerine-type disinfectant mouthwashes containing alcohol or peroxide were forbidden to prevent irritation of the healing sites, and dry socket. (My partner got that with her wisdom teeth extraction a few years before, and she was in so much pain that she couldn't sleep, even on strong painkillers ... I was highly motivated to avoid that outcome). I got a prescription germicidal mouthwash --clorhexidine gluconate--which tasted horridly bitter-chemicalish but banished the rotting taste and kept the sites clean til they healed.
It wasn't a bad experience, more uncomfortable and inconvenient than anything.
(no subject)
Date: 1/13/15 04:52 pm (UTC)(no subject)
Date: 1/13/15 05:31 pm (UTC)Bottom was a whole other kettle of fish: they didn't get good numbing on the left so I could feel them breaking the tooth in half and taking each half out. They tried a second shot of anesthetic, but all it did was some nerve damage that had me tasting lemon with the left side of my tongue for a year.
Obviously, I did this without sedation. I 100% support every person's right to choose sedation, and I hate useless pain, but there's always a small chance sedation goes wrong. I felt the pain did not outweigh the risk, and even with unanesthetised pain, I don't wish I'd done it the other way. Don't let a dentist railroad you into choosing sedation/no sedation, pick the one you want.
Useful info: top is much easier than bottom, usually, so do that second. Don't forget to eat with hydrocodone, or you'll throw up. Drink lots of fluids, but make sure that it's clear liquids and not red koolaid just in case you throw up anyway.
(no subject)
Date: 1/13/15 10:53 pm (UTC)(spoiler warning if you don't want to read anything scary—my mom found this tough!)
I'm apparently sensitive to Novocaine (or whatever it is they use to knock you out) and it didn't work on me, so I spent the whole time screaming so loudly that a maintenance dude doing work in another office got freaked out and had to leave.
The thing was, I told them it wasn't working, and they didn't listen—
—so, uh. If the kidlet starts talking about how she can't breathe and how she feels weird from the drugs and how she doesn't like it, maybe she's got some sensitivity to it too?