Extractions - General Anesthesia or Not?

[weakjawmcgraw]

Hey, everyone!

I've lurked around on this board for a while, but I'm beginning my orthodontic adventure in a few days, so I've decided to post for the first time.

I have ICR (idiopathic condylar resorption), which is now in "remission." However, it's left me with a 6mm overjet, open bite, and TMJ pain, so I'm going to be getting orthognathic surgery (BSSO, Lefort I), and braces are a part of the treatment. According to a few orthodontists I met with (including my final choice) and my oral surgeon, I'm having to get four premolars removed before I can get braces.

I'm having the extractions done on Wednesday, but I'm nervous for a few reasons! I have really bad health anxiety, and I think I'm coming down with a cold (but maybe not! haha), so I'm nervous about that interacting with my oral surgery / having to get reschedule. I called today to check on their policy, and the oral surgeon's office said that, unless I'm running a fever, I'm probably good to go. I don't know if anyone else can attest to this?

Secondly, I'm nervous about general anesthesia. I hate the idea of going under (the horror stories have my anxiety spiking!) and have played around with the idea of just getting local and staying awake for the duration. (It's only supposed to be like 20 mins, so I think I can muddle through it.) I was wondering if anyone has had extractions with just local anesthesia and can tell me how it went? Or should I just suck it up and also do the general?

Thanks so much, and I'm very excited about joining this board! :)

[assertives]

I personally had general anaesthesia when I got my extractions. But, I had my premolars extracted during my wisdom teeth surgery, total 8 teeth, so GA was needed in my case. I didn't get any of that delirium that people talked/videoed about. I woke up 15 mins after my surgery was over, and I was just a tad dizzy for about an hour after that before the hospital discharged me. I did have a bruised/sore throat from the tube though, but that went away a few days after my surgery.

My experience with GA was pretty much uneventful I'd say. My anaesthetist was really good, gentle and encouraging. He gave me the right amount of anaesthesia for my body and I slept very well and remembered nothing about the surgery after that.

I'd say though, if you are only going to be getting routine extractions, i.e. extractions that don't need surgery, just go with the local anaesthesia. I say this because you will be undergoing jaw surgery later, and GA is not good for the body, so if you can avoid going under too many times, avoid it.

[djspeece]

I've had multiple extractions under local, and for me it's the way to go. I am an RN, and while I trust general anesthesia, I dislike the recovery time and "hangover." I had an inguinal hernia repaired under local and some conscious sedation, and that wasn't too bad (although I do have a vague recollection of the surgical team joking with me so God knows what they got me to say. I worked in the hospital and knew them all, so they had their fun ) Your dentist will be more professional, no doubt.

This of course assumes that you can keep your anxiety in check for the 20 minutes, perhaps meditate or go to your happy place . Best of luck to you!

[Beemur]

I only had one tooth at the front out and one that was growing up in the palate of my mouth, I avoid anything that will make me unconscious because I hate feeling groggy and my dentist said no worries and gave me 8 injections so I was beyond numb and would't feel a thing. She was a bit worried the tooth up in my palate was going to cause discomfort whilst removing but I literally felt nothing but my head being pushed on a bit, I've had cleanings that are ten times more painful by far
My partner is booked in to get two wisdom teeth out and he hated the idea of going under and she said so long as they can get him numb enough there's no reason for him to need to be put under at all. She said it's really common for people to prefer being awake for the extractions and she only refuses it if it's a complex wisdom tooth case. Have a chat to whoever is taking the teeth out and I'm sure they will be happy to discuss all options with you

[GemmaRVN]

I am due to have braces fitted in a few weeks but I require two extractions (molars). My main concern is the extractions of my teeth :( I’ve had a bad experience with local anaesthesia in the past where the dentist hit my facial nerve and it was so painful, since then I have avoided local anaesthesia altogether.
I think having a general for 2 teeth extractions seems unlikely :( I am so nervous.

[weakjawmcgraw]

[quote=GemmaRVN post_id=500793 time=1520540985 user_id=31525]
I am due to have braces fitted in a few weeks but I require two extractions (molars). My main concern is the extractions of my teeth :( I’ve had a bad experience with local anaesthesia in the past where the dentist hit my facial nerve and it was so painful, since then I have avoided local anaesthesia altogether.
I think having a general for 2 teeth extractions seems unlikely :( I am so nervous.
[/quote]

I ended up having general anesthesia for my extractions because my surgeon offered it. Even if you do get general anesthesia, though, you'll still have to get local around the extraction sites. My extractions went really well, and the pain afterwards was completely manageable. (It did get annoying to eat only soft foods for about a week and a half.) I understand the nervousness with such a terrible past experience! (So sorry, by the way!) But I think letting whoever is doing the extractions know about your hesitations or past experiences will make them probably take more care in administering the local anesthesia. (Regardless, I think they'll probably be very careful about administering local anesthesia!) Anyways, I say all this just to get to the point that I don't think you have too much to be nervous about! The procedure, which I was SO nervous about, and the recovery were actually much easier than I anticipated! (The pressure during the first week of braces are worse than that, in my opinion!) Good luck!! Sending positive vibes!