Is this legit?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

zoolander

Blue Steel
10+ Year Member
5+ Year Member
15+ Year Member
Joined
May 5, 2004
Messages
54
Reaction score
0
My OMFS resident today, at an appt to get my wisdom teeth taken out, said that he only removes two wisdom teeth at a time, and that I'll have to come back to get the other two taken out.

The prev. resident at the pre-op consultation had said, "yeah, let's do it, they're partially erupted and not impacted, come back during your elective when you're not taking call." (I'm a medical resident)

So there I was in the procedure room, and this guy, after some questioning, admitted that he doesn't ever do all four wisdom teeth at a time if possible, and I'd have to come back to get the other two done. WTF?

Can I get all 4 taken out at once for only one recovery period? Is this a legit approach to wisdom teeth- is there any benefit to doing only two at a time? If they're not painful, what's the urgency on getting them out?

Thanks in advance.

Members don't see this ad.
 
they can use only use local...
it's done all the time.

if u were bilaterally blocked you could easily do some bigtime damage to yourself.
..and as u know there are more potential complications with GA..

IV conscious sedation would be another anesthesia option...


just an uneducated guess
 
toothcaries said:
they can use only use local...
it's done all the time.

if u were bilaterally blocked you could easily do some bigtime damage to yourself.
..and as u know there are more potential complications with GA..

IV conscious sedation would be another anesthesia option...


just an uneducated guess

I don't get what you're saying- when dentists/oral surgeons only use local anesthesia, they only take out two teeth at a time?

What do you mean by 'easily do bigtime damage' with a bilateral block- is there an increased risk of injury w/bilateral nerve blocks? If so, why?

Have you seen pp get bilateral nerve blocks for wisdom teeth extraction, or is local anesthesia for 4-tooth extraction contraindicated for some reason? To get 4 out at once, is conscious sedation or GA required?
 
Members don't see this ad :)
zoolander said:
I don't get what you're saying- when dentists/oral surgeons only use local anesthesia, they only take out two teeth at a time?

What do you mean by 'easily do bigtime damage' with a bilateral block- is there an increased risk of injury w/bilateral nerve blocks? If so, why?

Have you seen pp get bilateral nerve blocks for wisdom teeth extraction, or is local anesthesia for 4-tooth extraction contraindicated for some reason? To get 4 out at once, is conscious sedation or GA required?

If you numb up both sides you are much more likely to bite your tongue (or lip or cheek) and cause some pretty bad damage. If they are going to do all 4 it would be prudent to consider the option of general (depending on the patient), of course saying that, I have to admit that all 4 of mine (as well as some other people I know) were yanked with only local and in one visit.

grtuck
 
Just to further clarify - though I think grtuck may hvae cleared it up for you. Local anesthetic can last a long time and being bilaterally numb will leave you with no virtually no feeling or proprioception in your mouth. Read - you will chew through your cheeks and turn your tongue into a bloody pulp!!! :D Not to mention possibly breaking your teeth.

Your jaw muscles are capable of some serious power. Many people have some type of parafunctional habit like teeth clenching, cheek biting, tongue biting, etc... Without some pain and proprioception to keep these habits in check you can cause yourself some serious harm. Sounds like a legitimate residency policy to me.
 
Most 3rd molars are taken out all in one visit. Even when you're put under general or IV sedation your entire mouth is numbed with anesthetic. Marcaine is even used on the mandible (bilaterally)to give the patient longer relief after the surgery. Usually the only time to worry about bilateral blocks is in children or individuals with less control. The issue is probably one of time and ability :eek: .

tjb
 
Bilateral blocks with 3rd molars are very common. Will it cause serious damage worse than having 2 lower impacted 3rd's yanked out of your head? I doubt it because it is done all the time.

Once you get into private practice and have a patient who wants all their tx done at once on the mandible then you will be doing a bilateral block. Do patients bite their tongue, lip, cheek occasionally? Yes. Should you do it in children? No.
 
I'm an OMFS resident and we always do all 4 at my institution...at least whenever we have the chance. We get more experience that way and that's what private practice guys do. I'm not sure why you would only do 2 in your situation...sounds like an unusual policy. We do most of ours under concious sedation if all 4 are coming out, but for single ones we just use local as long as they're not impacted.
 
Soon after I got out of the Army and went back to college, all four of my 3rd molars started hurting like blazes. I finally went to see an oral surgeon after I could only keep the pain under control with ice in my mouth 24/7. He put in the IV, the lights went out, I woke up with a mouth full of gauze, and all 4 Wizzies were gone. The only complication was one dry socket. Total cost was $100.00 cash up front. That was in 1972.
 
1972? Groundhog, I didn't realize you were... ummm... mature. :)
 
I'll do 4 if I have enough time.

Do 2 if front desk only gave me time to do 2 and I have no better pt to fit in that slot.
 
Top