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how much does a impacted wisdom tooth extraction hurt? will it hurt for several weeks? or a couple of days? just curious.. can i do it under local anesthesia?
wisdom tooth
- Thread starter redstorm
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Are you going to be *getting* wisdom teeth out, or *taking* wisdom teeth out? Your post makes it a little hard to tell.redstorm said:
...oops. I hope this isn't construed as unprofessional mockery. I'd hate to scare off a new user with my rampant immaturity. Better close the thread.
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It hurts a ton, better start screaming and run the other way.
...just kidding (don't close the thread please guys, I know it was unprofessional!)
Get it done under IV sedation and who cares, you won't feel a thing!
...just kidding (don't close the thread please guys, I know it was unprofessional!)
Get it done under IV sedation and who cares, you won't feel a thing!
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redstorm said:
All of mine were impacted, and they didn't hurt too bad. I was under general anesthesia, however. Like the typical wisdom tooth stories you'll hear, I bled on and off for a day or so, and had some minimal swelling.
It was painful, but not too painful. More like an annoying dull throbbing. You can manage, that's for sure.
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Both my lower wisdom teeth were impacted, but the uppers were not. My Doc gave me local and 800 mg of ibuprofen. I can still remember him jerking my whole face around while he worked FOREVER to get the lowers out. He tried to remove them in one piece at first, but ended up sectioning them and still had a horrible time getting them out.
Point is this, it just took a little demerol and ibuprofen to keep me happy for a couple of days, even with the whiplash to my neck
On the other hand, I have a friend that had some that were fairly easy to remove, so he opted not to have general. He really wishes that he had been put under now. So it really depends on you more than anything, when deciding if you need more than local.
grtuck
Point is this, it just took a little demerol and ibuprofen to keep me happy for a couple of days, even with the whiplash to my neck
On the other hand, I have a friend that had some that were fairly easy to remove, so he opted not to have general. He really wishes that he had been put under now. So it really depends on you more than anything, when deciding if you need more than local.
grtuck
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I'd take the IV sedation for impacted 3rds. That combined with some good pain meds should do the trick.
To grtuck or anyone who can answer: Just out of curiosity, why did the surgeon prescribe both Ibuprofen and Demerol? In this case is the Ibuprofen just to control swelling? Seems like demerol alone would take care of the pain. Darn it, I wish I remembered more from pharm.
To grtuck or anyone who can answer: Just out of curiosity, why did the surgeon prescribe both Ibuprofen and Demerol? In this case is the Ibuprofen just to control swelling? Seems like demerol alone would take care of the pain. Darn it, I wish I remembered more from pharm.
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DDSSlave said:
He doesn't explicitly mention that he took them simultaneously (although it seems that way), so perhaps he used the Ibuprofen when the Demerol ran out?
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DDSSlave said:
He told me to take the Demerol only if I needed it, but suggested that the Ibuprofen would be enough, and to only use the Demerol if the Ibuprofen didn't work. If I remember right, he only gave me small doses, and there was only enough for like 1 day. Maybe he thought I was a drug addict
I don't remeber if he told me that I could take them at the same time or what. I had this done back in 1997, so it's all a little foggy...
Also, from what I understand it isn't uncommon to use both. For example Lortab, Tylenol 3, Oxycodone, Hydrocodone are listed in Peterson's contemprorary oral surgery book as options for post-op pain management to consider depending on the amount of expected post operative pain (chapter 10, page 217 in the 4th edition). I am taking surgery right now though, so I am still unlearned about this, and would appreciate any further feedback anyone with more experience could provide.
grtuck
T
toothcaries
grtuck said:
an example would be to stagger the drugs...
tell pt to take 600 mg ibuprofen 6qh prn and and write a script for vicodin 5/500 1-2 every 6hr prn..
at 12pm pt takes the vicodiin
at 3pm pt takes the advil or whatever..
at 6 the vicodin again..
at 9 take the ibuprofen again..
get the picture?
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grtuck said:
That seems to make sense. The Demerol sounds like overkill, but I guess that's the point if the 800 mgs of Ibuprofen isn't working. Can anyone else comment on what they prescribe after complicated exodontia?
How about uncomplicated exodontia? For the last few full arch extractions (usually involving 5-10 teeth) I've been prescribing 600 mg Ibuprofen q4h prn. Is this inadequate? I haven't had any complaints from my patients, but I've been considering stepping it to Tylenol No.3 or Vicodin. Any thoughts?
T
toothcaries
DDSSlave said:
be careful prescribing so much ibuprofen...
u dont really want to exceed 3.2 grams/day.
also..
the ibuprofen is an antiinflammatory...
...the vicodin is hydrocodone(alters pain perception) w/ acetaminophen(also for pain)
(i'm still a dental student) but..
as far as what to use..
OTC for simple extractions..
the mild narcotic (vicodin) for flaps, bone removal, low pain threshold pts..generally all difficult extractions.
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toothcaries said:
Yeah, I actually tell them every 4-6 hrs and not to wake themselves up in the middle of the night to take it. But a very good point, and one of the reasons I've been considering just switching to Vicoden
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redstorm said:
i had an impacted tooth before. it's hard to describe how much it hurts.. after taking a pain killer pill, i felt drunk-like, knocked out myself and napped away hours and hours. i was groaning with pain once the local anesthesia went away. it hurt only about a day for me.
T
toothcaries
DDSSlave said:
a simple rule for ibuprofen..
either 800mg every 8 hrs or 600mg every 6 hrs...
(8-8 or 6-6)
...easy to remember for when the residents and faculty try to pimp ya...
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i had one of my wisdom tooth extracted from an omfs it was a good experience per se under local anesthesia with no sedation. i had swelling 4 abt 3 days. pain lasted 4 i think just a day. what really bothered me actually was the sutures i had 2 use liquid and semi solid 4 abt a week. i was placed on antibiotics and anti inflammatoryredstorm said:
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well i just came back from the general dentist who took about 15 sets of xrays.. I said all i want you to do is evaluate my wisdom tooth because im going out to california. ANyway he looks at the x rays and says. your wisdom tooth is pushing up against the crown of the other tooth. I think i can do this. well IM pretty sure. I asked him,"is this routine" he says nothing is routine but i think i can do this. You dont have to go to oral surgeon. SO he numbs me up with mepivicaine and starts going to town pulling and yanking for a good 10 mins. Finally the tooth comes out in one piece. He says great your all done.. puts gauze in my mouth charges me 560 for the xrays, the exam and the extraction. he said it was fun.. Is that too much for a wisdom tooth.
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redstorm said:
I think you actually got away pretty lucky, all things considered.
Often times that would cost you in the range of $1000-1500, depending on the area of the country.
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Most oral surgeons I know charge about $1500 for 4 wisdom teeth, not one extration. Also, if someone came to my office for eval of wisdom teeth, there is nothing wrong with a screening panorex. That's pretty standard at OMS residency programs. I don't know when the last time I saw a full mouth series. As a general dentist, I would also do bitewings.
T
toothcaries
redstorm said:
it's difficult to comment since we don't know what was done...
personally,
i'd go back to that dental office and have the charges explained to you...
if u felt there was an error.
it's good for u and the dentist...
...since obviously you wont be referring anyone there if you feel cheated..
i will say..
$560 is well within the range of a fee schedule at the 95th percentile for radiographs, consult and a potential soft tissue/bony impaction..
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Note to self: never say "I think I can do this" in front of a patient. 
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Dr.SpongeBobDDS said:Note to self: never say "I think I can do this" in front of a patient.
Before extractions, I've had several patients ask me "have you done this before?" My standard response is, "Well, I've read the book...how hard can it be?"
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A periodontist I used to shadow was asked on a couple of occasions how many implants he had done (when he was doing consults with some of his patients), and he would answer like this, "Well....I've done about 8 or 9.......................................................................Hundred." (Note: I can't remember the exact number, but it was something like that).
grtuck
grtuck
