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Wisdom Teeth: Novocaine vs. Anesthesiology

ShadeShade Registered User regular
edited May 2008 in Help / Advice Forum
With the extra paycheck from the IRS showing up this Friday, I decided to spend it on finally having my 3 remaining wisdom teeth pulled. I had one out when I was 18 with just Novocaine, and it was an awful experience. The dentist used too little of the drug and I was in pain the entire time. I had actual nightmares for a year afterward.

So here I am at 22, needing to have the other three pulled out, and I'm more than a little nervous. I really want to have general anesthesiology, but am worried about the cost. All of my extra funds are currently tied up in savings for PAX (of course). The dentist I have now is very nice, and seems trustworthy, but he only uses Novocaine. Would it be worth it to go to a stranger and be practically asleep through it, or should I cowboy up and go to the nice dentist I know with just topical numbing? What is the cost difference?

Edit: Oops, this is Korriander. I forgot to log Shade out before posting.

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Posts

  • ThanatosThanatos Registered User regular
    edited May 2008
    If you're feeling things when the dentist is working on you, speak up. The first bunch of cavities I had, I went through a significant amount of pain because I could feel the metal digging into my gums. When I mentioned this to the dentist, he said "why didn't you say something?" and made a point of giving me an extra shot of Novocaine in order to make sure I wouldn't feel anything.

    Personally, I, for one, would prefer the Novocaine, because I fucking hate the side effects of the anesthesia.

  • TheungryTheungry Registered User
    edited May 2008
    I don't have any information on the cost difference, but I can say that general anesthesiology is almost always worth it if you can afford it. I'd had 2 major oral surgeries (one pre-braces, and one for all 4 wisdom teeth) both at an oral surgeon instead of at a dentist, and the general anesthesiology was great. I got on the chair and woke up too groggy to really feel discomfort, and was home and happy within an hour. Now, some folks have a nauseous reaction to it, so there is that to be wary of, but in terms of not feeling traumatized, its a totally different world.

    If you do end up with local anesthetic, though you should request nitrous oxide. Its a mild very temporary high, and it takes away a huge amount of the anxiety that builds traumatic dentistry. Again, I don't know how much it costs (my dentist is a personal friend and doesn't bill me!), but its probably much cheaper than getting the sleepy needle.

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  • QuidQuid The Fifth Horseman Registered User regular
    edited May 2008
    I'm with Thanatos. Novacaine is perfectly fine to use, you just need to make sure your dentist knows if you're in pain. I had to do this a couple times and they gave me more and I wass fine.

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  • SeptusSeptus Registered User regular
    edited May 2008
    Well, within anesthesiology, there should be options. There's the IV anesthetic which is most costly but puts you completely out, and I've also used an oral anesthetic before which sort of put me at the edge of grogginess/sleep for the duration and that was cheaper and also fairly sufficient in terms of stopping pain.

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  • DocDoc Registered User, ClubPA regular
    edited May 2008
    I had just novicane and no gas or anything. I was told that I had pretty good anatomy, so the teeth came straight out without issue.

    You will be really cranky for the next couple of days, just a heads-up.

  • ihmmyihmmy Registered User regular
    edited May 2008
    another option for anxiety is valium - it's what my dentist gave me prior to have my wisdom's pulled (both times, did the left side then the right side a year later). But I'm up in Canuckia so it might be a bit different regarding what they'll do for pre-op anxiety

    anywho, I've always had novacaine and never had a problem. I mean, not a physical problem, just mental ones because I verge on being phobic about dentist work beyond a basic cleaning. Throwing up post-tooth extraction just doesn't sound like fun and most folk in my family get really nauseous from general, I figured I shouldn't bother with it (plus hereabouts only an oral surgeon can put you under general, and that's a 1-2 year waiting list)

  • SatanIsMyMotorSatanIsMyMotor Registered User regular
    edited May 2008
    If you can get the gas then for the love of god get the gas. Up here in Canada it costs $100 for the gas and I think it was probably the most sound investment I've made in my life.

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  • mastmanmastman Registered User regular
    edited May 2008
    I did the oral surgeon/general anesthesia. Was pretty fantastic. I slept most of the day, but I was completely conscious around dinner time

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  • Arch Guru XXArch Guru XX Registered User regular
    edited May 2008
    If you can get the gas then for the love of god get the gas. Up here in Canada it costs $100 for the gas and I think it was probably the most sound investment I've made in my life.

    This man speaks the truth. I had two wisdom teeth out a few years back and had gas with it, and that almost made the overall experience worthwhile.

    Should have been a rock star.
  • nuclearalchemistnuclearalchemist Registered User
    edited May 2008
    I had the anesthesia and everything worked out fine for me. I didn't have the nausea that went along with it, though. The key to wisdom teeth is not just what happens during the surgery, but making sure they give you good stuff to take after the surgery (I had a really bad set of wisdom teeth, and was on prescription painkillers for 2 weeks).

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  • SkyGheNeSkyGheNe Registered User regular
    edited May 2008
    Anesthesiology by far.

    I blinked and the operation was over. I went home with minimal pain and went to sleep. Teeth were fine afterwards. I only took the pills because my doctor said I should.

    I'm allergic to painkillers. I threw up.

    The pain was not bad enough to take painkillers.

    I do not know if this would have been true had I gone the only Novocaine route.

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  • meekermeeker Registered User regular
    edited May 2008
    Man, I could not imagine only Novocaine. Mine had yet to cut through the gums, so they had to cut the gum to pull them out. No IV, just a shot and then Nitrous Oxide to keep me under. Vicodin afterwards.

    No insurance?

  • korrianderkorriander Registered User
    edited May 2008
    When I had the one wisdom tooth pulled, it was with nova. I felt everything, very painful. The dentist told me to wave my hand if I was in pain. When I started waving my hand, he barked at me and told me to just be quiet and hold still, then started yelling at the nurse who was assisting. I was crying by the end of it, and the guy just ignored it. That's why I'm asking. I can handle a lot of things, but that dentist successfully scared me poopless to go back. All of my wisdom teeth are impacted, so it won't be a simple, quick thing, either.

    The general consensus seems to be getting the gas. Anyone know what that costs, though? My insurance will cover 60%, either way.

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  • EggyToastEggyToast Registered User regular
    edited May 2008
    The thing with only novocaine for me is that tooth extraction isn't just the sensation of pain -- there's blood in your mouth, the smell of blood & spit & tooth, and the pulling sensation.

    I'm very good at dentists -- none of it bothers me. The smell of teeth being drilled, the pulling sensation and having your head moved around by the interior of your jaw, the shot of novocaine, I'm cool with all of it. I know they're doing good work and they're going to make my mouth better in the end. I still wanted to be knocked out, though, because it's like 15 minutes a tooth at minimum, so in your case that's 45 minutes of work. That's a long-ass time.

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  • AngelHedgieAngelHedgie Registered User regular
    edited May 2008
    To be honest, you want to have an oral surgeon to the extraction, not a dentist. And as people pointed out, this is a lot of work, and it takes time. And he may have to do things like break the tooth. You're best off going under, so you don't have to deal with what's going to happen.

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  • korrianderkorriander Registered User
    edited May 2008
    Does anyone know what the difference in cost is? If it helps, I live in Spokane, WA.

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  • RawrBearRawrBear Registered User regular
    edited May 2008
    When I had my wisdom teeth removed a while back I just went with the local anesthetic, the oral surgeon who preformed the operation was planning to go with general anesthetic but for some reason the idea of a big needle in my arm, and being knocked out itself scared the shit out of me more than the actual operation did so I did it without.

    From a pain perspective, there wasn't any. However it was far from being a comfortable experience as I could still feel the pressure and sound from cracking/drilling the teeth (mine were impacted). Like Doc said, I was pretty damn cranky afterwards and despite the fact that I did nothing but sit on a table the whole time I was pretty exhausted too.

    Judging by your experience from your first tooth, you'd probably be much happier going under rather than being awake the whole time.

    I'm up in Canada like Arch Guru, but the injected general anesthetic I was originally going to have was around 100$ if I remember correctly.

  • SatanIsMyMotorSatanIsMyMotor Registered User regular
    edited May 2008
    Well, like I said above, the administration of Nitrous was completely optional and it cost me $100 out of pocket.

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  • Vrtra TheoryVrtra Theory Registered User regular
    edited May 2008
    Since we're all giving anecdotes: I prefer not going under, so I opted to go with nitrous + novocaine instead (which also saved me $300 - sounds like I would have gotten ripped off had I paid for the anes.!). I had no problems with nitrous + novocaine, the surgeon did have to yank my teeth around and crack them and such, but I didn't feel any of it. The whole thing took maybe 40 minutes.

    That said, I 100% agree with AngelHedgie on who should do the surgery. Your dentist might be great, but imo they should be referring you to an oral surgeon for wisdom teeth removal.

  • chromdomchromdom That Guy Parkin' on the BoulevardRegistered User regular
    edited May 2008
    I think you may have to wait for your dentist/surgeon to give you your options. In my case, which required a hammer and chisel, novocaine just wouldn't cut it. I don't remember if gas was offered or not, but I had general anesthesia. I think I went out and played hockey that night, but was definitely on the ice within 24 hours of having the Big Dig.

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  • Shazkar ShadowstormShazkar Shadowstorm Registered User regular
    edited May 2008
    Anecdotes... huh, well, fuck, go to an oral surgeon and... well, mine was like, I put my kids out when I do this to them, I'll do the same for you. Got stuck with an IV, and a little bit later I woke up not remembering a goddamn thing, except my mouth was numb and full of Novocain and stuff to stop the bleeding...

    Getting knocked out is the best. Do that shit.

    EDIT: Then again, the oral surgeon knew my dad so didn't charge us for the anesthesia, so I guess... I dunno if it'd be worth it.

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  • SeñorAmorSeñorAmor Registered User regular
    edited May 2008
    Septus wrote: »
    There's the IV anesthetic which is most costly but puts you completely out

    This is not true. I had my final 3 wisdom teeth pulled out 2 weeks ago and while my ortho was explaining methods of anesthesiology, he told me that the IV drip fucks with your memory making you forget what just happened. You are completely awake the whole time, you just don't care that some dude is clawing at your teeth. Personally, anything that fucks with your brain is not ok with me. I chose to go with the local and had absolutely no problems whatsoever.

  • SeñorAmorSeñorAmor Registered User regular
    edited May 2008
    To be honest, you want to have an oral surgeon to the extraction, not a dentist. And as people pointed out, this is a lot of work, and it takes time. And he may have to do things like break the tooth. You're best off going under, so you don't have to deal with what's going to happen.

    Agreed 100%. In fact, I'm told that nowadays regardless of the ease of wisdom teeth removal, most dentists won't remove them, instead referring you to an oral surgeon.

  • skyybahamutskyybahamut Registered User
    edited May 2008
    When I had mine taken out, I had then put me out, I-V drip, the whole she-bang. It was worth it. After the drugs wore off I was in some pain for a while, not to mention a little, um, loopy I guess is the best way to put it. (Have some one drive you home for the love of God)

    Which ever way you choose, be sure to follow the mouthwashing instructions. No one wants to get absess. Also they will probably give you dissolvable stiches. those last about 1 and a half to 2 weeks. Or at least mine did. NO STRAWS FOR A WEEK TOO.
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  • FeralFeral Who needs a medical license when you've got style? Registered User regular
    edited May 2008
    Let's get some terminology straight.

    There's local anesthetic, which is novocaine or lidocaine.
    Then there's IV sedation (aka "twilight sleep"), which is usually valium + demerol or something similar. You're awake for the procedure but high as fuck and you can't feel a thing.
    And then here's general anesthesia (which also involves an IV) where you're totally unconscious.

    I went with IV sedation, because it was cheaper than GA. I'm glad I did. I was up and on my feet and walking around within 20 minutes, and by an hour later I was fully cognizant. There was no pain during the procedure. I was awake, and I could hear the dentist talking and I could hear the saw going, but I didn't care - I was in a state of complete zen.

    The out of pocket cost for me with Delta Dental was about $300. Had I lacked insurance, it would have been around $1600. Keep in mind that this is in downtown San Francisco, it would probably be cheaper in Spokane. Getting general anesthesia would have added another $2000 to that total.

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  • Blake TBlake T Registered User regular
    edited May 2008
    Novacaine is used for easy extractions.

    I have had a friend who's teeth were taken out on his parent's kitchen table because it was an easy extraction and his mother is a dentist.

    I had a nerve running directly underneath mine and my dentist wasn't comftable in doing it. He refered me to an oral surgeon. I had an IV of stuff and it was literally like I just wasn't paying attention and the entire time just flew by, I was awake and I can remember them vaugely poking around, but it was like reading a book with the tv on, you are only vaugely aware of what is going on on the tv.

    Have a chat with your dentist about how complicated he expects the procedure to be, if he thinks it's just an easy job, go with the novacaine, if he things it would be something more complicated go see a dental surgeon and get drugged up propper.

  • Mom2KatMom2Kat Registered User regular
    edited May 2008
    Okay first of all it is not general anesthesia. You go into waht is called Light sedation. You are responsive to some degree but otherwise you don't give a damn. In a general you are right out and oten require way morre monitering than a dental surgeon or dentist can offer. That is one main reason why Light sedation is used. That and it is way easier to reverse and has fewer side effects. It is often used when you x-rays indicate that there are facial nerves close to where your impacted teeth are. Be prepared you can have some lating numbness if the nerves get fucked with. It will usually fix itself in a few weeks/months time.

    If your more comfortable you can ask your dentist to refer you to an oral surgeon and have light sedation there. Most dentist do not have the training/equipment for more than novocain.

    I myself have had two half impacted (the front half of my top wisdm teeth came in the back half stayed impacted) wisdom teeth removed with novocain and the dental equivalent of hammer and chisel. I personally had no problem with it besides some tugging and looking like the Dentist had roughed me up from teh blood. However my dentisit is in my opinion excellent and I have fallen asleep during 3 seperate root canals. (what else are you gonna do for 1.5 while ever thing is numb?)

    I don't know where you are, but if you are in BC I do know that if it is bbad enough and your dentist has hospital rights as well as thinks it warrents it, you can have it done in a hospital covered under MSP.

  • PheezerPheezer Registered User, ClubPA
    edited May 2008
    If you're not planning to go to an oral surgeon, change your plans.

    As for the operation, I had novocaine. I had a severely impacted lower right wisdom tooth, they had to open the gum, crush the tooth, and extract it piece by piece. You mostly can't tell what's going on, but you feel pressure when they're cutting you open and you hear the crunch. You can also swallow a certain quantity of blood during the operation if it gets around the dam. So if you're queasy in any way, or ever have been in the past, you might really consider going under.

    I'm against doing so whenever unnecessary because it's generally a royal pain in the ass and has certain risks that I feel to be unnecessary. Personally I'd repeat my decision to stay awake for the procedure, even though the surgeon had bad popular country music playing for the whole time I was in there (it's not a short procedure, mine clocked at around 45 minutes).

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  • PheezerPheezer Registered User, ClubPA
    edited May 2008
    Mom2Kat wrote: »
    Okay first of all it is not general anesthesia. You go into waht is called Light sedation. You are responsive to some degree but otherwise you don't give a damn. In a general you are right out and oten require way morre monitering than a dental surgeon or dentist can offer. That is one main reason why Light sedation is used. That and it is way easier to reverse and has fewer side effects. It is often used when you x-rays indicate that there are facial nerves close to where your impacted teeth are. Be prepared you can have some lating numbness if the nerves get fucked with. It will usually fix itself in a few weeks/months time.

    If your more comfortable you can ask your dentist to refer you to an oral surgeon and have light sedation there. Most dentist do not have the training/equipment for more than novocain.

    I myself have had two half impacted (the front half of my top wisdm teeth came in the back half stayed impacted) wisdom teeth removed with novocain and the dental equivalent of hammer and chisel. I personally had no problem with it besides some tugging and looking like the Dentist had roughed me up from teh blood. However my dentisit is in my opinion excellent and I have fallen asleep during 3 seperate root canals. (what else are you gonna do for 1.5 while ever thing is numb?)

    I don't know where you are, but if you are in BC I do know that if it is bbad enough and your dentist has hospital rights as well as thinks it warrents it, you can have it done in a hospital covered under MSP.

    You don't want it done in a hospital. They're less used to working with mouths and you can expect bruising, and more stitches and a generally less clean job.

    IT'S GOT ME REACHING IN MY POCKET IT'S GOT ME FORKING OVER CASH
    CUZ THERE'S SOMETHING IN THE MIDDLE AND IT'S GIVING ME A RASH
  • IvanIssacsIvanIssacs Skull Leader SDF-1Registered User regular
    edited May 2008
    So when I had my wisdom teeth removed, I went with the novocaine. Apparently I was somewhat resistant to it because my right side wasn't numb enough and I nearly felt everything that was being done (not really pleasant). Left side was totally fine which was weird. And the dentist decided not to give me any pain meds!

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  • ImperfectImperfect Registered User regular
    edited May 2008
    Hahah, pheezer - I was considering napping out during my last root canal (this Monday), but I didn't want the dentist to think I'd passed out and something bad had happened.

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  • Shazkar ShadowstormShazkar Shadowstorm Registered User regular
    edited May 2008
    Septus wrote: »
    There's the IV anesthetic which is most costly but puts you completely out

    This is not true. I had my final 3 wisdom teeth pulled out 2 weeks ago and while my ortho was explaining methods of anesthesiology, he told me that the IV drip fucks with your memory making you forget what just happened. You are completely awake the whole time, you just don't care that some dude is clawing at your teeth. Personally, anything that fucks with your brain is not ok with me. I chose to go with the local and had absolutely no problems whatsoever.
    Oh yeah, that's true, you just don't remember it. That's what I had, my mom came and saw me but I just didn't remember it. It was fucking awesome. My dad uses that all the time with his patients for whatever random procedures he does (gastroenterologist).

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  • poshnialloposhniallo Registered User regular
    edited May 2008
    I had local anesthetic when I had wisdom teeth out (along with the 6 goddamn root canals I needed last year).

    It was a really tricky extraction for which I had to go to a dental university hospital rather than a normal dentist. It took a few hours, and I kept watching the dentist go change his mask, hat, and goggles, because my blood getting all over everything.

    However, there was no pain.

    As others have said, if you have a local and then there's some pain, let the dentist know.

    And then they'll sort you out.

    If you're squeamish about blood etc then get the sedation. But don't do it because you think there'll be pain otherwise.

    I figure I could take a bear.
  • taliosfalcontaliosfalcon Registered User regular
    edited May 2008
    I've pretty much always been put out for any dental procedure due to the fact local anesthetics don't work on me very well at all (they tend to wear off in 5-10 minutes no matter how much they pump into me) But based on my experiences with sedation I don't see why anyone would not do it, no pain, no unpleasent experiences at all, when I wake up I tend to feel a very slight bit nauseous for 15 minutes or so and thats it for side effects.

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  • ShadeShade Registered User regular
    edited May 2008
    poshniallo wrote: »
    I had local anesthetic when I had wisdom teeth out (along with the 6 goddamn root canals I needed last year).

    It was a really tricky extraction for which I had to go to a dental university hospital rather than a normal dentist. It took a few hours, and I kept watching the dentist go change his mask, hat, and goggles, because my blood getting all over everything.

    However, there was no pain.

    As others have said, if you have a local and then there's some pain, let the dentist know.

    And then they'll sort you out.

    If you're squeamish about blood etc then get the sedation. But don't do it because you think there'll be pain otherwise.

    My only problem is that last time I HAD a local do it, I DID let him know I was in pain, and he told me to shut up and hold still.

  • The CatThe Cat Registered User, ClubPA regular
    edited May 2008
    Thanatos wrote: »
    Personally, I, for one, would prefer the Novocaine, because I fucking hate the side effects of the anesthesia.

    Its really not a good idea to post as if this is inevitable. I've never had a reaction to knockout, either the full general or the other method they use for wisdom teeth (eggy explained it in alyce's thread).

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  • The CatThe Cat Registered User, ClubPA regular
    edited May 2008
    Pheezer wrote: »
    You don't want it done in a hospital. They're less used to working with mouths and you can expect bruising, and more stitches and a generally less clean job.
    That's not good advice either. Oral surgeons here don't operate in their own rooms for stuff like wisdoms (I'm pretty sure they don't do anything much there), they just do the consults at their rooms and then book you and them into one of the local hospitals for the actual procedure.

    tmsig.jpg
  • ThanatosThanatos Registered User regular
    edited May 2008
    The Cat wrote: »
    Thanatos wrote: »
    Personally, I, for one, would prefer the Novocaine, because I fucking hate the side effects of the anesthesia.
    Its really not a good idea to post as if this is inevitable. I've never had a reaction to knockout, either the full general or the other method they use for wisdom teeth (eggy explained it in alyce's thread).
    Yeah, it's not, in fact, inevitable. I just fucking hate it.

  • grendel824_grendel824_ Registered User
    edited May 2008
    I had one of the worst experiences in getting my wisdom teeth out (no putting me under, either) because one of my teeth was fused with my jawbone. Cue an 8 hour day at the dentist's office, with him calling in favors so a surgeon could come in and fix it 1-2-3. As horrible as it was, I wasn't ever in any pain and if the dentist didn't want me out, I was inclined to trust him. Still, I'd pay good money to have the memonry of those sounds/sensations of a tooth being snapped off of jawbone and reverberating through my skull erased... D:

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