Getting wisdom teeth removed, need advice from a CRNA

BSNtobe2009 · Oct 15, 2006

I was told 10 years ago that I needed by wisdom teeth pulled, warned about tons of problems, the whole scary story.

Still waiting for the problems to start.

If it ain't broke, I leave it alone. I think it's an unnecessary surgery unless they are bothering you or causing you pain.

BethBSN · Oct 15, 2006

Thanks guys for answering...I am sort of a wimp when it comes to dentists so I will probably see about conscious sedation or novocaine with the gas. I remember "getting the gas" when I was young and it was awesome, it took away my anxiety now that I'm thinking about it.

Yeah, mine aren't "broke" either...they said that they are hard to clean and would eventually decay..? I want to get invisalign when I graduate (some people buy a car...I'm buying braces); it was unclear to me whether or not the wisdom teeth removed would affect the braces.

passgasser · Oct 15, 2006

You asked the advice of a CRNA. So, here it is.

This may be just me, but I want an actual trained anesthesia provider! I would love to have a CRNA!

Wise choice. Provision of anesthetic drugs is best, and most safely performed by educated anesthesia providers. While there are other people out there who give such drugs (like propofol), and many claim they have done so safely thousands of times. Unfortunately, regardless of what they may claim, these folks are deluded. These drugs are safe in the hands of folks who have been educated in anesthesia, but can bite, and bite hard. An education in anesthesia prepares you for when this happens. As much respect as I have for nurses, those not educated in anesthesia simply are not prepared to deal with all the possible consequences of the medications.

Am I just being paranoid about this? Can oral surgeons do the surgery AND monitor my sedated self effectively?

No, you are not being paranoid. If you want sedation beyond conscious sedation, I would personally demand that it be provided by someone educated in anesthesia. And no, a week end seminar does not count. Also no, no one can effectively perform ANY surgery and monitor sedation as well.

I live in the St. Louis area and have looked at the some oral surgeon's websites, they say they have "experienced surgical staff" but do not give any credentials (RN, CRNA, etc). Please help.

i'd suggest you call the offices of the oral surgeons you are interested in, and ask point blank if their anesthetics are administered by trained anesthesia providers. If not, you might ask if there are provisions to bring in a CRNA for your anesthetic.

I noted that you talked about "getting the gas." The "gas" in question is undoubtably nitrous oxide. Yes, it can be helpful, but by itself is not sufficient for anesthesia. And, if not used in the presence of appropriate monitors (i.e. gas analyzers, pulse ox, etc) can be very dangerous. Lots of dentists use it, but without such monitors. These monitors are considered to be standard of care in anesthesia. Without them, you are counting on the dentist to be able to "eyeball" your anesthetic, all the while concentrating on getting your surgery done. Not a safe situation.

pickledpepperRN · Oct 15, 2006

If I needed sedation I would definitely want a professional administering it and responsible for nothing else. There have been a few lawsuits due to patients becoming brain damaged after hypoxia when given pills by an unlicensed person. The dentist was sued.

That said I finally had the upper left one removed a few months ago. It had been through the gums more than 20 years ago and never decayed. After having sore swollen gums and foul odor treated with antibiotics I had it removed with local novocaine only. It was truly fast and easy for me. Lots of skill for the oral surgeon, I'm sure. Drove home and put ice on it.

I only took two Vicodin. One that evening and another the next day.

In my twenties I had the bottom ones out with just a local. It took a long time, he was using a hammer and chisel in addition to pliers. All I felt was my lip being stretched. Came home and went to sleep. I had lots of pain. I think it is because I didn't keep ice on it. The following year with the other bottom one it was the same with the carpenters tools and stiches. I put ice on it right away and all night. Much better.

You can use 2/3 water and 1/3 rubbing alcohol in a zip lock bag to make a slush.

busyernurse, BSN, RN · Oct 15, 2006

BethBSN --Hate to hear that you will have to go through that! I did not long before I finished nsg school, and I was terrufued, and most of it was fear of the unknown. Also some of the earlier posts, waking up and seeing pliers, or hearing the sounds that accomp. the procedure. Gives me the willies just thinking about it!

You are 100 percent right to ask the questions you are asking, I did too. Due to very unpleasant memories of going to our pediatric dentist, for quite a while, I stressed about even just a simple filling, and I know it makes me seem like a baby, it is embarrassing! I went for the day surgery route, Anesthesia, and waking up later w/ no memory of what had hppened. All four of mine were impacted, and the oral surgeon got all of them at once, thank God! Good luck, and try not to stress while doing your research. I'll keep you in our prayers.

A comment to Marie LPN, you go girl! after reading your posting. I thought I was the only one who felt like that!

SharonH, RN · Oct 16, 2006

I had my wisdom teeth removed and it was a very big deal! I had conscious sedation administered by the oral surgeon and I woke up near the end, while they were still working on the last one. Unfortunately I was unable to move or communicate in any way so they had no idea that the stuff had begun to wear off! You are wise to research this before you get the procedure done.