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adult tooth to be uncovered, go with general anaesthetic or not?

  • 21-04-2012 2:05pm
    #1
    augusta24
    Registered Users Posts: 633 ✭✭✭


    Hi everyone,

    I am just looking to see if anyone has any experience/advice to share on this!

    Basically, have an adult tooth still in the roof of my mouth and the plan is to go into hospital under general anaestethic and have it uncovered and then braces on to bring it down.

    My orthodontist did also give me another option however as I have no VHI and he recognised the costs associated with going into hospital for the day.
    He said he could try uncover the tooth in the chair in his own surgery obviously no general anaesthsia. But he said that sometimes this is not straight forward as the tooth can be deeper than previously expected.

    I guess I'm just looking to see what other people think on having this precedure done in the chair with no anaesthesia? Has anyone had this done (or performed it) and would you say absolutely no to this, or is it worth considering?

    Many thanks in advance :)


Comments

  • #2
    kkth0360
    Registered Users, Registered Users 2 Posts: 102 ✭✭kkth0360


    Hi Augusta,

    Personally I would almost never recommend general anaesthesia for surgical exposure of a buried tooth. I refer my patients to an oral surgeon for these procedures, and they either have it done with just local anaesthesia (the numbing injection, same as you get for fillings etc), or LA combined with some intravenous sedation. If the tooth is quite deep, or you are particularly nervous the IV sedation is great - you would feel totally relaxed and would have very little awareness or memory of the procedure afterwards. But many patients, including young teenagers, do just fine with LA only.

    Even if you have the IV sedation, this works out MUCH cheaper than day-case general anaesthesia. Surgical exposure with sedation would likely cost in the region of €300-€500 (plus initial consultation fee of around €100-€150).

    Maybe ask your orthodontist to refer you to an oral surgeon who offers treatment under sedation, and go along for a consultation to discuss your options.

    Best of luck with it.


  • #3
    augusta24
    Registered Users Posts: 633 ✭✭✭augusta24


    Thanks very much for your reply! I'm afraid I'm not very experienced in this area. My orthodontist has planned to do the procedure himself in the hospital (also going to take out wisdom teeth if I choose this option, but that's only because they look likey they may cause difficulty in future, not essential to remove them at the moment). To be honest I assumed that this meant he was an oral surgeon? But maybe I'm incorrect on this... what exactly is an oral surgeon?

    Thanks for your feedback, it has certainly made me think a lot more about this and I won't be ruling out the Local anaesthetic option now.


  • #4
    helimachoptor
    Moderators, Science, Health & Environment Moderators Posts: 21,676 Mod ✭✭✭✭helimachoptor


    Iv sedation op, GA is too extreme for this


  • #5
    augusta24
    Registered Users Posts: 633 ✭✭✭augusta24


    Really? I'm so confused as to why my ortho wanted to do this option now! Maybe he just wanted to play it safe perhaps?

    He did say that he thinks one of my wisdom teeth on the bottom looks like it might cause trouble later on as it is growing sideways and although it is partially uncovered, there is not enough room for it to come through fully.

    Do you think that if I left this wisdom tooth alone for a few years, that this could cause trouble to my braces? I wonder if maybe this is why he just wanted to get it all done before the braces are put on?

    The wisdom tooth hasn't started to cause any pain or anything and he says it hasn't done any damage yet either. But I must admit that financially I can't exactly afford to throw away money if it isn't necessary. Very busy in college at the moment too so would rather not take a lot of time off if it is unnecessary also.
    However, if this wisdom tooth could somehow affect the braces then maybe I am better off to get that done too, and so go with general anaesthetic?


  • #6
    helimachoptor
    Moderators, Science, Health & Environment Moderators Posts: 21,676 Mod ✭✭✭✭helimachoptor


    I'm not a dentist I just mod here :) but their opinion is pretty uniform on the use of GA for dental procedures. GA takes longer to get over and you can't maintain your own airway which has risks. I'm sure one of them will be along to give some advice


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  • #7
    Oral Surgeon
    Registered Users, Registered Users 2 Posts: 3,240 ✭✭✭Oral Surgeon


    augusta24 wrote: »
    Hi everyone,

    I am just looking to see if anyone has any experience/advice to share on this!

    Basically, have an adult tooth still in the roof of my mouth and the plan is to go into hospital under general anaestethic and have it uncovered and then braces on to bring it down.

    My orthodontist did also give me another option however as I have no VHI and he recognised the costs associated with going into hospital for the day.
    He said he could try uncover the tooth in the chair in his own surgery obviously no general anaesthsia. But he said that sometimes this is not straight forward as the tooth can be deeper than previously expected.

    I guess I'm just looking to see what other people think on having this precedure done in the chair with no anaesthesia? Has anyone had this done (or performed it) and would you say absolutely no to this, or is it worth considering?

    Many thanks in advance :)
    augusta24 wrote: »
    Thanks very much for your reply! I'm afraid I'm not very experienced in this area. My orthodontist has planned to do the procedure himself in the hospital (also going to take out wisdom teeth if I choose this option, but that's only because they look likey they may cause difficulty in future, not essential to remove them at the moment). To be honest I assumed that this meant he was an oral surgeon? But maybe I'm incorrect on this... what exactly is an oral surgeon?

    Thanks for your feedback, it has certainly made me think a lot more about this and I won't be ruling out the Local anaesthetic option now.

    I would agree with the others that the surgical exposure/uncovering of an unerupted tooth is best done under local anaesthesia alone or in conjunction with IV sedation (if the tooth is deep or the patient is nervous). I think that a GA for this procedure is overkill in the vast majority of cases and opens the patient up to extra risks associated with general anaesthesia....

    I'm a little confused by the person treating you... Is he an orthodontist or oral surgeon? Check these lists http://www.dentalcouncil.ie/specialistregisters.php

    Is he proposing treatment under medical insurance/ public system or you paying privately??
    If you have no medical insurance, then GA is by far the more expensive option as there is not only a procedure fee but also an anaesthetist fee and hospital fee... Having you wisdom teeth out only makes this more expensive as far as I can see....

    I'm not aware of any orthodontist who does their own surgical work in a hospital under GA (I may be wrong but havn't come across any....)

    I think you need to ask some more questions at your next visit to clear up the plan...


  • #8
    augusta24
    Registered Users Posts: 633 ✭✭✭augusta24


    Oral Surgeon wrote: »
    augusta24 wrote: »
    Hi everyone,

    I am just looking to see if anyone has any experience/advice to share on this!

    Basically, have an adult tooth still in the roof of my mouth and the plan is to go into hospital under general anaestethic and have it uncovered and then braces on to bring it down.

    My orthodontist did also give me another option however as I have no VHI and he recognised the costs associated with going into hospital for the day.
    He said he could try uncover the tooth in the chair in his own surgery obviously no general anaesthsia. But he said that sometimes this is not straight forward as the tooth can be deeper than previously expected.

    I guess I'm just looking to see what other people think on having this precedure done in the chair with no anaesthesia? Has anyone had this done (or performed it) and would you say absolutely no to this, or is it worth considering?

    Many thanks in advance :)
    augusta24 wrote: »
    Thanks very much for your reply! I'm afraid I'm not very experienced in this area. My orthodontist has planned to do the procedure himself in the hospital (also going to take out wisdom teeth if I choose this option, but that's only because they look likey they may cause difficulty in future, not essential to remove them at the moment). To be honest I assumed that this meant he was an oral surgeon? But maybe I'm incorrect on this... what exactly is an oral surgeon?

    Thanks for your feedback, it has certainly made me think a lot more about this and I won't be ruling out the Local anaesthetic option now.

    I would agree with the others that the surgical exposure/uncovering of an unerupted tooth is best done under local anaesthesia alone or in conjunction with IV sedation (if the tooth is deep or the patient is nervous). I think that a GA for this procedure is overkill in the vast majority of cases and opens the patient up to extra risks associated with general anaesthesia....

    I'm a little confused by the person treating you... Is he an orthodontist or oral surgeon? Check these lists http://www.dentalcouncil.ie/specialistregisters.php

    Is he proposing treatment under medical insurance/ public system or you paying privately??
    If you have no medical insurance, then GA is by far the more expensive option as there is not only a procedure fee but also an anaesthetist fee and hospital fee... Having you wisdom teeth out only makes this more expensive as far as I can see....

    I'm not aware of any orthodontist who does their own surgical work in a hospital under GA (I may be wrong but havn't come across any....)

    I think you need to ask some more questions at your next visit to clear up the plan...



    Thanks for that! Checking that list, he is an orthodontist. The plan is definitely to go privately into a hospital for the day under general aesthetic. He explained that since I've no vhi he's not going to charge for the actual procedure, so I just pay anasthetic and hospital fee.

    I'm going to seriously think about his other option of LA though after hearing everyone's advice here.


    Can I just ask one more question, obviously I know that nobody knows my case, but is it common for wisdom teeth to cause trouble when you have braces? Could it affect the result of the braces cos its partially up? Or will my braces still do their job? And is it likely that once the braces are off that the wisdom tooth could cause my teeth to crowd up again?

    I'd rather leave the wisdom teeth until they cause trouble and I have to get them out later but not if they are likely to stop the work of my braces! I want to have straight teeth forever after these braces!!


  • #9
    Lia_lia
    Registered Users, Registered Users 2 Posts: 6,691 ✭✭✭Lia_lia


    ^ Your ortho should know whether or not your wisdom teeth need to be removed judging by your x-rays as far as I know! My bottom wisdom teeth were removed before I got my braces in and my top ones came down with no problems.

    I know of a lot of people that had braces when they were kids and then to get their wisdom teeth removed a few years later as they could make the teeth crooked again.


  • #10
    btkm8unsl0w5r4
    Closed Accounts Posts: 9,535 ✭✭✭btkm8unsl0w5r4


    OP you do realize the hospital fees and anesthesia fees will be in the region of 1500-2000 euro. That a totally unnecessary expense. Either get it done under LA or LA and sedation, if your current surgeon doesn't offer this, ask for a referral to one that does.


  • #11
    augusta24
    Registered Users Posts: 633 ✭✭✭augusta24


    Tenley Proud Turquoise wrote: »
    OP you do realize the hospital fees and anesthesia fees will be in the region of 1500-2000 euro. That a totally unnecessary expense. Either get it done under LA or LA and sedation, if your current surgeon doesn't offer this, ask for a referral to one that does.


    It's going to be €900 for GA and hospital.

    I realise now it's unnecessary but I was just wondering about the wisdom tooth because I'd eater pay the €900 now and get it out if it's likely to undo all the work of my braces in the future!!


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  • #12
    btkm8unsl0w5r4
    Closed Accounts Posts: 9,535 ✭✭✭btkm8unsl0w5r4


    wisdom teeth dont cause late crowding. If you would need them out then your oral surgeon might advise you. It again is not a risk you take just for the sake of it, there need to be a clear indication for removal.


  • #13
    augusta24
    Registered Users Posts: 633 ✭✭✭augusta24


    Tenley Proud Turquoise wrote: »
    wisdom teeth dont cause late crowding. If you would need them out then your oral surgeon might advise you. It again is not a risk you take just for the sake of it, there need to be a clear indication for removal.

    Thanks for your reply, I've no idea about teeth so am at a loss here! I'll be calling my ortho tomorrow, it's just much better when I have a little knowledge already so I know what im talking about.

    He said my wisdom tooth is growing sideways and although it's partially up, there's not enough space for it so he just believes that it's very likely to cause trouble in the future, but it's not at the moment.


  • #14
    Oral Surgeon
    Registered Users, Registered Users 2 Posts: 3,240 ✭✭✭Oral Surgeon


    augusta24 wrote: »
    It's going to be €900 for GA and hospital.

    I realise now it's unnecessary but I was just wondering about the wisdom tooth because I'd eater pay the €900 now and get it out if it's likely to undo all the work of my braces in the future!!

    You would pay far less for the exposure under LA or IV sedation... If you don't have the unnecessary extractions then they cost nothing..... Don't have a GA for nothing...!


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