Your teeth and people who drill them

[ghost]

Pressure is typical to feel, however he shouldn't be shaking.  Teeth generally aren't that tough to get out.  Pay the extra dough and get an oral surgeon to do it.  They can even sedate you for the procedure.   

[Sky]

I was home brushing my teeth after lunch because they felt odd. Feel this roughness after brushing. Look in the mirror and WTF it looked like the insides of my lower fronts were all jacked up. I floss it good and it doesn't help. I start to panic, think about calling the dentist, start feeling the odd-looking spots with my fingernail. Some gritty substance comes away...oh, I just found out what plaque looks like. I've never had to deal with plaque in my life, which is good I guess.

I just got chewed out by the hygenist on my last visit, she was sure I wasn't flossing. I think I've figured it out, for breakfast each day (at work) I eat a fruit and nut bar. The dried fruit and sugary binders are probably getting lodged in there, as I often feel the fruit in there. The binder is so gluey and I don't brush again until the evening so it sits in there all day, every day. So much for those bars!

Kinda laughing that I just found out what plaque looks like at 41.

[Reg]

Are there any other vile bodily secretions you're unacquainted with? I'm fairly familiar with all forms of mucous at this point...

[01101010]

Pressure is typical to feel, however he shouldn't be shaking.  Teeth generally aren't that tough to get out.  Pay the extra dough and get an oral surgeon to do it.  They can even sedate you for the procedure.   

The shaking was from rocking it back and forth in the gums. The excuse given was that my roots were so long that they could not just wiggle it out but had to pry back and forth till it loosened up enough to be pulled.

[Hawkbit]

One of my widsoms rotted and had to be pulled after the dentist hit the nerve and it started bleeding.  Luck had it that their oral surgeon was onsite that day.  So they numbed it good and sat me down.  I was amazed to see that he only had two tools on his tray:  A rod with a metal loop on one end and a pair of pliers. 

It was all pretty easy, just scary for the first time.  It was over so fast I didn't know what to think.  I got some percocets for the pain, of which I didn't need any. 

[Slyfeind]

The last tooth I had pulled, I felt nothing. It was amazing. Just a ton of novocaine, no laughing gas or sedatives of any kind. But my dentist took it reeeeeal slow. My jaw was killing me halfway through the procedure. But I'd rather my dentist took his time and give me an aching jaw for an hour, than feel that pressure on my tooth. (Panic reflex indeed!)

[NowhereMan]

Last time I went to the dentist I got three (small, though one apparently was in a nasty spot) cavities filled and a telling off for not having been for a check up for three years. I also got told to stop drinking lots of sugary drinks, which confused me since I don't. In fact I'd say I've had maybe one non-diet soda in the last 4 months and that's more than usual. I don't drink fruit juice much either. He didn't offer any other explanation (beyond saying beer wouldn't be causing it) so I assume he just thought I was lying. Which isn't a big deal but I'm left wondering if my cavities were normal or ordinarily the kind of thing only people who are drinking lots of sugary drinks suffer with. Anyway time to see him again in the next couple of months so I'll see how things have been for the last year!

[Ironwood]

, no laughing gas

How old are you ??

 

[Morat20]

My grandfather still gets laughing gas -- he had to find a dentist that offered it. Otherwise he'd -- no kidding -- take the filling with nothing.

The man can't handle a novacaine shot, not there at least. (I've yet to find a way to say "He can't take a shot in the mouth" without it sounding pervvy).

The guy was ex-Army, boxed golden gloves, and I've seen him tear a chunk out of his arm and basically just pour alcohol on it to sterilize. And of course has had fillings done without anesthesia. But he'll practically hyperventilate if you mention a novacaine shot to deaden your gums.

Last time he needed real work done, they just sent him to an oral surgeon and they sedated him.

[Reg]

Is nitrous obsolete or something? My dentist offers it routinely along with the standard Novocaine shots.

[01101010]

Back when I was living with this psychopath girl, her dentist actually still offered ether. Honest to god I would not have believed it but I went with her and damn if he didn't. Of course this was back in 2001 and he was near 70. But still... fucking ether.

[Lantyssa]

My dentist office offers it.  I always get the shots, but when my partial fell out last week the assistant asked if I wanted shots or gas.  My dentist is my age, and the rest with the practice are about ours or younger.

(No cracks that my dentist is old, either. )

[Sjofn]

I have lovely teeth.   Well, health-wise, anyway. My lower teeth are kinda crowded and once in a while they go blah blah tartar build up blah and I nod and point out it's not covered and then they don't say anything about it until a year has gone by.

The only problem REALLY is that our dentist never. shuts. up. EVER. And it distracts him from what he's doing, or sometimes he'll stop doing whatever he's doing so you can answer him, etc. He does good work, but MAN. TALKY.

[Jimbo]

Nitros has to have a special scrubber and vent system set up any more, I'm sure that add the amount on the bill.

Sedation if I remember right, is four levels (found this off another site, since I don't have a membership at the ASA):

Minimal sedation:  Also known as anxiolysis.  A drug-induced state during which the patient responds normally to verbal commands.  Cognitive function and coordination may be impaired.  Ventilatory and cardiovascular functions are unaffected.

Moderate sedation/analgesia (conscious sedation):  A drug-induced depression of consciousness during which the patient responds purposefully to verbal command, either alone or accompanied by light tactile stimulation.  No interventions are necessary to maintain a patent airway.  Spontaneous ventilation is adequate.  Cardiovascular function is usually maintained.

Deep sedation/analgesia:  A drug-induced depression of consciousness during which the patient cannot be easily aroused, but responds purposefully* following repeated or painful stimulation.  Independent ventilatory function may be impaired. The patient may require assistance to maintain a patent airway.  Spontaneous ventilation may be inadequate.  Cardiovascular function is usually maintained.

General anesthesia:  A drug-induced loss of consciousness during which the patient is not arousable, even to painful stimuli.  The ability to maintain independent ventilatory function is often impaired.  Assistance is often required in maintaining a patent airway.  Positive pressure ventilation may be required due to depressed spontaneous ventilation or drug-induced depression of neuromuscular function.  Cardiovascular function may be impaired.

The idea that nitro can cause you to slip into a deeper state of sedation is one worry that the dentist would have to think about, plus the documentation probably required for sedating pt's.  I don't know what the ADA or Texas (that is where Ghost is at if i recall), handles out pt sedation for dental work.  I know more on moderate, deep, and general anesthesia, it is a labor and paperwork intensive procedure, and it should be, since you run the risk of your pt stopping breathing (or are stopping their breathing to intubate them during R.S.I/C.A.I.).  I do laugh at one thing ASA came down with, was the use of propofol (diprivan) only by Anesthesiologist for moderate sedation, since ER MD's can't manage an airway.  I've never seen ER doc's so pissed!  They were yelling at them that they don't cancel the case like they do if they can't get a tube down, they have to get it down (and it becomes a team effort, where every person who can intubate may ended up doing it, and all adjuncts are used).

[Fordel]

My teeth hate me (and I hated them for half of my life) and will probably need replacing one day in the future, I have little doubt.


I've had four pulled when I got braces as a kid, I had 4 wisdom teeth out as well. I've cracked one of the front ones, but the dentist fixed it somehow, though I don't know how much of it is actual tooth anymore or how much of it is dentist magic tooth replacement stuff.

My teeth are naturally rough and shitty (they apparently had holes in them too, not cavities, just natural holes), and I fucked them up even more as a kid because of poor brushing/flossing habits and my love of acidic and sugary drinks. They are stained too from the braces and my shitty brushing as a kid. My cavity rate has gone down since then, only like 2 a year now 

I don't think I have a single tooth that doesn't have some kind of filling or shielding or whatever on it.

My first dentist as a kid was apparently, terrible at his job. My parents and I didn't know this until we went to a new dentist and she went  at our teeth. I also had a good 4 year time period as a kid without any dentist, I'm sure that helped loads!


They aren't HORRIBLE to look at, but movie star straight and white they are not, not even close. They still chew food at least, for now. 



I always get the needle when work needs to be done, it doesn't bother me.

[Reg]

I always go for needle and gas. I've switched dentists a few times for various reasons and every time I've done it the new guy expresses horror at how awful the previous guy was and explains that every single filling must be replaced immediately.  It makes me a little suspicious really.

[Samwise]

If you've made it this far there's probably no point.  The dirty little secret of orthodontics is that braces won't make your teeth any healthier at all.  You won't be at less risk of periodontal disease or cavities, and recent research actually points in the opposite direction for periodontal disease.  It's almost 100% an esthetic venture. 

I'd like to hear more about this, as I've been considering orthodontic work with the primary goal of improving my tooth health.  

Right now I've got some crowding and the crowded teeth inevitably have plaque between them when I go in for my biannual cleaning.  My dentist thinks if I got the teeth straightened out it wouldn't be as much of an issue, and less plaque would mean fewer gum problems.  I've also been having some intermittent TMJ pain over the last couple of years and I feel like my increasingly crooked bite might be partly to blame for that as well, although that's not supported by anything my dentist has told me.

If straightening my teeth out isn't going to help any of that, I'd rather just save the $6k or however much, but it makes sense to me that having straight teeth would be a good thing health-wise.  What am I missing?

[Rasix]

I always go for needle and gas. I've switched dentists a few times for various reasons and every time I've done it the new guy expresses horror at how awful the previous guy was and explains that every single filling must be replaced immediately.  It makes me a little suspicious really.

Last one did just that.  Luckily it was only one filling, but they replaced an old style metal-whatever with what I'm assuming is the newer stuff the current one uses.  At least it's clear-ish.

I've only had two cavities in the last 7 or so years.  Before that, just one during college.  I've had a lot of teeth pulled for braces in the past (13 total, 8 adult teeth).

Last cavity filling was somewhat annoying.  They keep injecting me with novacaine but the tooth area just wouldn't go numb.  I think they were up to 5 shots before I said to just get on with it.  After that I got progressively more numb to the point where I couldn't feel the left side of my face for a few hours.

[Slyfeind]

Is nitrous obsolete or something? My dentist offers it routinely along with the standard Novocaine shots.

Maybe it's the term "laughing gas". I think that's a WW2 term or something.  (And no, I'm not that old either!)

[Strazos]

The last hygienists I went to actually liked having me...not because my teeth are super awesome or anything. I think it's mostly because I had no problem admitting that my flossing was...inadequate. And the plaque on the back of the lower front-4 is always bad with the crowding - after my last cleaning, there was actually a visible gap between the lower front-2. 

[ghost]

Right now I've got some crowding and the crowded teeth inevitably have plaque between them when I go in for my biannual cleaning.  My dentist thinks if I got the teeth straightened out it wouldn't be as much of an issue, and less plaque would mean fewer gum problems.  I've also been having some intermittent TMJ pain over the last couple of years and I feel like my increasingly crooked bite might be partly to blame for that as well, although that's not supported by anything my dentist has told me.

If straightening my teeth out isn't going to help any of that, I'd rather just save the $6k or however much, but it makes sense to me that having straight teeth would be a good thing health-wise.  What am I missing?

It seems to make sense, but any research they've ever done on the issue says that it is a wash, at best.  The most recent research, a huge meta-analysis done by a chick up at Washington, says that teeth are actually periodontally worse off for people that have had braces.  It's a very small amount worse, but it was statistically significant.  Also, TMJ problems are almost never corrected long term by braces.  Usually people will get better for the short term (while the braces are actually on the teeth) and then will regress again over time.  For adults I usually will tell them that the only real reason to get your teeth straightened would be if you don't like the way that they look-  and that is a very valid reason, in my opinion.  There is good research that shows that people with good looking teeth do better in school and in life (job, etc.). 

[Cadaverine]

So, about a year ago, I went in to the dentist to get my teeth looked at.  While there, the dentist tells me that my wisdom teeth are bothering me because I have no lower wisdom teeth, and so the top ones have dropped down a bit, and that I should just get them removed.  He mentioned something about oral surgery that sounded, to me, like it wouldn't be out of place in a Hellraiser film.

My question is, couldn't they just slap some novocaine in there, and yank them out?

[Hawkbit]

Usually, but not if they're impacted.  http://en.wikipedia.org/wiki/Tooth_impaction

I took my buddy to get all four of his done at once and they put him under.  He was back out in the anesthesia waiting area in about ten minutes, I swear they used a cordless Dewalt drill and a hammer/chisel on him.  He never knew the difference though, just had a couple stitches.

[ghost]

My question is, couldn't they just slap some novocaine in there, and yank them out?

They could, and I have done it that way many times, but for reasons Hawkbit mentioned the sedation is usually the best way to go.  Again, go with an oral surgeon if you can for wisdom teeth.  The complications involved with these teeth have the potential to be much worse than for other teeth so let an expert do it.

[Lantyssa]

And hope you don't have a poor reaction to ambien and lodine if that's what they give you.  It was a very unpleasant four days until I figured out it was the lodine and not the pain causing my nausea.

[ghost]

Edit:  you meant Lodine.  That's still a damned weird combination.

[Samwise]

The most recent research, a huge meta-analysis done by a chick up at Washington, says that teeth are actually periodontally worse off for people that have had braces.  It's a very small amount worse, but it was statistically significant.

Is that an average across all types of braces?  I can see how normal braces could cause harm by making cleaning harder, but removable braces (e.g. Invisalign) wouldn't have that problem, right?

[ghost]

Yeah, Invisalign wouldn't be applicable to that study because it only includes traditional braces.  My caution on Invisalign is be careful about what you are being told about it.  A lot of general dentists will try to use it and don't know what they are doing.

[Samwise]

My dentist gave me a referral to an orthodontist, so hopefully he'd know what he's doing.  I still have yet to go because the expense is unnngh, but on the other hand my teeth aren't getting any straighter on their own.

[ghost]

I believe there is an orthodontic residency where you are (San Francisco, right?).  You could get Invisalign through them at what would probably be a cheaper fee.  It will probably take longer, but the way residencies work now you'll get good treatment.  There's a lot of supervision.

UCSF Orthodontic Residency
Pacific Orthodontic Residency

[Lantyssa]

Edit:  you meant Lodine.  That's still a damned weird combination.

I used a lower case 'L'.  I didn't mean Iodine.

Ambien was for the conscious sedation.  I'm told I was able to run to the restroom prior to the surgery, but I don't remember it.  Apparently mid-operation was another moment, and I was somewhat awake when they wheeled me out to the car and did the final purging.

I had Lodine and Vicodin for home, but I wasn't able to keep the vicodin down long enough to help until the Wednesday after surgery, which was Friday.  Unfortunately I suffer from excessive inflammation after any surgical procedure, so the pain alone kept me mostly unconscious the entire weekend.  On the plus side, I heal well and quickly overall (no pain reduction though, and I seem to hold true to red-heads needing additional pain meds).  I always surprise doctors with the extremes of both.

[Minvaren]

I'm considering a single implant (#18).  Are these things primarily for the rich?  The one quote I've gotten thus far could get me a decent used car...

[Sand]

I believe there is an orthodontic residency where you are (San Francisco, right?).  You could get Invisalign through them at what would probably be a cheaper fee.  It will probably take longer, but the way residencies work now you'll get good treatment.  There's a lot of supervision.

UCSF Orthodontic Residency
Pacific Orthodontic Residency

^This. This is what I mentioned I did earlier. Braces (with six brackets for upper teeth to make some minor adjustments prior to bleaching and replacing 20 year old veneers) and it was $600 all in including upkeep, maintenance, and the retainer.

btw I hate   the retainer. Big stupid chunk of plastic in my mouth all the damn time. Worse than the braces.

[ghost]

Yeah, I read it wrong .  I was caught off guard by the Ambien as sedation.  That is not normal protocol.  

[ghost]

I'm considering a single implant (#18).  Are these things primarily for the rich?  The one quote I've gotten thus far could get me a decent used car...

You'll be looking at $3-5,000 probably.  Again, go to a dental school if you can.  You'll get a much better deal.