The Joys of Wisdom Teeth

Sorry for the lack of posts today. I had a wisdom tooth removed this morning and so far all is well. As usual, I learned a few things and I figure I'd share.

As a kid I had 4 teeth removed for braces, but I don't really remember that. I never had my wisdom teeth removed as my mother believed that you keep your teeth until there's a problem. My lower ones were impacted, meaning they grew forward into the tooth in front of them which prevented them from growing all the way in. They did grow in most of the ways, but they just don't do much except trap food so I have to be careful cleaning them. The lower ones are near the nerve and my current dentist agreed that the risk of nerve damage outweighed the benefit of removing these before something happened. I also learned that the risk increases as you age, so it probably would have been better to have them removed as kid. An x-ray showed I now have a cavity forming in the tooth in front so it's time to remove the wisdom tooth to get to it easily.

A few years ago I had a top wisdom tooth develop another cavity and had it pulled. I was surprised at how easy an experience it was. I went to an oral surgeon, had some Lidocaine (they don't use novacaine much anymore but still say it because most people know that word) and a short man with Popeye-like forearms used pliers and pulled a tooth out of my head. The whole thing took about 15 minutes, mostly waiting for the Lidocaine to take effect.

Apparently unlike the top ones, lower wisdom teeth are near a nerve. What they do is surgically open the gum, I think break the tooth in two, remove it and it just sounded much more involved. As a result I decided to have anethesia for this instead of just Lidocaine. It was my first time for anethesia. I had a hernia a few years ago and even for that they used a local and some medication that put me to sleep but not under (my own terms which I'm sure are imprecise). Afterwards I spoke to a doctor friend of mine who told me that most complications that come from anethesia happen in dentist's offices, so in the future I might make a different decision. The risk is low, but still, why take it?

I went to the oral surgeon a while ago for the initial consulatation. They took a cool full head x-ray. I previously had what I think they call bite wings where put a small piece of time in a holder inside your mouth that you bite down on to hold in place. I find it always just a little uncomfortable, almost gagging but not quite. Then of course the dentist leaves the room as short x-ray burst captures the image. This machine was different. You sit in a chair and a machine rotates 360° around your head taking one picture of your whole jaw. It looks like this. The consultation was a little weak. He actually said to me that it's the same speech to everyone and there's a small risk of permanent numbness and there's no way to know ahead of time. I know one person with a permanent dime-sized numb spot on his chin, I guess you get used to it. The tooth looked close to nerve but that doesn't correlate to problems developing. I told him as an engineer I'm used to make decisions on facts and doing some risk analysis on someone quantitative and he was giving me nothing, but so be it.

The most difficult part for me was that if you have anethesia you need to have someone pick you up and stay with you for 24 hours. Arranging that was little difficult and caused me to delay the procedure a while. Anyway it was today and in the mean time the surgeon I met left the practice so I switched to another oral surgeon in the same practice who was also recommended to me. He was more personable and said that complications are more common if the tooth is still completely under the gumline, which wasn't the case for me. That made me feel a little better.

They hooked me up to blood pressure, pulse and O₂ monitors and gave me small mask with oxygen . Then they gave me an IV with the drug. It's funny, I remember then hearing that the procedure was over and after looking at my watch I commented that that was fast, but I think at the time I thought I remembered the procedure, but now I don't at all. Anyway I was a little groggy and waited in teh chair for 30 mins in part for my head to clear (and for them to monitor me) and in part waiting for my ride who had another appointment in the same building. Most reactions to the anethesia will happen shortly afterwards.

They gave me a prescription for Vicodin and I stopped at CVS on the way home to fill it. A simple prescription for 24 pills, why does it take 15 mins to fill it ? There was no one else there and no one else came in the mean time to pick up a prescription. I guess so I could wander around the store and buy some ice cream, which I did (Cherry Garcia). The surgeon's office also gave me preprinted instructions for things to do. They were all generic but I've been icing my face on and off again to help with the swelling. So far so good but they said it will peak after 2 days and will persist for 5-7 days.

So for all this you have someone stay with you for 24 I had asked the nurse (assistant?) what should they look for, that seems a reasonable question. The answer was anything out of the ordinary, which I find to be completely useless. You don't want to call unnecessarily and they shouldn't want to have to waste their time. After the office closes is out-of-the-ordinary the same as the "in the event of an emergency" that I know I'll hear if I call their number? It's known stuff, the anethesia and the Vicodin, they must know what the side effects were.

So a friend staying here this afternoon told me to not fall behind in the Vicodin, apparently once you feel pain it's too late and hard to catch up. I hadn't heard that before and decided to call a doctor friend to chat and ask. It turns out that's kinda true. This kind of pain medication apparently first "covers" the pain and only after you'er pain-free would side effects kick in. So the idea of "wait until you can't stand it" before taking pain meds is to avoid side effects because that point all the meds will go to treat pain and not give side-effects. But of course, then you're in pain and they take 15-30 mins to take effect so you don't know for a while if you've taken enough. The other theory is to take it before you feel pain to avoid it all, but of course then you have a hard time to avoid taking too much for side effects.

Also from what I understand the prescription is for limited amount so you can't get addicted. Only you can judge your own pain. Taking an extra one if you need it should be fine and you'd need to take a lot for any serious side effects. Taking a whole bottle would bad. (I'm not a doctor so don't do anything stupid, the above is not advice). The common side effects are nausia, light headedness, etc. The one thing that's apparently still possible for me is for it to slows my breathing and I evidently wouldn't notice that myself. So that's what my friend is looking out for. Would it have been so hard to tell me that in the office? I know all the pre-printed forms are to avoid lawsuits and all that, but it's just so moronic that the way they do that is to be so generic (call for anything out-of-the-ordinary) as to be less than helpful.

Another thing that was a little annoying. I had prepared for this by buying soft foodand making soup this weekend. Soup is soft. I even made my own vegetable stock. The carrot and parsnip soup came out well though a little thin. It will be better next time. I also picked up some fresh pasta from my favorite local market. Before dismissing the nurse said I could eat anything, just chew on the other side, and I should avoid hot foods like coffee, tea, and soup because they promote bleeding. Wouldn't it have been nice to tell me this ahead of time so I could have prepared properly? Oh well, warm homemade carrot and parsnip soup is still pretty tasty.

Anyway, I'm fine. i went through various stages of lower jaw numbness but that seems mostly past. My jaw hurts a little on that side but between the Vicodin and the ice it's not bad at all. Dinner was tasty and apparently my breathing isn't slow. And I can still write way-to-long blog posts. :)