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Author Topic: Sedation Dentistry  (Read 6390 times)
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timothy42b
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« on: Jun 21, 2013, 10:14AM »

I'm near phobic for dentistry and have a highly overdeveloped gag reflex.

But I need a lot of work done and can't put it off any longer.

So I scheduled a half day session Tuesday.  He's going to do "sedation" dentistry.  I guess it's a pill plus gas.  He'll do a whole side of my mouth in one shot, then wait for next year to work on the other side. 

I can barely tolerate a cleaning so I'm not looking forward to crowns, etc. 

Has anybody done it this way?  I figure it may be better to get it all out of the way at once than multiple appointments over the year.  If i can stand it. 
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Tim Richardson
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« Reply #1 on: Jun 21, 2013, 08:54PM »

Good idea.

Working on phobic with triazolam is a win-win  for the dentist and patient.  You'll still be awake and have control over your breathing but you won't care.  And then, later, you won't remember.  And the dentist can work in peace.  It's awesome.
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« Reply #2 on: Jun 21, 2013, 09:01PM »

Just be careful that the dentist is aware that he should not change the set of your jaw (by making teeth higher of lower etc) and therefor changing your embouchure. That is what happened to me and I still can't play the trombone properly. I am not even sure I will ever will be able to play as I did previously.
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« Reply #3 on: Jun 22, 2013, 05:34AM »

Just be careful that the dentist is aware that he should not change the set of your jaw (by making teeth higher of lower etc) and therefor changing your embouchure. That is what happened to me and I still can't play the trombone properly. I am not even sure I will ever will be able to play as I did previously.

This is going to make for a really tough situation!

Even being able to have just the local anesthetic, get the "bite" back is as much art as science.  Well, it CAN be more science, depending on the dentist and his/her equipment. But ALWAYS a LARGE art component.

Any restorative work will go better with test fitting.  Those of us who have had fillings, crowns, etc. are likely to remember the dentist putting a slip of paper between the teeth and saying something like, "Bite gently... now move your jaw side to side."  That paper is covered with "ink" that will leave marks on the teeth where they would otherwise touch.  Those marks guide the dentist in grinding off high spots to get back just right.

That is hard enough when half the jaw is numb.  I can't imagine how this will be done under full sedation. 

My dentists have ALWAYS said that IF it feels odd after the anesthetic wears off I should come back and they will adjust it.  They mean grind off really, really minute bits to get it just right. 

Their goal is to get the full chewing process back, and to avoid having new pressure points from the new work that could then break other teeth or old work. You really want this... Google what REALLY happens between teeth, saliva glands, toungue, etc. when you are chewing. It's really quite a process that you would really miss once it' gone.

But my goal is just having my closed mouth feel normal as a starting point for when I set up to play. Of course I do NOT play with my teeth together.  But teeth together gives me the reference point for where my chops will go.

For both of these things, I agree with Graham. Before you get there, have a plan with your dentist on how you will get back to the orginal feel of closed teeth after the new work.

BTW when I say "grind" don't think in high school shop terms.  Often the difference between a good bite and poor one is thousandths of an inch. This is more like grinding in the sense of Starrett bringing measurement tools to National Bureau of Standards specifications. To me it's worth a LOT of discomfort to make it so the dentist can make that kind of miniscule adjustment with my face and me BOTH fully awake.  Quite a bit different from the amount of tooth that needs to be dealt with in removing decay, or preparing for crowns, etc.

These guys do this kind of finicky work ALL the time.  The more clear and specific you are about what you need, the more guidance they have on just how to apply their skill and art.

Good luck on this Tim!
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« Reply #4 on: Jun 22, 2013, 07:02AM »

Just be careful that the dentist is aware that he should not change the set of your jaw (by making teeth higher of lower etc) and therefor changing your embouchure. That is what happened to me and I still can't play the trombone properly. I am not even sure I will ever will be able to play as I did previously.

I had a small version of that happen many years ago when I had a short tooth extended to match the line of the teeth around it.

It was like i couldn't tongue anymore!  It took a long time to work through that and get tonguing again.


In theory, if you are having crowns done the dentist should be making a mold so that what you end up with is the same shape as what he took off but... that's the theory.
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« Reply #5 on: Jun 22, 2013, 08:45AM »

This is going to make for a really tough situation!

Even being able to have just the local anesthetic, get the "bite" back is as much art as science.  Well, it CAN be more science, depending on the dentist and his/her equipment. But ALWAYS a LARGE art component.

Any restorative work will go better with test fitting.  Those of us who have had fillings, crowns, etc. are likely to remember the dentist putting a slip of paper between the teeth and saying something like, "Bite gently... now move your jaw side to side."  That paper is covered with "ink" that will leave marks on the teeth where they would otherwise touch.  Those marks guide the dentist in grinding off high spots to get back just right.

That is hard enough when half the jaw is numb.  I can't imagine how this will be done under full sedation. 

My dentists have ALWAYS said that IF it feels odd after the anesthetic wears off I should come back and they will adjust it.  They mean grind off really, really minute bits to get it just right. 

Their goal is to get the full chewing process back, and to avoid having new pressure points from the new work that could then break other teeth or old work. You really want this... Google what REALLY happens between teeth, saliva glands, toungue, etc. when you are chewing. It's really quite a process that you would really miss once it' gone.

But my goal is just having my closed mouth feel normal as a starting point for when I set up to play. Of course I do NOT play with my teeth together.  But teeth together gives me the reference point for where my chops will go.

For both of these things, I agree with Graham. Before you get there, have a plan with your dentist on how you will get back to the orginal feel of closed teeth after the new work.

BTW when I say "grind" don't think in high school shop terms.  Often the difference between a good bite and poor one is thousandths of an inch. This is more like grinding in the sense of Starrett bringing measurement tools to National Bureau of Standards specifications. To me it's worth a LOT of discomfort to make it so the dentist can make that kind of miniscule adjustment with my face and me BOTH fully awake.  Quite a bit different from the amount of tooth that needs to be dealt with in removing decay, or preparing for crowns, etc.

These guys do this kind of finicky work ALL the time.  The more clear and specific you are about what you need, the more guidance they have on just how to apply their skill and art.

Good luck on this Tim!
if you are going to have many crowns done whether you are awake or asleep or just sedated then you will wake up in "provisional" crowns (made of plastic).  You wear these for a while (weeks, months), adjusted as needed, until you are stable and comfortable. Then molds are made of the provisionals and that information is sent to the lab.  Then you can be confident that the new permanent crowns will fit and function well with maybe only some slight tweaking.
Making adjustments should never be uncomfortable except for the lovely drilling noise.
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« Reply #6 on: Jun 22, 2013, 12:58PM »

I avoided the dentist for several years until 2005, when I got a full-time job and health/dental coverage.

I needed a lot of work done after years of neglect.

I opted for conscious sedation for my first visit back - a couple of cavities, a couple wisdom teeth, and a root canal (yikes!).

The sedation made the process go incredibly smooth. Even though I was in the chair for quite some time, sedation made the time go very fast.

Just make sure you have a driver - you ain't gonna be in no position to drive yourself home - the sedatives really work!

It was the only visit I ever used conscious sedation - luckily I have no fear of the dentist anymore!

Take your time - listen to your dentist - take care of your teeth!
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« Reply #7 on: Jun 22, 2013, 02:34PM »

Just make sure you have a driver - you ain't gonna be in no position to drive yourself home - the sedatives really work!

I opted for no sedation when I had some wisdom teeth out because I knew I'd have to drive myself home.  I was impressed that I never really felt anything after the shots.

I could HEAR a crunching sound as he was wrenching the teeth out of my jaw  Amazed but it didn't hurt  Good!
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« Reply #8 on: Jun 22, 2013, 07:42PM »



Just make sure you have a driver - you ain't gonna be in no position to drive yourself home - the sedatives really work!



My daughter volunteered to drive.  But she got this evil look in her eye and mumbled something about youtube videos.  Is there something I need to know?
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Tim Richardson
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« Reply #9 on: Jun 22, 2013, 10:35PM »

My daughter volunteered to drive.  But she got this evil look in her eye and mumbled something about youtube videos.  Is there something I need to know?
yup.  And the magic of sedation, if the right meds are used, is that you won't remember anything........the you tube video your daughter records will be quite entertaining.  :D
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« Reply #10 on: Jun 23, 2013, 05:26AM »

yup.  And the magic of sedation, if the right meds are used, is that you won't remember anything........the you tube video your daughter records will be quite entertaining.  :D

Just remember to put a disclaimer in advance that anything you agree to while sedated is subject to change.  Like the new car, the later curfew, the trip to Aruba, ... ;-)
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« Reply #11 on: Jun 23, 2013, 01:20PM »

Just remember to put a disclaimer in advance that anything you agree to while sedated is subject to change.  Like the new car, the later curfew, the trip to Aruba, ... ;-)
:D Good!
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« Reply #12 on: Jun 25, 2013, 01:49PM »

They did the work this morning.  I think I was there about four hours but it's still a bit fuzzy.

They gave me the pill, which wasn't a pill but powder under the tongue.  Triazolam, if i spelled it right.

Then they took impressions with some goofy sticky stuff.  Then fitted this rather uncomfortable nose clamp thingy on.  Then my wife was there to pick me up.  There is no memory at all of the work. 

Apparently one tooth split and they couldn't save it.  Funny, I didn't care!  All in all, the least unpleasant dentist experience I've ever had. 

He said not to play for two days.  I figure today is one day, I'll skip tomorrow, first time I've skipped in probably 3 years. 
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Tim Richardson
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« Reply #13 on: Jun 25, 2013, 02:09PM »

Glad it went well!
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« Reply #14 on: Jun 25, 2013, 06:10PM »

They did the work this morning.  I think I was there about four hours but it's still a bit fuzzy.

They gave me the pill, which wasn't a pill but powder under the tongue.  Triazolam, if i spelled it right.

Then they took impressions with some goofy sticky stuff.  Then fitted this rather uncomfortable nose clamp thingy on.  Then my wife was there to pick me up.  There is no memory at all of the work. 

Apparently one tooth split and they couldn't save it.  Funny, I didn't care!  All in all, the least unpleasant dentist experience I've ever had. 

He said not to play for two days.  I figure today is one day, I'll skip tomorrow, first time I've skipped in probably 3 years. 
Isn't great?  The dentist loved it too.  No tongue rodeo.  No heaving and gagging.  No potty breaks. No questions.  :D
And the best part?  You didn't care. You don't remember so you'll be less anxious next time.
Yes Triazolam (Halcion) is correct.  Works great.  Lasts only a few hours. No side effects. Safe.  Easily reversed if necessary.

Bravo.
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« Reply #15 on: Jun 25, 2013, 08:47PM »

I will be very interested to find out what shape your lip is in after all the work you outlined is completed. I am assuming the recent sedation was just the beginning. Anyway, I agree that dentistry was overdue. It was just that all that rebuilding work you mentioned had me a bit worried in view of my own experience. Except, maybe I was wrong and it was not the dentistry that wrecked my lip. It is a bit to early to say but I have experienced some recovery in the last few days. Touch wood my recovery program is working. I will tell you about it when I am sure.
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« Reply #16 on: Jun 25, 2013, 11:42PM »

No tongue rodeo. 

That is hilarious.  Love it.
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« Reply #17 on: Jun 26, 2013, 03:28AM »

That is hilarious.  Love it.

I never know what to do with the damn thing. I try to tuck it out of the way, but it's always IN the way. Embarrassed!

I'm lucky with my teeth in that I've needed very little done. However, before my dentist retired last year, he asked me if I was happy with my two front teeth as they had rather a rough edge. I thought, you've been looking after my teeth for 15 years and why didn't you ask before??? Anyway, when he gave them a new edge, he made one of them much too long, but was able to grind it down when I went back.

Good luck with the recovery, Tim and Grah.
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« Reply #18 on: Jun 26, 2013, 09:28AM »

Wow - I just PM'd a poster about a similar experience...

Got my braces off a month ago (after 2.5 years), and got back to my original comfort level and range within two weeks (!) - great flexibility and control. Then Monday I had my four upper front teeth ground down and four temporary crowns put on to make me pretty (plus the teeth were showing cracks - really had to do it).

Holy crap! it's worse than when I had the braces on! It's like the newly-aligned teeth are blocking part of my lip, so the buzz is affected; maybe airflow too? i lost some range (unless I use pressure and reset my embouchure) and the flexibility I always enjoy is not there. It feels like there's a foreign plate of material behind my lip (which there is)...

Okay, I know it's only been two days...I will be working on it for a couple of weeks to see if it just goes away. Any suggestions from other who have experienced this?
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« Reply #19 on: Jul 23, 2014, 05:39AM »

I had the second iteration done last week.  Last year I had the upper right side done, this year the upper left.  I do what I can afford once a year. Next year we'll take care of the missing tooth on the lower left.

Question though:  what does sedation really do?

I had an extraction and a temporary bridge done last week.  In a month or so I'll get the permanent bridge fitted.  I went in yesterday to have him check the healing and he says it is doing well (it aches a bit though).  He said the tooth was extremely difficult to get out, he had to really work, and he wondered if I remembered any of it. 

Nope.  Powder under the tongue, nose piece on, and woke up being wheeled down the hall. 

So, did I suffer, and have amnesia?  or was I out? 
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