What is the chance of a decayed wisdom tooth falling apart during extraction? Should I be awake?

I am 35 years old, and my upper left wisdom tooth is very decayed is broken (pieces are missing.) I am going for a consultation later today with an oral/maxillofacial surgeon. The receptionist said that if I only need to be numb he may be able to extract it today saving me the additional $185 consultation fee. But if I need to be asleep I'll have to reschedule. I know there is a good chance the tooth could crumble into a million pieces as it is being pulled due to the decay. How likely is that? Also, if there is a good chance of that happening, with then the tooth being taken out piece by piece, should I be awake or have IV sedation? I also keep hearing about the awful noise you hear whem it is extracted while you are awake, and about the painful injections to numb the area. (Injections that can make you gag, I've heard. I gag easily.) Also, if it;s infected, do I need to take antibiotics first to get rid of the infection before it is pulled so that that the infection doesn't spread?

What is the chance of a decayed wisdom tooth falling apart during extraction? Should I be awake?
The decision as to whether you need to be asleep is up to you and your dentist. I have seen many, many patients do well under the conditions you are describing.





Yes, a tooth can break apart and can be brittle when an extraction is performed. I have worked with dentists who have easily removed broken reamining pieces with ease. It all depends on the dentist performing the treatment and also depends on how broken down the tooth is.





As for the antibiotic, yes, it is a good idea to have antibiotics prior to any treatment, so the anesthetic will work more effeciently...this also aleviates pressure caused by swelling from infection.





Question regarding the anesthetic...do you gag due to the topical gel placed in the mouth prior to the anesthetic? Or do you gag from opening your mouth? I know sometimes that topical gel can cause gagging with senstive patients. Let your dentist know prior to any treatment being done. This will give them a heads up so you'll be more comfortable.





Best of luck to you. :)
Reply:I think you will do fine! :) Keep your chin up. Report It

Reply:I don't know if it will fall apart, i dont know about the infection either. but let me say this. Pay the money and go under. I had all four of mine done at once and it is a good thing i did because the next time i need a tooth pulled they are all coming out at once. It hurt so bad afterwards. Go under. They had to cut the corners of my mouth because i have a small mouth, and cut my gums, and hold my mouth open for a long time. My jaw hurt just as much as my gums did when it was over. go under.
Reply:If it is infected, you would need to start taking antibiotics a couple days prior to the removal to help prevent it spreading afterwards. The tooth may well break apart while he tries to remove it, but at that point you would be numb or asleep either way. What you chose really depends on how tough a cookie you feel you are, and what you think you'd prefer. IV sedation doesn't necessarily put you to sleep. You are really in a kind of twilight sleep as a rule, where you respond to things like questions, but you feel pretty mellow and just don't mind what's going on. With that sort of sedation, you will still get a local anesthetic. With a general anesthetic you are asleep completely, and don't get the injections at all because they aren't needed. For just one tooth, and in the upper jaw, the local won't be that bad- no worse than the injection for other jaw teeth. You might hear some noise, as it is close to the ear, but you can cover that with an IPod and your favorite tunes. IV sedation or the general (also done via IV) will mean you have to hang around longer, because you can't leave until you are back on your feet, going to the bathroom and holding liquids. And you have to have somebody to do the driving. With the local, you can drive yourself if you need to. No matter what, you will get painkillers to cover when the local wears off, or when you wake up post op. You will have to discuss all the options with the oral surgeon though, after he's had a chance to look at the tooth in person and evaluate what's going to be needed.
Reply:OMG I feel your pain...I too have wisdom teeth that are broken, I am going to my consultation this Thursday...I am SCARED of dentists, like I get anxiety just thinking of them. SO i am going to pay the extra money to be put under, I cant stand the thought of being awake while they do that! I have been awake to have a tooth pulled and vowed to never do that again!! I was petrified the whole time, while i didnt feel PAIN i felt the pressure and the noises awww groossss. Please message me and let me know how it goes, as I am going on Thursday and am scared!!!
Reply:I'm not a qualified dentist (yet) so first off you should ask your dentist about any concerns you have. (S)He is duty bound to explain the pro's and con's (not just financial) of the two treatments so that you are capable of making an informed choice about it. Also they should be happy to ease you mind about things I'm assuming your friends have told you about treatments they've had.





The "awful" noise isn't too bad. I've never had a tooth pulled so I can't tell you what it feels like but the noise is a kind of a loudish cracking nut shell sound. The injection shouldn't be painful if it's done correctly and definately shouldn't make you gag. If it's done correctly you'll feel a little spot in your gum feel a bit uncofortable but not painful.





I've seen a tooth (which was mostly filling) crumble but the dentist I was shadowing was very skilled and just gave the guy a bit more pain relief (just incase), drilled the root out and sewed his gum up.





Hope that helps.
Reply:I have never had this done (yet but will one day) but if it were me, I think I would choose the iv sedation. One being I could take a little nap and the other being I don't like needles in my mouth. If it is abscessed he might want you to take antibiotics first, but if it is just decayed it is possible there is no need for them. It is possible that it could break into several pieces. I had a tooth pulled one time (6 weeks after giving birth by c-section) and it was one that had been filled when I was a child and had decayed under the filling. Part of it had broken off while I was eating. When he went too pull it, it broke in half. Thank goodness he had deaden it well. Good luck and I hope you do well.