Dental Sedation with Wisdom Tooth Extraction

My 20 year old has an impacted wisdom tooth. The dentist thinks they will have to remove some of the bone. He wants her to go under general anesthesia for the procedure. Is this necessary because of the bone? I’m uncomfortable with using anesthesia unnecessarily. There are so many risks and we have a relative with serious complications to anesthesia. What would your recommendation be?

Kelly

Dear Kelly,

Someone asleep from dental sedation

Bear in mind I haven’t examined your daughter. However, at her age I would be very surprised if general anesthesia was warranted. With a twenty year old, the bone is still very pliable because there is not really any cementum accumulation at the roots. She is in the ideal age range to have her wisdom teeth extracted. As she ages, that cementum builds up and makes the procedure more difficult with a greater risk of complications.

My recommendation would be oral conscious sedation. This is sometimes called sleep dentistry. However, don’t push your dentist into that. His suggestion signals to me he is not completely comfortable with the procedure. Your daughter would be much better served finding a dentist who is experienced and confident. To find that dentist, simply do an internet search for “Sedation Dentist”, find out if they do wisdom tooth extractions, then schedule a consult with them.

If they recommend general anesthesia as well, there may be some complicating issues the first dentist did not explain to you. My guess is your second dentist will think oral conscious sedation will be perfectly sufficient.

There are always additional risks with general anesthesia. With your family history, it seems like that risk is higher. I’m with you on this one and would not want to jump into that unless it were absolutely necessary.

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Is a Cracked Crown a Dental Emergency?

I have five porcelain crowns. They have served me well for just over 15 years. With one, there has been a slight defect in it from the beginning. It was never before visible, but could only be felt by my tongue. Lately, it has changed. I can now see it and it feels more like a crack. I am assuming I have to replace the crown, which I am fine with. I am just wondering if it requires an emergency appointment. I don’t want it to break in public.

Allie

Dear Allie,

Gilbert CEREC Crown

While I would not consider this a dental emergency, I would not put it off either. Based on the changes you described, I would expect it to go sometime soon. It has had a good life. Given the amount of time you’ve had all of these crowns, I would expect that others will start to show their age soon too. You have a couple of choices here. You could replace the dental crowns all at once, or you can just replace them one at a time. There are benefits to both.

If you get them done all at once, you will be done with it. Though, of course that is a bigger chunk of money at once. If you do them one at a time, you can pay a little at a time, but you will be making trips to the dentist more often, possibly at unexpected and inconvenient times. It really is six of one; half a dozen of the other. It’s just which inconvenience is the least problematic for you.

One thing to be aware of is that you don’t want a dentist saying you have to replace them all at the same time in order for them to match. That tells me the dentist does not have adequate cosmetic skill. Speaking of aesthetics. If you want to whiten your teeth, the time to do it is now before you have the new crown made. This way, the crown can be made to match the new whiter color. It is certainly not required. I just wanted you to be aware that teeth whitening only works on natural tooth structure so the crowns themselves will not whiten.

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