What can I expect? (Dentist appointment)

[Tama]

I managed to get signed up at a free dental clinic and made my first appointment to have some teeth removed. I thought you had to be examined first, but they let me make the appointment, so I guess it doesn't matter.

Anyway, what can I expect them to ask/tell me? If I point out the worst teeth, they look and remove? Will they remove these teeth if there's an infection? (There's a bulge that extends from one tooth back a few teeth)

Also, I have EXTREME anxiety, so how do I let them know about this?

[Sapphire Silk]

Just tell them you are very anxious. They will understand . . . this won't be their first rodeo with anxiety. Ask about whether or not they can use nitrous oxide to relax you before they inject you with the numbing medication . . . but you will need a ride if they say yes. You can't drive after being on that stuff.

If your teeth are that bad, and you can't afford restoration work, then pulling them may be the best option. Ask about options and what you can afford. If there is infection, depending on how bad it is, they may have you take a course of antibiotics first before you actually have the work done. That's for your safety so you don't get a systemic infection, so don't balk if they want you to do that.

Ask about options for pain control after the work. Honestly, acetaminophen is an EXCELLENT pain control med for dental work. Acetaminophen (paracetamol) with codeine (aka Tylenol #3) is also a great option. Ibuprofen (Motrin, Advil) may also be recommended. They may write for something else depending on how bad your teeth are and how much work they have to do. It's OK to say, "I'm not used to taking this stuff and have no idea what I will really need, can you please talk to me about what works best to control pain at home?"

Just remember if they write for a strong opiate you must take care in driving, especially if you are not used to the stuff.

Listen to the dental hygienist's suggestions for tooth care for the future. She really is interested in keeping the rest of your teeth healthy, and it's her job to do that education, not the dentist's. There are lots of things you should be able to do cheaply to take care of your remaining teeth; it is always better to keep your own teeth as long as possible if you can do so without creating other health problems for yourself.

I'm so glad to hear you were able to get in to see a dentist! I understand your anxiety; I feel the same way. For me, a good dentist is as much about the dental hygienist as the dentist himself, so build a rapport with her/him and things will go much better. Don't be afraid to tell them about your fears, when you're in pain, and make reasonable requests about how they handle your mouth.

[Tama]

The infection thing has me the most scared. I've been on four different antibiotics in five ER trips in the past six months and I'm all kinds of worried because the lump went down, but never completely went away so the idea of systemic infection has me freaked the hell out. I just want this done so I can rely on brushing to keep my teeth nice and healthy again.

I don't drive, so no worries there. Not sure about the pain meds, I've never been on anything stronger than Tylenol.

The worry just gets worse the closer I get to Tuesday. Antibiotic resistance fear, fear of infection, drill or pliers..

Murphy loves my brain.

[EricKei]

I had a badly damaged and curved tooth pulled last year. It was my first proper dentist visit in about a decade at that point. I can tell you this: Novocaine is your friend. They rubbed the injection point with a numbing ointment, let that sit in for a few minutes, gave me the shot, and let me chill for 40 minutes or so...I honestly didn't feel a thing when it came time for the extraction ^_^ I warned them in advance that I'm a complete pansy when it comes to pain. If anything, they appreciated the heads-up! I also kept my eyes shut tight during the actual procedure...it really helped my mental state, and not SEEING the tools actually calmed me down a lot. Denial ain't just a river in Egypt, ya know?

As for recovery -- The basic thing (and they should go over this in detail) is to make sure you have some sterile gauze (have some sharp scissors to cut it with) and salt. For the first few hours, there will normally be some mild bleeding (nothing to freak out over), so you will need to pack the now-open areas with gauze and be ready to swap them out as needed.

They will likely also have you occasionally rinse with warm (NOT HOT!) salty water -- several times on day 1 (until the bleeding stops entirely), and probably 2+ times a day after that for a week or so. This will serve both as a general rinse, and as a method for helping to keep the environment in your mouth "hostile" to infectious bacteria -- From what I gather SS and other medical professionals can tell you a lot more about that than I can.

[Tama]

Novocaine was good, but my gums are inflamed. They were last time I saw a dentist six years ago and they probably are not. I remember then it took four shots to get me through one tooth. Thinking about it, the bulge may prevent them from even giving me the stuff.

Thanks for the warning about the bleeding though.

[klhanson]

the bulge is more than likely an abcess. I had a infected tooth with a abcess and they did pull it.. Novacaine isn't too bad except when they have to do one in the roof of your mouth. OUCH.. other than that i barely felt it.. But they also had me stick a numbing thing in my mouth before they did the shots too.dd

[Tama]

I'm worried about getting infected when they pull it. Some of these teeth can't be pulled normally, they're cracked practically down to the gum.

You can tell I worry too much here. Lol

[EricKei]

Mine had to be cut in two vertically and pulled out in two hunks. Still took less than 15 minutes for the actual cut & pull part. It's amazing how efficient they've become these days

btw to add something to my earlier one: Rinse GENTLY. You don't want to loosen any scabs/healing skin while it's...well...healing. For me the bleeding stopped after 2 hours and 6 or 7 sterile gauze pads (gauze to keep the area dry and wick away the fluid).

[Tama]

Is there a big risk of the clots coming loose/sticking to the gauze? I've heard that pain of exposed bone is HORRIFYING!

[wolfie]

Also, while recovering, avoid drinking through a straw (especially viscous drinks like milkshakes) and smoking - both increase the risk of dislodging the clot and causing "dry socket".

[Tama]

Ohh geez. I am on a soft diet and have been eating mostly by letting food soak, and a bit of suction. Guess that's out! How long is that supposed to go on BTW?

[EricKei]

Scab coming loose -- as long as you're careful, minimal. It may be best to stick to just eating broth or something like that, on that day, after the procedure. NO STRAWS for at least a week or so (until you're sure), and try not to inhale/slurp. I was able to eat "real food" by midday the next day (jaw was sore is all)/24 hours...but still no straws.

I was given some mild pain meds to account for the Novocaine wearing off later in the day -- not even Codeine-level of power. I found it more annoying than painful, and I'm one of those people who has to steel myself and close my eyes before getting a simple shot! So, it's not so bad as long as you do what they say.

Dry socket -- thanks, Wolfie! I couldn't recall the proper term -- is what you're trying to prevent with the warm salt water gentle rinses. For me, they recommended I do it a few times a day for a week, I think? Including right before bed and right after waking up, of course, and especially, immediately after eating. I don't know about the exposed bone thing, but they basically told me, "Yeah. You don't want that. Trust us. Just follow our instructions and you'll be fine."

Ask them in advance what to expect, ask them to give you details in writing. Assume that, while you're in the gauze phase (maybe 3 hours for me), you don't wanna talk/move your jaw too much. I got thirsty a couple of times at home, so I just literally poured some water into my mouth on the right side (pulled tooth was on the left) in between gauze changes. In the end...? My jaw was a little sore from consciously keeping it shut/holding the gauze there with my teeth.

[MoonCat]

Tama, you'll need to do more than brushing once the bad teeth and any infections are gone. You MUST floss as well. Trust me on that. I learned the hard way. I also use both an anti-bacterial mouthwash and one that helps with gums that tend to bleed. It's good that you're getting this taken care of, as periodontal disease can lead to many other health problems.

One tip for anxiety I can give you: When you get in the chair, make a point of tensing and then relaxing your shoulders a few times, and taking slow, deep breaths. Ask the tech and the dentist to let you spend a minute or two doing this. It really does help to relax you. Also, they should let you ask to take a break during the procedures if you need to. You can set up a signal beforehand, like raising a hand to let them know you need to stop for a minute or two. My dentist was very good about this.

[Tama]

Thanks for pointing all this out. They'd probably tell me this but I'd have a hard time absorbing all the you must do and must no dos at once.

[Aragarthiel]

All I know about this kind of thing is from having braces. I had to have several baby teeth pulled because they never came out and the adult teeth were growing next to them. It wasn't too bad, most of them didn't even require anesthetic, but the ones that did, my lip felt curled for a few hours, then I was on an applesauce and mashed potato diet for a day or two.

On a side note, when I got my braces in, they put one of the brackets slightly under my gumline and made it start to recede (I suspect I was allergic to the metal in my braces as well, I kept getting blisters and my gums were constantly swollen), and now it bleeds if I'm not gentle. If you ever had braces, ask if they could have screwed something minor up to cause/help further any dental problems. Probably not, but nobody ever thinks to ask.