Get sedation for your extractions to minimize risk of complications

My dentist is about to pull seven teeth from my upper jaw to make room for a full upper denture. This seems pretty traumatic to me. He’s very old fashioned and doesn’t even use nitrous oxide. I’m 60 yrs old and have had a lifetime of physical pain as a polio survivor with complications. Don’t you think he’s asking a bit much from me? He’s been my dentist for 20 yrs so I don’t really want to change dentists this late in the game.
– Suzanne from Idaho

If you’re dreading the idea of having seven teeth extracted with only novocain and you don’t want to switch dentists, then I would recommend that you ask your dentist to refer you to an oral surgeon for the extractions. The oral surgeon will be able to sedate you for the procedure.

A tooth extraction, in my opinion, is the most traumatic type of routine dental treatment, and having seven teeth extracted at once, especially if you are stressed out about it, carries a high degree of risk of some adverse event, such as a stroke, heart attack, or other complication. Plus, when you’re having upper extractions, it requires a lot of novocain. Each tooth requires a separate injection.

I served as a consultant once for a lawyer in Colorado who was defending a dentist against his dental board who wanted to take away his license after a woman died in his dental chair. The board was alleging that he had over-sedated her. But it was my opinion, after closely examining the records of what drugs were given, compared with the timeline of her appointment, that the woman had gone unconscious as a reaction to the large amount of novocain she had been given, and the dentist misinterpreted her reaction as a reaction to the sedative medications, and mis-managed it as a sedative overdose. My conclusion was seconded by another expert in dental sedation. She had a number of teeth extracted that day, which required a large amount of novocain. Since she was a high-risk medically compromised patient, she ended up dying from that.

I’m not suggesting that you are at risk of dying from this procedure, because I am assuming that medically you are in good condition and that your dentist is very capable. (You mentioned you have complications from polio, but since you didn’t mention any medical complications, it’s sounding like you just have disability and pain complications.) But I am telling you that there are risks of complications from an appointment with multiple extractions, both from the stress of the appointment and the large amount of novocain required. That risk is minimized with appropriate, competent administration of sedation. Worrying about it, as you are, also increases your stress level.

Of course, if any assumptions I am making are incorrect, then that changes the conclusions.

This blog is sponsored by Cleveland implant dentist Dr. Brad Hylan