Wisdom teeth removal
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Anonymous
| It's opioid people. |
Anonymous
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In most third world countries kids never get any anesthesia to get the tooth out and no post op painkillers, they are doing just fine.
Nobody much complaint, this is what it is. They use only some kind of herbal tinctures in place for antibiotics to prevent any infections and still fine. It is hard to believe but when you look at this, humanity as such survived without opioids till 1990s. |
Anonymous
Yup. |
Anonymous
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Are dentists hooking patients on opioids?
https://www.marketwatch.com/story/are-dentists-hooking-patients-on-opioids-2018-12-05 A new study says patients getting the painkillers for wisdom tooth extractions face increased abuse risk "Wisdom tooth extractions might lead to more suffering that could, in theory, last years. That’s according to new study that says the procedures may end in opioid abuse for some patients. The study released this week found an almost 7% increase in the risk of persistent opioid use after reviewing 2015 prescription records for dental patients between the age of 16 and 25. “The findings suggest that a substantial proportion of adolescents and young adults are exposed to opioids through dental clinicians,” the JAMA Internal Medicine study said. “Use of these prescriptions may be associated with an increased risk of subsequent opioid use and abuse.” Monday’s study is another reminder on the risks related to the painkiller medication. Last week, the Centers for Disease Control and Prevention said opioid abuse was partly to blame as average American life expectancy edged down to 78.6 years in a third year of slight average life expectancy decreases. The CDC noted two-thirds of the 63,632 drug overdose deaths in 2016 involved opioids, which include heroin, fentanyl and oxycodone. The latest study started with a data set of almost 750,000 people aged between 16 to 25, which happens to be around the time wisdom teeth become a problem. Within that group, nearly 13% of the patients received one or more opioid prescriptions. When patients received the powerful painkillers, dentists were the ones writing the prescriptions in 30.6% of the cases. The study scrutinized 14,888 patients who received opioids through dental work, and compared them to a group double that size, which didn’t get the painkillers. Dr. Alan Schroeder, the study’s lead author, said the findings left him with questions about the amount of opioids prescribed and why so many wisdom tooth extractions were happening at all. Patients with the painkillers received about 20 pills on average and such a large number could tempt misuse or diversion of unneeded pills, he said. Schroeder, an associate research chief in the pediatric hospital medicine division at Lucile Packard Children’s Hospital Stanford, credited dentists for reducing their opioid prescription amounts over time. Still, he added, “I think we have a lot more work to do.” Here’s what they found: • 6.9% of the group with received a subsequent opioid prescription in the following 90 days to a year. Before their first prescriptions, they didn’t have any record of opioid us in the preceding 12 months earlier. By contrast, just .1 % the control group ended up with an opioid prescription in the same timeframe. • 5.8% of group exposed to opioids then had at least one encounter with medical providers who gave an opioid abuse–related diagnosis. The same thing happened for a mere 0.4% of the control group. Researchers acknowledged the study used diagnosis codes, so some misclassification could have occurred. Also, as with all studies, it’s difficult to distinguish between correlation and causation. Dentist have been giving fewer opioid prescriptions in recent years, according the American Dental Association. Responding to the JAMA study, they noted dentists wrote 18.5 opioid prescriptions in 2012. Five years later, they wrote 18.1 million prescriptions. “This is progress, and we know there is still more we can do,” the ADA said. The dental association said more research supports its policy of advising dentists to prescribe other medication rather than opioids. “The ADA continues to be dedicated to raising awareness and taking action on the opioid public health crisis,” the group said. Nevertheless, they said more attention was needed for the links between wisdom tooth extractions and opioids during postoperative care. The good news: Efforts are being made to cut down on opioid prescriptions. The CDC said opioid prescription rates have been decreasing since 2012; still the potency remains three times higher than prescriptions in 1999. As for younger patients, research last month said medical professionals have halved their opioid prescriptions to children and teens between 2012 and 2017." . |
Anonymous
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My older child had his wisdom teeth out when he was about 18. They didn't "need" to come out, but the prevailing wisdom (ha) at the time was just to have them removed to prevent future crowding.
I now have another child who is 19 and the dentist is saying they don't automatically take wisdom teeth out anymore, unless there's an actual problem. My feeling is I would rather have them removed *before* they become a problem - one is out but the other three are impacted. So far, only the one that's out has been a little sore, but he says the other three don't bother him. Anyone have any advice as to remove/not remove? |
Anonymous
| Opioid, schmopioid. The small amount of lemonade Tylenol 3 that gets prescribed "as needed" for the first day or two after extraction is hardly heroin. Legitimate narcotic prescriptions are not a problem. Huge amounts of Chinese fentanyl is a problem. People filling dozens of scripts for hundreds of pills is a problem. The same people who will cast aside any notion that marijuana is a gateway drug are convinced that a couple of not very powerful pain pills to help a patient sleep the first night or two is going to turn the patient into an instant dope fiend. It's just ridiculous. If you don't want the medicine, don't fill the script. Follow the label directions. |
Anonymous
| Oh, and to the "dentist," you might want to look back at that acetaminophen/ibuprofen dosing. The 500g (grams) you recommended is 500 times the standard dose of extra strength Tylenol. It is 1,000 tablets. Acetaminophen is a liver toxin. Might want to check the directions. |
Anonymous
If it is a little sore, ask the dentist. Sore because it is erupting and there is room, no big deal. Sore because it is pushing against the nerve of another tooth, it needs to come out. |
Anonymous
| I had mine out with novocaine only, even though they were impacted. Just listened to really loud music to distract myself. Didn’t want risks or side effects from sedation. Also didn’t take any opioids- they should be more of a last resort IMO. |
Anonymous
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When I had 4 impacted wisdom teeth out at 23 under twilight sedation, I had a phobia of developing opioid-induced constipation and refused to take my Percocet. Instead I alternated 800mg Advil and 1000 mg Extra Strength Tylenol every 3 hours (so Tylenol at 3pm, Advil at 6pm, Tylenol at 9pm, etc). This included setting alarms during the night so as not to allow the pain to get away from me. It worked absolutely fine. The worst I had was a dull headache for a bit. By day 3 I had dropped the Tylenol and started weaning down to a regular dose of Advil.
One caution: I had an atypical infection. It may have started as soon as 3 days after the procedure, but I didn't notice it for almost 2 months because all the information said an infection would be accompanied by fever and terrible pain so you'd definitely know. Well, I had neither of those things, just mild tenderness and swelling that wouldn't go away, but it did not become obvious that something was wrong other than just slower healing at one side until about 2 months in when it started draining pus and I finally realized what was going on. The oral surgeon freaked out. It took 2 different antibiotics to get rid of it. No permanent damage and I was never in serious pain, but don't assume it can't get infected because it's been too long. |
Anonymous
| Besides the opioid discussion, why are all of these wisdom teeth being removed in the first place? Are all of these kids actually having problems or is it a "well they may become impacted..." thing? |
Anonymous
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If the child or his parents have a history of nausea after general anesthesia, that’s something to consider; vomiting after oral surgery is not a good time. That said, there safe oral medicines that reduce nausea. An experienced oral surgeon may even push something through the IV if you mention it as an issue. That said, if DS is really wound up about having his teeth out, general will be the most psychologically comfortable way to go into the procedure.
I had twilight anesthesia. I also had anxiety as a teen. Between being super anxious on the day on the extraction and seeing a MoCo surgeon with a tendency to under-anesthetize his patients (the online reviews explain that I’m not the only one), the twilight did not induce anxiolysis, sedation, or retrograde amnesia. (Fortunately, the novocaine worked.) |
Anonymous
I am following this thread bcs DD is having her wisdom teeth taken out next week. They are impacted as they say. Few months ago, one of her incisors started to move and even get loose. She had braces and all teeth were fixed. And this was on the bottom where she still has an inside metal wire retainer. Orthodontist took an x ray and said that her wisdom teeth are moving her other teeth and getting them loose even. I have one wisdom tooth, don't have the other three, so I also never thought there is a need to do anything about wisdom teeth, but if they are going to cause my DD to lose her front teeth, then yes, she is having problems and they are impacted 100%. WYGD? |
Anonymous
Impaction is not the only issue. My DD's three wisdom teeth (not everyone gets all four teeth) are all coming in perfectly straight according to the x-rays, with no impaction (sideways tilting). But she is fully grown (18), has a small head, small mouth and no room for additional teeth to come in. Eventually they will erupt through the gum (see below...). She also had years and years of braces and other orthodontia done, and if the wisdom teeth stay in, they eventually will crowd the rest of her teeth that we spent a fortune and many years fixing. DD gets her wisdom teeth out this month. Different case: My DH is from another country where they do not routinely take out wisdom teeth and don't even really take them out for impaction unless there's pain or serious issues. His wisdom teeth were fully erupted (meaning: "came in" and were there above the gum line like all his teeth). But because they're so far back in the jaws, they are an utter pain to keep really clean, and he was getting decay there as an adult despite his best efforts. On the dentist's advice he had them removed and it's been far better for him. The dentist said that erupted wisdom teeth in many adults means decay, cavities, even infections in some people. DH had a really easy time with the removal because the oral surgeon only had to pull the teeth--he didn't have to cut down into the gums as is done with unerupted wisdom teeth (which is what's being posted about in this thread). Does that help, PP? |
Anonymous
"In most third world countries" they are not doing wisdom tooth removal, PP. Not sure you understand that we are not talking about simply yanking out a tooth you can see. We are talking about surgery that digs into the gums and possibly bone to get teeth that are not even showing above the gum. Herbal tinctures in place of antibiotics? Are you actually suggesting that we should be fine if we spurn antibiotics? I live in a place where antibiotics are available; are you saying I should instead embrace herbal tinctures to fight a diagnosed infection in my child because it works fine in "third world countries?" No thank you. |