Sedation Dentistry for Four Teeth Extractions in the name of #ABetterMay

My Instagram followers are the most supportive group of moms I've ever known! Thank you for the outpouring encouragements. I apologise for not being able to reply to you on extraction day because I was mostly on autopilot mode after worrying myself crazy about sitting on that foreign dental chair. Oh the aftermath wasn't what I feared most because I know I will deal with whatever pain that comes knocking at my jaw. That dental chair is a terrorising sight. For me at least who has Dentophobia. I know the fear is irrational but I couldn't block it away. I found new courage to dental appointments after my experience with Pure NZ Dental but this time, my review was with a Dr SL Chan, whom I've never met before. 

Dr Chan was recommended by Dr Justin as one of Singapore's best. When I heard that, I knew I will  be expected to pay a fee at Singapore's highest too. 

"Why can't you do it for me Dr Justin?" I questioned.

A COMPLICATED CASE

An X-Ray showed that my teeth situation was in a lot of trouble. Not only was my wisdom tooth in a lying down position, I had a nerve line running across it! That meant there is a possibility of permanent nerve damage should I have it extracted.

To think 10 years ago a dentist I saw was ready to have all four of my wisdom teeth extracted without picking up on that nerve line! I did engage that dentist's [I cannot remember who I went] services and he proceeded with my left lower wisdom extraction first. It was such a traumatising experience hearing him saw, feeling him pull, bearing the pain even though he had given me local anaesthesia three times and listening him rant, "Wah. This is supposed to be straight-forward. Why is it so hard to remove? Sorry, change plans." Thank goodness I told him to stop at that tooth because I was in so much distress! This experience with him made me stopped visiting all dentists even for scaling the next eight years.

Imagine what might happen if he started with my right wisdom tooth instead. My cheeks, lips and tongue would probably be "paralysed" today from nerve damage.

Dr Justin, our family's resident dentist, was not going to take that risk. He took the extra mile to have my scans sent to Dr Chan of Aesthetic Recontructive Jaw Surgery Pte Ltd for a discussion. The next thing I know, I was booked in for a chat with a dental specialist who owns a wealth of experience under his belt. "If you go to Dr Chan, I know you will be in good hands." assured my dentist.

WHY AM I EXTRACTING MY TEETH?

All these teeth extraction business came about when my right [lower] third molar started trapping food in between itself and my sleeping wisdom tooth. It came to a point where I found it hard to clean my teeth and resorted to ugly ways like running my finger deep into my cheek to have it scrapped off with my fingernails. I know right? No public image but I didn't care. That trapped food was more irritating than my husband shaking his legs. I wanted that wisdom tooth out to prevent an impending tooth decay.

So really, I doing this in the name of good oral health.

APPOINTMENT DAY WITH DR SL CHAN

I was every ready for this appointment. In fact, I was determined to get the extractions done on consultation day. I had procrastinated for far too long [could have done it when I was 16] about getting my teeth braced up and this 2018 #ABetterMay project gave me added courage to move forward on this.

Then people, well-meaning I know, started sharing with me about my over-confidence on pain management.

"You will need someone to pick you up on surgery day"
"What in the world are you thinking? How can you bring the children back from school after sedation?"
"You will be on liquid diet for the whole week! Don't even think of eating proper food."
"Oh the pain. It is going to hurt like crazy."

With that, I started to panic.

Upon arriving at the dentist's office, I psyched myself up to stay cool. However, when the real deal was up, I started to tremble and tear. As they sat me down on the dentist chair to have my IV administer, I fought back my tears to save me from embarrassment. It may be an easy thing for many, but with me wretched with Dentophobia, it was almost misery.

Before we commenced, Dr Chan sat me down to talk through the options. Without a doubt, we will remove the upper two wisdom teeth which are relatively straightforward and a bottom [premolar or canine I have no idea] tooth in preparation for my braces journey with Dr Natalia, an orthodontist at Pure NZ Dental.

Now what did Dr Chan suggest?

1. Remove the wisdom tooth and risk the possibility of a nerve damage i.e. I will feel numbness for the rest of my life  on my lips and tongue on that side. The risk is high.

2. Leave it be and work on it only when the tooth it is pressing on starts to decay [a matter of time].

3. Cut the crown of the wisdom tooth away and leave the root in.

Underneath the gums is a sterile place and the root will be kept safe in there. Besides, there is a chance that the root may move its position out of the nerve line and that would be the perfect time to have it removed if necessary. The downside is, should I get an infection before it fully heals, we will be back to square one. I will have to have the root removed no matter what and the risk of nerve damage remains.

I decided to cut the crown [coronectomy] believing wholeheartedly I have a charmed life and nothing bad will happen to me. Besides, I am supposed to finish two different courses of antibiotics for 10 days. Meyer said I will be a strong woman this week with all the antibiotics in me.

SEDATON VS GENERAL ANESTHESIA

I told Dr Justin that I won't be able to sit through the process with me being awake. The last experience was too much for me to handle. The only possibility I knew was have me on general anaesthesia rather than local anaesthesia. I want to be knocked unconscious.

He shared with me that there is an in-between solution to LA and GA.

Sedation.

Now what is the difference?

Patients under general anesthesia have a complete loss of consciousness. This means that the patient will not feel, hear or remember anything. Disadvantages of general anesthesia are that it may cause side effects, such as nausea, vomiting, headache and a delay in the return of normal memory functioning. Anesthesiologists may sometimes have to deal with severe fluctuations in physiological parameters once a patient is put under general anesthesia.

In contrast, sedation is somewhere between being very sleepy, being relaxed in consciousness, and yet not unconscious. It is given only to relieve anxiety, with very little effect on patient awareness leaving the patient capable of responding to external stimuli (tactile or verbal). As an advantage, the adverse effects that may be associated with general anesthesia are avoided with sedation. Moreover, patients maintain their natural physiological reflexes and are capable of breathing on their own.
[source:-https://www.news-medical.net/health/What-is-the-Difference-Between-Sedation-and-General-Anesthesia.aspx]

I thought it was bizarre that I will wake up not knowing anything that happened. It was as if I was being hypnotised, that a part of my memory will be removed to take away the trauma tooth extractions can put on fearful patients. Oh but I'd rather that then to be totally conscious!

Dr Chan told me I will be feeling sleepy in a minute and advised me to just, Go To Sleep. I responded, "Okay!" but I wanted to resist it to debunk the science. I kept awake! I remember I heard no voices [wow they were very quiet] and felt a little tug in my mouth. With that tug, I remember curling my left leg up to put my foot on the chair because it makes me feel more grounded and in control. A gentle hand pushed my knees down and I let it be. Then a tap on my shoulder, "You are done." and I opened my eyes with a smile.

So hey! I did remember what happened! I looked at the time and it was an hour later. So no I didn't remember anything that happened except that five second experience of a tug in the mouth and a raised knee!

Amazing this sedation business? Dr Chan told me if he asked me to open my mouth wider during sedation, I will be able to respond. However, I remember none of that. I heard no one talking nor  clinging and clanging of instruments. I failed at fighting science *haha*

I walked out of the room and my husband came just in time to pick me up. I teared as soon as I saw him, not because I was in pain but because my comfort had arrived.

THE PAIN

What pain? As I write this on Day Two of surgery, I haven't popped any painkillers other than the ones given to me before the extractions at 1030 hours. Everyone told me, "Oh it's [the pain] going to kick in but it will all be worth it."

Time check: 1600 hours and the numbness on my cheek had worn off. I still felt no pain. Only when I went to drink a sip of warm water did it hurt a little. Otherwise, it was so manageable, the packets of mandatory painkillers and back-up painkillers were left untouched! I found that rather odd because I remember very clearly I suffered bad from many of my surgical removals due to overcrowding. My mother had to prop me from my bed to feed me porridge back then.

Yes there is a little swelling and ache on that wisdom tooth that went through the coronectomy. However, I am extremely surprised that my three other extractions returned no pain whatsoever!

By nightfall, I was singing CarAoke on the drive back from dinner with perfect diction!

Dr Chan, a leading Singapore Dental Surgeon at Aesthetic Recontructive Jaw Surgery Pte Ltd. His workmanship is top-notch. 

I now understand why I paid S$3000 [of which, a portion will be claimed from Medisave] for his services and I will not hesitate to return to him again for future complications because some money is worth the assurance.

Some costs you might find helpful if you need to see a specialist for complicated cases:
Consultation: S$150
Coronectomy: S$1000 [for cutting that wisdom tooth]
Wisdom Tooth Extraction: S$500 each [uncomplicated]
Normal Extraction: S$150

So now what! With a hole in my set of teeth, should I implant a gold tooth to fill that gap? *haha* [no lah... we are making space in preparation of braces]

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