I need a dentist's opinion please....
 

My dentist referred me to an oral surgeon to extract a tooth as it has a lot of filling with the filling being close to the nerve.nApparently it is not a candidate for a root canal. Oral surgeon required a dental medical which I have done because I have atrial fibrillation, high blood pressure and am on blood thinners. They want to know if I can handle being put under with the anaesthetic. There is a risk of a stroke.

So my question is this. Can a tooth be extracted with lots of freezing in the gums? I am thinking that if the tooth breaks apart then it could be traumatic getting the shattered tooth remaining out?

I will likely see the oral surgeon this week. Minimal pain from the tooth. Anybody experienced this and what were the options?

As always thanks for your opinions.
Cheers, Guy

I'm not a dentist, but I've had a similar experience.
I cracked a tooth, and apparently the crack was too deep for a root canal / crown.
My choices were to wait two weeks for an appointment to extract with a local anesthetic, or wait six weeks for an appointment for a sedated removal. I wanted that sucker out that afternoon, but such is the state of the local oral surgeon availability. I got the local, the roots of the tooth were curled around pretty good, so the doctor cut the tooth into a couple of pieces and pulled each with one or two roots. I don't remember exactly. They gave me headphones and I concentrated on the music, not what was going on in my mouth.

Bonus. Didn't have to get wheeled out in a wheelchair, and I was allowed to drive myself home.

You will eventually need to stop taking your blood thinners to allow the dental work is my understanding, thus the stroke risk increases. Your now saturated with a daily thinner med. Over time it leeches out enough to change your blood profile over time. Then your bleeding can have normal coagulation.
Minimal downtime from the heart meds would be the goal.

Thanks for this. It is what I wanted to hear. A local anesthetic would be my choice and a set of earphones. I will run that by the oral doctor and see what he says.
Cheers, Guy.

Hope it goes well, Guy!

Thanks Steve. Both my parents had false teeth by the time they were thirty years old. To have most of my original teeth in my seventies is a bonus.

Hopefully Ted it won't come to this point if I have a local anesthetic. I will do what the doc says.
Cheers, Guy

I had a cracked tooth removed a year ago. The dentist was going to replace a crown that failed but the tooth cracked in between getting the temp and permanent crowns. It was really the worst pain I have endured. The oral surgeon got me in and tried to numb me with local injections but the tooth was infected and they couldn't get me numb, so I went under a general. If it is not infected, they should be able to do it with just a local. If you are not in a bunch of pain, they may put you on antibiotics prior to knock down any infection so the local is more likely to work.

I don’t know if I was under local or general when I had my cracked tooth removed. I could sense the surgeon working away, but I wasn’t fully asleep and I felt no pain. I understand general means you are totally unconscious but I dunno.

Good Day Guy,

I’ve been a dentist for 30+ years and taught full time at USC Dental School.

First, I salute your general dentist’s caution and desire to ensure you can withstand the procedure. It is very common to get a MD referral when doing more extensive procedures.

You ask if the teeth can be extracted “with lots of freezing of the gums.” If you mean literally freezing the area for anesthetic I would say no. There were some studies on this but I don’t think they proved effective.

If you mean a lot of local anesthetic (numbing the area and NOT putting you under general anesthesia) . . . .yes that is possible, but can be more stressful for the patient (and doctor.)

If the tooth breaks apart, that is a setback, but oral surgeons are accustomed to this situation and can handle it quite adeptly.

The biggest concern I would say you have is the issue of your blood thinner. Your MD needs to coordinate with the Oral Surgeon so when your tooth is extracted you will be able to get the initial clot. Usually they have you stop the blood thinner a set time before the extraction, and resume taking it a set time after the extraction.

They want you to be calm, relaxed and comfortable for the procedure and have the ability to clot afterwards.

Best of luck to you

Raffi

Thanks all for the advice. Yes Raffi your points are well taken. I had the large tooth extracted yesterday by local anesthetic. To be honest I was dreading it but the experience was not that bad. My head was covered by a towel of some sort. The oral surgeon told me what he was doing. It seemed what hurt the most was the local anesthetic but it was minimal discomfort. The tooth being about seventy five years old took some persuasion to come out.

The doc said I will likely be back to get another removed. Too much filling. Virtually no pain after the freeze came out. A bit of bleeding after. Thanks again all of you for your suggestions and support!:)

Cheers, Guy.

Glad to hear that went well. Thanks for the update!

I had a cracked molar pulled a year or so ago. The dentist said it wasn't infected so he could do it right then. A local freezing, same as for a cavity, and the tooth was out.

I got a good chance to observe the pulling tool and it looked like it grips the whole tooth and tightens the grip on the tooth as he grips the handle.

Mine clotted up good and within 2-3 days it felt like normal.

I, too, had a similar experience. I don't know what the surgeon gave me, but I was able to drive myself home. I was aware of the hammering and yanking on the tooth to get it out. He told me the first half came out easy, but the other half was a bear.


https://forums.pelicanparts.com/off-topic-discussions/1170917-broken-tooth-but-i-got-lucky.html

(not a doc here but just relating experience..so just opinion..YMMV..not all heart issues require the same strategies)

Those meds are band-aids.
Other natural band-aids which might be worth noting are getting enough water, potassium, magnesium, D3, VitaminC.
Walking at your own pace is perfect excercise.

A good BP machine will show when you're off if you don't already feel it. Some are pure junk. Write it down on a chart. Smart watches can do the same thing and call paramedics with a fall.

Cadioversions (shocking the muscle) seem to be useless long-term. One older relative with half a dozen. One with over a dozen.

Ablation (burning a small area of heart muscle creating conflicting rhythm using a probe inserted up through leg) seemed to finally work. You want a good facility and doctor who's done plenty of them.

Metoprolol/Dofetilide polished it off and worked for a relative personally. YMMV. She's made it half a decade plus past a few sure near-death points in life. Some meds involved had a great negative effect and she replaced them. Never be ashamed to call up and say "this isn't working". You are doing them a favor.

Wishing you a good outcome. To give you some solace, I also have AFIB, take blood pressure and diabetic pills as well as zomig injections.

My point? I had all these meds and more pumping through me when I had my emergency spinal surgery, fusing my C3, C4, C5, and C6 together. Hey, I'm still here...:)

The most obvious point is there's a direct relationship between dental hygienics and heart conditions: Bacteria in the bloodstream.
So use mouthwash and occasionally hydrogen peroxide before brushing on a regular basis.

Cut out sugar/starchy foods at least a few hours before bedtime, so you don't sleep with a mouthful of bacterial waste.

Drink more slightly acidic drinks at night. Teas without caffeine. Plain water w/lemon will always work.

I am not a dentist but am getting an extraction of a molar next week. I am about your age, have some of your health issues and the original request by the dentist was to use anesthesia....which I do not like.

After discussion, we are going ahead with just using novocaine - lots of it - and I have deep roots in my teeth.

I am not too worried as I have 7 implants, all of which had the original tooth extracted without anesthesia. it hurts, you neck will be a bit sore and its no fun......but all of them came out with zero issues and tolerable pain.

My best friend is also my dentist and he fully supports what I am doing - he has treated me for over 35 years and I have a full mouth reconstruction - every tooth in my mouth is either an implant or crowned....so lots of experience in the dentist chair.


I would say go ahead without anesthesia as anesthesia also has risks.

D.

I have a similar situation, a cracked upper molar. Too close to the sinus for my dentist to be comfortable, I'm off to the oral surgeon in two weeks.