Concerns About Wisdom Tooth Extraction: Risks, Costs, and Anesthesia Options

Q: Concerns About Wisdom Tooth Extraction: Risks, Costs, and Anesthesia Options

Hello： Based on what you mentioned, you have a strong fear of dental visits. <br>I strongly recommend that you go to the oral surgery department of a medical center for tooth extraction under general anesthesia, and express your desire to be hospitalized for observation post-surg

The lower right wisdom tooth appears to have a cavity, and it has not fully erupted yet. I also have questions regarding general anesthesia for tooth extraction and related concerns?

Excuse me, doctor.
My wisdom teeth have mostly come in.
Previously, I observed that my lower right wisdom tooth had only partially erupted, and I experienced a feeling of swelling in that area twice, with a year between occurrences.
The first time, the sensation lasted for a day and then disappeared.
It felt very swollen, and there was redness and swelling, but at that time, the wisdom tooth had not yet erupted.
I had a similar sensation when my molars came in, which lasted only about an hour, and a few days later, I saw the teeth emerging.
Since I had heard from others that wisdom teeth can be uncomfortable, I attributed that sensation to the eruption of teeth, and the swelling and redness subsided the next day.
The second time, there was a slight feeling of swelling, which lasted only 1-2 hours, with some redness and swelling, but I still did not see any teeth.
Before the pandemic, I went for a check-up, and the dentist said my wisdom teeth were coming in, with no cavities, just a need to clean the gaps between my teeth properly.
After the pandemic, I was unable to go for dental check-ups.
A couple of days ago, I felt some itching in that area and spat out what seemed to be tiny fragments of a tooth (could it be remnants from the chicken leg I ate that day?).
Upon inspection, I found that the wisdom tooth had only partially erupted, but there was a cavity on that part, with some brown material on it (possibly remnants from the soy sauce egg I had that day?).
I immediately cleaned my teeth to see what was going on.
When I gently brushed that area, it didn’t hurt, and the brown material came off, revealing a white tooth underneath.
Based on the shape and position of the cavity, it was clear that it was not just a simple tooth eruption.
I have been very careful to clean that area, but I have been feeling anxious and worried these past few days.
After brushing my teeth, I even used a toothpick to fill the cavity with toothpaste, which I know is ineffective, just to calm my nerves.
I regret neglecting my dental health while focusing on my studies and work.
I have severe dental anxiety and am very sensitive to pain.
As a child, I had two supernumerary teeth extracted, and even after anesthesia, I still felt pain.
I was held down by a nurse and couldn’t express my pain, which made me dread dental visits in the future.
I would be taken to the dentist by my family, and just thinking about it makes me tremble, sweat, feel weak, and want to cry.
Given the situation with my lower right wisdom tooth, I cannot delay any longer, as I fear it may affect my molars.
I have decided to see a dentist (I really have no choice) to check the condition of my wisdom teeth.
It seems likely that extraction will be necessary.
However, I am afraid of the treatment and local anesthesia, which might make me nauseous, so I am considering general anesthesia for the extraction.
My wisdom teeth on the left upper and lower are normal, while the lower left is angled and has not erupted but is pushing against the adjacent teeth (without any sensation).
The upper right is fully erupted, while the other two have only partially erupted.
I would like to ask the doctor, what are the risks of general anesthesia? Is it fully out-of-pocket (I’ve heard conflicting information about this)? What is the estimated cost for extracting all four wisdom teeth? Is sedation treatment only available at clinics? Will the extraction take a long time? How many days would I need to stay in the hospital? My teeth are relatively large, and I’m unsure about the length of the roots, as the dentist did not mention it.
I also suspect I might have periodontal disease since my father has it.
I am feeling very anxious, but my lower right wisdom tooth does not hurt.
I am afraid that if I don’t quickly seek information and force myself to make an appointment, I will end up not wanting to go to the dentist again and delay treatment.

Jing, 20~29 year old female. Ask Date: 2021/09/30

Dr. Lin Jiayong reply Dentistry

Hello: Based on what you mentioned, you have a strong fear of dental visits.
I strongly recommend that you go to the oral surgery department of a medical center for tooth extraction under general anesthesia, and express your desire to be hospitalized for observation post-surgery.
Regarding the costs (tooth extraction is covered by health insurance, while general anesthesia is usually out-of-pocket), it will depend on whether you meet the criteria for special status.
It is advisable to discuss this with the dentist who will perform the extraction.
Sincerely, Lin Chia-Yung, Department of Dentistry, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2021/09/30

More Info

When it comes to wisdom tooth extraction, there are several factors to consider, especially if you have a history of dental anxiety and sensitivity to pain. Your concerns about the risks, costs, and anesthesia options are valid and deserve careful consideration.

Risks of Wisdom Tooth Extraction
The extraction of wisdom teeth, particularly those that are impacted or positioned awkwardly, can carry certain risks. These include:
1. Nerve Damage: If the roots of the wisdom tooth are close to the inferior alveolar nerve, there is a risk of temporary or permanent numbness in the lower lip and chin.

2. Infection: Post-operative infections can occur, especially if proper oral hygiene is not maintained after the procedure.

3. Dry Socket: This painful condition occurs when the blood clot at the extraction site dislodges or dissolves, exposing the bone underneath.

4. Sinus Issues: For upper wisdom teeth, there is a risk of creating a communication between the mouth and sinus cavity, which can lead to sinus infections.

Given your history of dental anxiety and sensitivity to pain, it is crucial to communicate these concerns with your dentist or oral surgeon. They can provide reassurance and discuss pain management strategies.

Anesthesia Options
There are generally three types of anesthesia used for wisdom tooth extraction:
1. Local Anesthesia: This is the most common method, where the area around the tooth is numbed. However, if you have a strong fear of dental procedures, this may not be the best option for you.

2. Sedation Dentistry: This involves the use of sedatives to help you relax while remaining conscious. It can be administered through oral medications or nitrous oxide (laughing gas). This option can help alleviate anxiety and discomfort during the procedure.

3. General Anesthesia: This is often recommended for patients with severe anxiety or those undergoing more complex extractions. Under general anesthesia, you will be completely unconscious and unaware of the procedure. While this option is generally safe, it does carry some risks, including respiratory complications and reactions to the anesthetic. It is essential to discuss your medical history and any concerns with your anesthesiologist.

Costs and Insurance
The cost of wisdom tooth extraction can vary widely based on several factors, including:
- The complexity of the extraction (impacted teeth may cost more).

- The type of anesthesia used.

- The geographical location of the dental practice.

In the United States, the average cost for a single wisdom tooth extraction can range from $75 to $300 for a simple extraction and $225 to $600 or more for an impacted tooth. If you are considering extracting all four wisdom teeth, the total cost could range from $300 to $1,500 or more, depending on the factors mentioned above.
Regarding insurance, many dental plans cover a portion of the costs associated with wisdom tooth extraction, especially if it is deemed medically necessary. It is advisable to check with your insurance provider to understand your coverage.

Post-Operative Care
After the extraction, it is essential to follow your dentist's post-operative care instructions to minimize the risk of complications. This includes:
- Taking prescribed medications as directed.

- Avoiding strenuous activities for a few days.

- Maintaining a soft diet and avoiding hot or spicy foods.

- Keeping the extraction site clean to prevent infection.

Conclusion
Given your anxiety and the potential complexity of your case, it is highly recommended to consult with an oral surgeon who specializes in wisdom tooth extractions. They can provide a thorough evaluation, discuss the best anesthesia options for your situation, and help you understand the costs involved. Remember, addressing your dental health is crucial, and taking the first step to seek treatment is commendable. Don't hesitate to ask questions and express your concerns during your consultation; a good dental professional will be more than willing to help you feel comfortable and informed.

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