Is it possible to be totally sedated during dental surgery?

talipandas9talipandas9 Bigaon ever... PEx Influencer ⭐⭐⭐
Is it possble to be totally sedated during dental surgery? As in, you are totally unconscious/unaware and won't be able to hear all the drilling that will be done?

By the way, assuming this is possible, how will the dentist keep your mouth open?

If this kind of surgery is possible, who will perform it - a dentist or an oral surgeon (assuming they are not the same - I'm clueless!)? Who do you recommend?
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Comments

  • smilewarriorsmilewarrior Moderator PEx Influencer ⭐⭐⭐
    If you want to be unconscious, I suggest you undergo general anesthesia ( it will be very costly).

    A mouth prop or retractors will be used to keep the mouth open.

    It's the anesthesiologist (a physician) who delivers the anesthesia. If it's surgery, it's usually an oral surgeon who performs it.

    Oral surgery is a specialty of Dentistry.
  • bishopbishop amdg PExer
    i had four oral surgeries before...

    from what i know, di daw pwede unconscious. that's what my surgeon said. kelangan daw conscious.
  • smilewarriorsmilewarrior Moderator PEx Influencer ⭐⭐⭐
    ^^
    Nope.

    Oral surgery can be done under conscious sedation (meaning you're semi-awake) or under general anesthesia. Any oral surgeon knows this.
  • talipandas9talipandas9 Bigaon ever... PEx Influencer ⭐⭐⭐
    Originally posted by smilewarrior
    If you want to be unconscious, I suggest you undergo general anesthesia ( it will be very costly).

    A mouth prop or retractors will be used to keep the mouth open.

    It's the anesthesiologist (a physician) who delivers the anesthesia. If it's surgery, it's usually an oral surgeon who performs it.

    Oral surgery is a specialty of Dentistry.

    How much would it cost? Can you please give a rough estimate?
    Can you also provide the sequence of events that will happen until I get totally sedated?

    Where can I find a good oral surgeon?

    Thanks for the quick reply smilewarrior. You're so reliable when it comes to this subject matter.

    bishop How did you feel during your 4 oral surgeries? Did it take long before you recovered your consciousness/bearing? Did it have an effect on your memory?
  • smilewarriorsmilewarrior Moderator PEx Influencer ⭐⭐⭐
    @talipandas9: Have you visited Dr. Gigi Estrada of PGH?
  • mac326mac326 eating ice for lunch PEx Influencer ⭐⭐⭐
    I had oral surgery before and I was under general anesthesia. May impacted teeth ako and hindi kinaya sa clinic. It was really painful and hindi rin matanggal nung surgeon yung impacted teeth. parang hook shaped na yung impacted teeth kaya it was really hard to remove that's why sinarado na lang ulit yung gums ko. ayun, general anesthesia was necessary.
  • talipandas9talipandas9 Bigaon ever... PEx Influencer ⭐⭐⭐
    Originally posted by smilewarrior
    @talipandas9: Have you visited Dr. Gigi Estrada of PGH?

    Yes, I did attempt to see Dr. Estrada yesterday at the OPD of PGH. My gosh - I didn't know that there was a series of steps before one can see a specific doctor at the OPD. Call me dumb or absolutely clueless on this matter. Besides, the quota was already filled up when I came in the afternoon. Sayang nga eh - libre pala yung consultation.

    Anyway, since I am a dependent on the HMO card of my sis, I tried using it today to see a particular dentist that accepts my HMO card. The dentist evaluated my teeth's condition through visual/ocular inspection only - without the use of dental (periapical or panoramic) xray. She said that I need to have 10 teeth filled and 4 are to be extracted. She told me that she need not pull out the front tooth that cracked and gave way already because my mouth will sag. Is this true? She told me that she will put (or install - I don't know if this is the appropriate word) a dowel (tama ba ang spelling?) What is a dowel?

    I got to ask her every question I had in mind. It's a good thing she was patient. Somehow good things must come to an end when we talked about the price: she told me to prepare at least
    > P50K or more to cover the entire dental procedure that needs to be done assuming I'll be totally sedated. Kaya nga, she was discouraging me because she said the dental OR alone would cost ----> P25K! Tama ba ito?

    When I asked her about the price of the fillings, she quoted P450 if done in her clinic? Is this price okay or too much? I have no idea how much a tooth filling costs. By the way, di ba yung pagpasta hindi naman invasive? Meaning, there are no needles involved?

    By the way, my dental checkup did not end up with just a visual inspection. She gave me a free teeth cleaning to make me feel how a typical dental procedure is done. She was able to notice that I was really too anxious about the whole thing. In a way, I enjoyed the experience - non-invasive kasi eh.

    The hospital facility by the way is ----> St. Luke's Medical Center. Do you think I'll be able to find a more affordable deal in the vicinity of 25-30 K in other hospitals here in Metro Manila?

    Thanks again smilewarrior.
  • smilewarriorsmilewarrior Moderator PEx Influencer ⭐⭐⭐
    "Yes, I did attempt to see Dr. Estrada yesterday at the OPD of PGH. My gosh - I didn't know that there was a series of steps before one can see a specific doctor at the OPD. Call me dumb or absolutely clueless on this matter. Besides, the quota was already filled up when I came in the afternoon. Sayang nga eh - libre pala yung consultation. "

    -It's better to come before 7 am or 12:30 pm, there really are a lot of patients who go to UP-PGH Opd.

    -You could also try going directly to Hospital Dentistry and ask for an audience with Dr. Estrada. She's a consultant there.

    "She told me that she need not pull out the front tooth that cracked and gave way already because my mouth will sag. Is this true?"

    - Yes. The bone that suppports the tooth exists because the tooth is there. When the tooth is removed, the bone shrinks. This can affect how the lip drapes the mouth.

    "She told me that she will put (or install - I don't know if this is the appropriate word) a dowel (tama ba ang spelling?) What is a dowel? "

    - It's like a screw that will be placed inside the tooth. It's needed so that the crown/jacket won't get dislodged.

    *****Will the tooth be root canaled?

    "I got to ask her every question I had in mind. It's a good thing she was patient. Somehow good things must come to an end when we talked about the price: she told me to prepare at least
    > P50K or more to cover the entire dental procedure that needs to be done assuming I'll be totally sedated. Kaya nga, she was discouraging me because she said the dental OR alone would cost ----> P25K! Tama ba ito? "

    - Yes, it's correct. General Anesthesia can cost that much.

    "When I asked her about the price of the fillings, she quoted P450 if done in her clinic? Is this price okay or too much? I have no idea how much a tooth filling costs. By the way, di ba yung pagpasta hindi naman invasive? Meaning, there are no needles involved? "

    - The basic rate for dental fillings nowadays is P500 a surface. A tooth can have 6 surfaces so you can spend from P500 to P3,000 a tooth depending on how big the cavity is and on how much filling material needs to be used.


    - She's undercharging by about P50.

    - When the cavity is very deep, discomfort may be felt. The deeper it is , the more intense the sensation. Anesthesia may need to be placed and that would involve needles.


    By the way, my dental checkup did not end up with just a visual inspection. She gave me a free teeth cleaning to make me feel how a typical dental procedure is done. She was able to notice that I was really too anxious about the whole thing. In a way, I enjoyed the experience - non-invasive kasi eh.

    "The hospital facility by the way is ----> St. Luke's Medical Center. Do you think I'll be able to find a more affordable deal in the vicinity of 25-30 K in other hospitals here in Metro Manila?"

    - No, atleast none that I know of. Even if you go to PGH, special rates are only given if your the type who lives on the streets, can't afford to eat regularly, have no job or no stable source of income. If you get considered as a private patient, you will pay private rates.
  • talipandas9talipandas9 Bigaon ever... PEx Influencer ⭐⭐⭐
    ^^Thanks again smilewarrior for thoroughly replying anew. I really appreciate it.

    So, do you think I'm just being charged fair enough by the dentist from St. Luke's? I have this feeling that I'm being charged this high because let's face it - St. Luke's is known as one of the most expensive tertiary medical institutions in Manila. I was wondering if I could get the procedure done in a hospital like say Mary Chiles, Metropolitan, or Chinese Gen (nope, I'm not Chinese but I live near these 3 hospitals that cater mainly to Chinese patients), if I would end up paying less compared to St. Luke's.

    Could you be kind enough to provide me a private contact number of Dr. Estrada - if you have her number? Modesty aside, I would rather pay her than suffer the inconvenience of going and queueing up at PGH - it just doesn't fit my morning schedule at work. Since you're recommending Dr. Estrada, I would also want to explore this option of having my teeth fixed by her.

    By the way, can I ask additional questions if you won't mind? When I told my mom that most of my teeth need not be extracted but only filled anew, she was apprehensive because she told me that eventually tooth fillings need to be replaced if they get loose. Is this a correct impression? I mean, she's worried that if I'll undergo something drastic like oral surgery, then she suggested that it would be better to have my teeth all replaced by dentures already so that I'll be sure later on that I don't have to worry about loose teeth fillings. Honestly, I was happy to find out that some of my teeth need only to be filled because I still believe that natural teeth is always better than dentures but then again if I will have to worry about my fillings later on, then I'd rather play it safe.

    Regarding the dowel, my dentist gave the same explanation about the need for it so that the lip would not drape over the mouth. If I will be totally sedated, would it be better to have this installed already? How much is a typical dowel? Is it the same as a crown or jacket?

    With your query about it being root canaled, she didn't say so. I think she was wary I'd be worried more if I hear about the dreaded RCT or there's just no need at all.

    Final question: is her examination by visual means enough already? I was expecting she would subject me to a periapical or panoramic Xray to get a thorough evaluation of my teeth. She even asked me how come I know this terms. Siyempre, I told her I researched a lot about it through the internet - including of course your valuable inputs every time - thanks talaga! ;)
  • smilewarriorsmilewarrior Moderator PEx Influencer ⭐⭐⭐
    @talipandas9:
    Yes, you're being charged fairly. As I've mentioned above, she's slightly undercharging, which may be explained by you being connected with an HMO, hence the discount.

    Obviously, things would be different if you weren't going to undergo the expensive general anesthesia. I honestly don't know if the other hospitals you mentioned charge much less.

    I don't have Dr. Estrada's cell number, but you may be able to contact her by landline at : 521-8450, local 5220.

    **Just because you don't have teeth doesn't mean you won't have any problems inside your mouth.

    Nothing can replace the comfort afforded by real teeth. Denture wearers should not be envied. It's the other way around.

    It's really a good idea to do all that you can to preserve your teeth, reserving tooth removal for dire/ extreme circumstances.

    For the dowel with the crown, that would cost somewhere around P15,000 to P20,000. The crown alone would cost from P6,000 to P10,000 depending on the quality of material used. If the tooth needs to be root canaled, that would be an additional P6,000 to P10,000.

    You can always ask her to have your chipped tooth x-rayed for a more thorough evaluation, but expect to pay for the x-rays.
  • pinkrosepinkrose Member PExer
    talipandas9: she's not overcharging. nung nagpa-surgery ako ng impacted teeth last may, i went to 3 different dentists para humingi ng quotes. they all discouraged me from undergoing full sedation kasi magiging super mahal. medyo mura na nga yung dentist na pinagtanungan mo. pero ask ka na rin sa PGH, mababa talaga sila sumingil dun :)
  • talipandas9talipandas9 Bigaon ever... PEx Influencer ⭐⭐⭐
    Thanks smilewarrior and pinkrose for your insights/replies. I really appreciate it. :) If only I could muster the courage to face and endure the dreaded needle at least 4x (because I'll be needing at least 4 extractions), then I don't have to undergo total sedation. Kaso nga lang, talagang pag nakita ko na yung needle, the thought of it piercing my gums - eooowwwww....nooooo.... get me out of here! I guess it's really the phobia for the needle that hinders me.

    By the way, do I have the right impression that for every tooth that needs to be extracted, there's 1 local anesthetic shot that must be aimed at the right spot or else I'll need more than 1 for that specific tooth? Geez....

    smilewarrior Matibay na ba yung fillings na gamit ngayon? Sayang naman kasi kung basta na lang matatanggal di ba considering the huge cost involved?

    What about the dowel with crown? Can I ask my dentist to install it to immediately after all the fillings and extractions are done while I'm still totally sedated? By the way, I know this has been asked before in Misa's thread but will the dowel with crown match the natural color of my teeth or will it be an obvious add-on because of the difference in color? Will I still be able to eat food that are tough (e.g. corn on the cob, chicharon, etc.) if I have a dowel with crown?

    Thanks again.
  • smilewarriorsmilewarrior Moderator PEx Influencer ⭐⭐⭐
    @talipandas9:
    It will the dentist who treats you who can answer all the questions you posted above.

    For the anesthesia, well it depends, but usually it's 1 set of injections per tooth.

    The quality of the materials used will determine whether the fillings will stay or not and whether the crown will match the other teeth or not.

    If you want quality work, you have to be willing to pay.

    Times are hard nowadays, we're all trying to stretch the peso. Despite this, it's not a good idea to go bargain hunting when it comes to your health.

    You can ask your dentist directly how much you'll spend to achieve the results you want.

    If you don't mind, may I ask who's the dentist you visited? If I know the dentist, atleast I can give you assurance that you'll get quality work. If I don't, then you may have to ask other patients of the dentist if they are satisfied with the dentist's work.
  • talipandas9talipandas9 Bigaon ever... PEx Influencer ⭐⭐⭐
    I got to talk to her again this afternoon. The details of the work to be done with the corresponding charges are:

    13 Light Cure - 6,500
    2 Fixed bridge - 12,000
    1 Dowel - 1,500
    4 Extraction - 2,000
    1 Root Canal - 3,000 (4-6 sessions)

    She told me she will waive the 2,000 for the extraction if I decide to have everything done in her clinic.

    Here comes the shocking part of the quotation:

    Dental OR - 25,000
    PF - 10,000
    Anesthesiologist - 50%-75% of her PF
    Room (cheapest ward) - 755 x 2 or 3 days
    Medicines -- ???

    Total rough estimate: a mind boggling P70,000-80,000!!!

    She suggested that probably a psychiatric session could help me since I told her that the greatest hindrance in having the needed dental treatment done in her clinic is my fear of the dreaded needle. Will this be able to help me? I know I should be helping myself on this but let's face it - it's a mind thing I guess at this point in time.

    I got to ask her about the need for the RCT as you posted in your previous post. She checked my front tooth again (the one that cracked) and she said yes. If I elect to undergo total sedation, she will perform the 1st session of the RCT with the succeeding sessions to be done in her clinic. Why can't the RCT be done in 1 session? Gee... I didn't know I will have to endure a lot more pain even though I'll be knocked out already once I elect for total sedation.

    I hope you won't mind if I withhold the name of the lady dentist. I think she's okay in the sense that I'm comforatble with her and she really answers my questions well. Now if only she can do something about my fear of the dreaded needle....

    Thanks again smilewarrior.
  • smilewarriorsmilewarrior Moderator PEx Influencer ⭐⭐⭐
    ^^
    Good luck. All that's really important is that you trust the dentist. With trust comes peace of mind, and this will help you conquer your fear.

    All the fees stated above are realistic and very reasonable.

    "Dental OR - 25,000
    PF - 10,000
    Anesthesiologist - 50%-75% of her PF
    Room (cheapest ward) - 755 x 2 or 3 days
    Medicines -- ??? "

    - even this part is not surprising, it's even more realistic than what you previously posted.

    Added info:
    There is such a thing as "Same Day Surgery" or SDS. It means even if you undergo general anesthesia, you won't get confined in a room after the procedure so it will come out cheaper. You will have someone accompany you home and you'll recover at home instead of the hospital.
  • talipandas9talipandas9 Bigaon ever... PEx Influencer ⭐⭐⭐
    Is sedation through nitrous oxide a safer alternative to total sedation by general anethesia passed through the spine? Another different opinion I seeked from another dentist yesterday suggested that I undergo nitrous oxide sedation to overcome my dental fear.

    Hmm... honestly, I have apprehensions about this because sniffing nitrous could possibly damage my brain. Is this true?
  • smilewarriorsmilewarrior Moderator PEx Influencer ⭐⭐⭐
    I honestly don't know if any dentist in the Philippines use nitrous oxide for sedation. It would be the cost that is prohibitive, as the room has to be specially designed with a proper ventillation system that can remove excess nitrous oxide and the entire dental staff has to be trained with Cardio-pulmonary resuscitation and with the use of equipment for life-saving techniques.

    I'm not saying it's never done in the Phil. I'm just saying I don't know of any dentist personally who does this. I could just imagine how much they would charge.

    Yes, if the level of nitrous oxide is not well monitored, it can cause brain damage. It's actually the dental staff more than the patient who is at risk since they're the ones who are regularly exposed to the gas. I'm an orthodontist, sedation would be better explained by either an Oral Surgeon or a Pediatric Dentist, of which I am not.

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