Rowyn (rowyn) wrote,
Rowyn
rowyn

Surgery

I scheduled an appointment to have my wisdom teeth removed on Wednesday.

I liked the surgeon. He was younger than I'd expected, though still older than I am. I dn't know why I expected him to be a white-haired gentleman. Just the impression I'd gotten from the dentist's office, I suppose. He was friendly and comfortable with the subject.

The wisdom teeth in my lower jaw are pointed sideways. I hadn't realized this. They really are; they're growing directly towards the roots of my other teeth. It was sort of neat to look at the X-ray --- really look at it -- and see this. The one on the upper left side isn't even in my jaw; its roots are up by my sinuses. The one on the right isn't impacted; it's emerged and rotten, and needs to be pulled; the surgeon said I should definitely have it out.

The other three ... the surgeon said that he couldn't -- literally couldn't -- make a recommendation on whether or not I should have them removed. He said it's elective surgery.

They're not causing me any problems now. My mouth doesn't bother me at all. But they are growing sideways. And the older I get, the more likely they are to (a) cause a problem and (b) become more difficult to extract. The biggest risk in this sort of surgery is damage to the nerve running through the lower jaw, which can, in rare cases, result in permanent numbness across the lower lip and chin. The surgeon said he'd seen this happen less than twenty times, usually in people much older than me, out of many thousands of extractions he's done. So it's not a huge risk. But it's the most likely serious complication. In my particular case, the bottom of the root of my wisdom teeth may be touchng the nerve -- or it may not be; no way to say for sure without a CAT scan or, of course, surgery. But from the x-ray, they're on the same plane and barely adjacent, which isn't good, but isn't as bad as having the root entertwined with the nerve, which can happen.

The surgeon said I could schedule to have just three of the teeth removed, so that, if there did turn out to be trouble with the nerve, at least there'd only be damage on one side. He also said that, if he goes in on one side and decides the nerve is too close to the tooth, he can opt not to take the other one out, even if I said I wanted all four gone. He's done that before; it's his discretion at that point.So that's another little safeguard. But if I said I only wanted three pulled, he would only pull three, even if he thought (during surgery) there was no possible complication with the other side. Which makes sense.

The main risks of not having surgery are that the impacted teeth will rot the bone of my jaw; he said there's already been some damage there. And cause gum disease. And possibly abcess. I might live my whole life and have nothing ever happen to me, never even notice that there was a problem. I wished he could give me figures on that. I wish I could know the odds. It's hard to weigh the risks when you don't have figures to work with, But he didn't know. He said, "I'm a surgeon. People mostly only come to me if they've got problems. So of course, I only see the problems."

I scheduled to have all four out on Wednesday. This time of year is very slow for them; most of their patients are students, so once school is in session, business slacks off. This is good, because if it wasn't going to be this week, it would have to wait until April. Lut starts work next week.and I need him to help me with this. I'd considered that I could take a taxi home after the operation, but the surgeon said specifically that I need someone who'll bring me to the surgery, take me home, and stay with me the rest of the day.

They need to use general anaesthesia to do the surgery, which means that I'll take off both Wednesday and Thursday.

Unless I change my mind.

I don't have to do this. They're not causing me any problem now. And while the surgeon is right that, given present technology, it'll be easier to do it now then later ... that could change. Medicine is improving all the time. Maybe in ten years, or thirty, there'll be some easier way to fix the problems caused by impacted wisdom teeth. I don't know that this is the right way to bet, but it's something I didn't consider when I was in the office.

I know that the real risk of surgery is mostly short-term discomfort and complications, and a small chance of permanent nerve damage. But that's not the part that really worries me.

What I'm worried about is dying.

I guess that makes sense, in a way. I mean, dying is certainly more important than suffering nerve damage. but if the chance of nerve damage is tiny, then the chance of death from anaesthesia has to be astronomically small.

...

Well, maybe it isn't; one not-very-scholarly-looking source I found on Google said that in Great Brtain, there were 3 deaths for 35,000 cases of GA for dental work. I don;t know what year that was for. But one in twelve thousand is rather better odds than I really want to have for a thing like "death".

Still. People die all the time, of all sorts of things. Most of the general anesthesia deaths are probably of people considerably older and less healthy than I am.

Hmm.

Actually, I think it'd be conscious IV sedation, and not GA; the surgeon said I'd get nitrous oxide followed by an IV drip.

I should just go ask zaimoni to give me the odds; I'm sure that'd be more effective than me googling for it.

Anyway ... I don't know. Lots of people i know have had their wisdom teeth out. Lut did.

I could wait another six months and do it. It'd be cheaper for me to have it done next year; I've used up a good chunk of my dental deductible for this year already, so I'm paying an extra $180 or so out-of-pocket to do it now. Cost isn't important to me on this, though. Pain and dying and permanent nerve damage, yeah, that worries me. A couple hundred dollars, eh, who cares.

Which is a pity, in a way; I have more control over the money issue than anything else.

Just a matter of what risks I want to take, I guess.
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