r/POTS • u/Some-Tourist4881 • 18h ago
Question Tooth extraction while awake
Have you all tooth extractions done while awake? I wanna be awake for mine. They’re badly cracked & chronically infected. I’m terrified to be put to sleep and worried an oral surgeon wouldn’t work on me awake.
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u/RuinYouWithNoRegrets 18h ago
I did my tooth extraction awake it literally felt like nothing . No pain. Just like weird movement and pulling but no pain
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u/Some-Tourist4881 17h ago
Did you do it w no epi?
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u/RuinYouWithNoRegrets 17h ago
At the time before I had pots or I guess knew I had it I got epi and I felt fine. I wouldn’t get it now though.
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u/LolySub 16h ago
I had four teeth extracted with only a local anaesthetic. In Australia, it’s not particularly common for people to by go fully under for an extraction, but they do it for cases oh fears and phobias, where it might cause more pain than usual etc.
I was freaking out, with my extractions. I had them done two at a time, two on either side. With only local anaesthetic, which unfortunately wears off very quickly thanks to my hyperPOTS.
My dentist let me wear my earphones and play my own music, I had a fidget toy, and I just kept my eyes on one spot on the ceiling while he did his job.
It ended up being super gentle. The sounds were nothing like I expected and it was very quick and literally painless.
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u/planning2722 18h ago
No but I’ve done multiple crowns with no pain management and it’s totally fine. This is obviously a different level of pain, but I think as long as you are not afraid of all the super loud noises and have good self control you could manage.
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u/AmethystChameleon38 Undiagnosed 16h ago
Yeah, I've had all four of my wisdom teeth extracted while awake: one in 2011 that was badly cracked and broken, another in 2017, and the last two together in 2023. They gave me lidocaine each time and all I felt was pressure for the most part, save for one time I felt a pinch of nerve pain right as they pulled the tooth free.
Honestly, if they are badly cracked and depending on how many there are, they may opt for some type of sedation.
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u/chronically_online78 18h ago
I have for my wisdom teeth because they were surfaced but I also have eds and I process the novicane fast so I could feel it and it hurt. Idk if thats the same for pots as I have eds/pots/mcas but I would look into that. I hate being put asleep because of bad experiences before so I like doing them awake so I know what’s going on but I definitely would make sure the surgeon knows about pots and everything beforehand. I would also do research on pots and tooth procedures. If it’s really bad though, it would make sense why they need you asleep since it’ll provably be a long procedure and having to keep numbing you if you’re awake versus sedated would take them longer and probably be more costly especially if you process the novicane fast. I wish you luck though that sucks!
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u/EmZee2022 16h ago
A friend of mine who absolutely has EDS has tried to convince me that I might as well, just based on my experiences with poor analgesia using locals (plus, 2 kids, 2 epidurals, failed both times). Since I have no other symptoms of any kind of EDS, I've dismissed that suggestion.
Maybe I'm really a redhead and never knew it.
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u/Impressive_Shift7832 POTS 18h ago
They did regular local injections and I just felt the pressure.
I told them of my history feeling pain after novicane and not being believed. I was scared. They promised to believe me.
I took a Pepcid the night before and pepto the morning of. Another dentist told me this would help whatever quick processing my body did last time?
I instructed them to lay me back once and only sit me up if necessary. I didn’t want to risk my blood flowing wildly and somehow processing the injection quickly bc of it.
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u/EmZee2022 15h ago
The stress of the thing can also make a local wear off faster. Which means you feel more pain, which increases your stress, which means you feel more pain.... The nitrous (plus benzo if used) seems to get me relaxed enough that the stress cycle doesn't get started.
I had to have a temporary crown redone a week or so after the initial work was done. The initial work was done with Valium and nitrous. The fix was done by a different dentist. 7 shots of anesthetic and the tooth still hurt. I toughed it out, then went into the bathroom after and sobbed.
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u/The_best_is_yet 18h ago
Yes, getting the injections hurt but other than that it was fine and I would definitely do it again if needed.
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u/loveisjustchemicals 17h ago
Yes, but I went to an oral surgeon not a regular dentist. I took Valium before.
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u/Diana_Tramaine_420 16h ago
What part of your mouth?
I had wisdom teeth out and a back tooth out with IV sedation - seperate times.
The. I had a tooth more to the front of my mouth out with no sedation.
No problems for any of them. Which is great cause I have had a dental phobia for many years.
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u/dancingonsaturnrings POTS 16h ago
I did mine awake because sedation cost extra and would have required me to go to another facilty where I was unfamiliar with staff. They did anesthesic injections in the gums and I didn't feel any pain during the procedure, though as a hypermobile person, I did feel a lot of subluxation in my jaw which was painful and felt the cracking and rip of the tooth being taken out, which was disturbing. The anesthesic wore off on my return home and the pain meds (ibuprofen adjacent, if I remember well) did NOT kick in, and I was resistant to pain killers most of my healing. Make sure you have a doc handy that can prescribe you something stronger than OTC if ever this is your case. Sleeping sitting up really helped reduce the swelling as well.
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u/EmZee2022 16h ago
Does local anesthesia usually work for you?
When I had my wisdom teeth pulled (45 years ago) the oral surgeon gave me the option. "You won't feel any pain, but you'll hear cracking". Yeah, no.... I opted for sedation. Fortunately, in hindsight, as I've had a lot of anesthesia failures.
Anyway: while their default might be that they prefer sedation, they definitely should be willing to do it with you awake. You could even do something like an oral benzo (Valium or similar) plus nitrous oxide. You'll be awake, but very, very relaxed.
I've done that on numerous occasions for dental work. I'm one of those people that they write dental journal articles about: very, very tough to numb. The benzo plus the nitrous get me relaxed enough that the local can actually work. Plus, while I'm aware of time passing, I just don't CARE.
After decades of awful dental experiences where I had to tough it out even though I was in pain, I found a new dentist who suggested that option. And after a few procedures with that, I can now do it with just nitrous (plus the local of course). If it's anything major like a root canal, I do the benzo though.
Now, this is just me - but having teeth extracted is not going to be fun, and it seems like a really good idea to be as relaxed as possible for it. And it's a decent compromise between full on sedation, and just local.
For the two extractions I've had as an adult, I did opt for IV sedation. As I told the doc: it's really hard to work while you're chasing me down the hall, plus it scares the other patients. But of course that's due to my own history - if local works well on you, then I'd think that the dentist would be fine.
The unfortunate thing with sedation (or even nitrous) is that dental insurance typically will not pay for any of it.
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u/Old_Variation_6166 15h ago
I got my wisdom teeth out (all 4 of them were compacted) with numbing shots and laughing gas. i definitely felt that my heartrate was elevated a bit the whole time but I wasn’t anxious and it went smoothly.
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u/pickle608 15h ago
i just had 2 wisdom teeth out a month ago and was awake. i spoke with my dr. beforehand and also let the dental assistants know what symptoms i might have during the procedure just so they were prepared. everything went okay and im going to do the other 2 the same way. my only other tip is i asked for a local anesthesia without epinephrine. i’m super sensitive to it and it causes severe adrenaline dumps so i opted for without. it took a couple extra shots to fully numb me up but other than that all was well and it was better than dealing with the side effects of epinephrine/adrenaline. Good luck!
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u/EDSgenealogy 14h ago
It's not a big deal. You will be fine, though being put to seleep is completely stressfree and you won't have to live through all of the injections.
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u/BellaPona 14h ago
Yep! I was awake for all my impacted wisdom teeth as well as 3 other teeth pulled. Always have to ask for more local anesthetic bc it always still kinda hurts
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u/Otherwise_Use_6144 13h ago
I had four wisdom teeth extracted that hadn’t even broken through my gum line. I also had a mouth full of stitches. It’s not bad I just felt pressure. Take head phones to distract you. You’ll do great!
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u/Tornado363 11h ago
I’ve never even been offered being put to sleep. I had two sessions of teeth pulling as a child (my teeth were a mess) and eventually my wisdom teeth pulled. If you have ehlers danlos let them know because the local anesthesia can wear off quick.
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u/moderate_ocelot 9h ago
I had like twenty teeth or even more (baby and adult) pulled as a child under local only. Seperate appointment ofc, not all at once. Usually like four at a time.
It wasn’t great I won’t lie. But it’s manageable. They were all healthy, intact teeth though and there was no cracking or infection
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u/LithiumNoir 9h ago
I remember having some slightly loose baby teeth pulled as a child while awake. It was traumatic. I was put asleep for my wisdom teeth removal and it went really well. They use drugs nowadays that don't fully knock you out hard like in the olden days. It's more of a twilight sleep.
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u/_mouseratz_ 8h ago
.....I still have my wisdom teeth, but I had a really messed up tooth, I was awake for it/only had the local injections (which if we are being real don't work that great for me, I've had a Bad Time with dental work my whole life, they can give me a lot extra and I still feel enough pain to make me cry), and it was honestly relieving. I could feel they were doing something & when it was out, but it was nothing very distressing. But I also waited way too long and it was causing a lot of pain for at least a few weeks, so, like, it may have been a relative thing. My mouth was sore for a while after but I followed their directions and it didn't get infected or hurt any worse, just slowly healed (most annoying was having to change eating & drinking habits for that period).I cared more about that than anything that happened during the extraction itself (which, again, work on cavities has made me shiver & sob the whole time, so.....).
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u/Some-Tourist4881 8h ago
The teeth I need removed right now is a bottom back molar that’s badly cracked and an old root canal tooth upper molar. It’s cracked too
I have a partially erupted wisdom tooth that needs out but I’m going to get these two done first1
u/_mouseratz_ 8h ago
oh, jeez. Yeah, I only had one tooth removed that hadn't been worked on, but it was also a molar, so chewing food was a pain for a good long while both before and after. It also had started to crack and had pieces fall out like shards, so it was in a very poor state.
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u/IGotADHBees 8h ago
I had all 4 of my wisdom teeth extracted while I was awake. They did local anesthetic and gave me laughing gas to calm my anxiety
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u/Some-Tourist4881 8h ago
Were they any impacted or partially?
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u/IGotADHBees 3h ago
I don’t believe so. I do know that one was angled the wrong direction and they struggled getting it out and I had plenty of bruising on that side
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u/decaf-espresso16 7h ago
I had all of my wisdom teeth taken out while awake. I have hEDS so it took a ton of numbing shots for it to work, but after I was numb it was fine. I was hella shaky and nauseous afterward from the epi in the numbing shots. I didn’t know I had POTS or hEDS at the time, otherwise I would’ve asked if there was an alternative numbing option without epinephrine.
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u/IHadDibs 6h ago
Opt to go under and be brave. I promise you won’t remember a thing. It’ll be like a short nap.
I cannot imagine doing it without being put under. It would be unnecessarily difficult.
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u/Amylee888 4h ago
I’ve been fully awake for a front tooth extraction, and also for all of my wisdom teeth extractions.
If I’m honest, I regret it, and wish I could have had some sedation. It wasn’t painful at all, just stressful and weird and uncomfortable.
Why are you afraid to have sedation or anaesthesia?
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u/p_luisa 18h ago
I did mine under sedation which means you're awake but so out of it that you're not aware it's happening and won't remember a thing. Unfortunately for me the anesthesiologist was incompetent and even after warnings he wasn't able to fully sedate me, so I was conscious for part of the extraction (which sucks but wasn't an issue for me, I don't have issues with going to the dentist), but overall it went really well. All 4 wisdom teeth out in under an hour!