Orthodontics - Orthognathic surgery

Orthodontics - Orthognathic surgery > My story > DECEMBER 13, 2007 - The removal of my wisdom teeth

My story

DECEMBER 13, 2007 - The removal of my wisdom teeth

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Note: What follows is not an email that I had sent to my loved ones. It's rather the story of the removal of my wisdom teeth as I remember it. I thought that it would be a good idea to present this story to prepare those who don't know what to expect during their extraction appointment. Let's not forget that my wisdom teeth had completely erupted in my mouth and their extraction was very easy for my surgeon. The procedure could be different from one person to another depending on the location of wisdom teeth and the complexity of the removal.

The week prior to my wisdom teeth removal appointment, I had met with my surgeon at my orthodontist's request. Indeed, my orthodontic treatments were progressing well and she had come to the conclusion that I would be soon ready to undergo my orthognathic surgery. I then had to see my surgeon again for him to evaluate my case once more now that my teeth were a lot straighter. This appointment would also allow me at the same time to ask the questions that I had accumulated about my orthognathic surgery since the beginning of my dental treatments.

My surgeon did his evaluation of my teeth and the position of my jaws and he confirmed to me that I was indeed about ready to undergo my orthognathic surgery. I was also calmer about the idea of undergoing it; I had perceived at this moment that my surgeon was satisfied with my attitude towards the surgery. The idea had matured in my head if we can say so... However, he told me a very bad news! He told me that he had to extract my 4 wisdom teeth!! If I remember well, his exact expression was: "I must remove your wisdom teeth ASAP!" However, my orthodontist had confirmed to me at the beginning of my orthodontic treatments that I would not have to have teeth pulled out! I was then panicked in the examination room, because the idea of having teeth pulled out scared me more than the orthognathic surgery! It was unconceivable for me to get teeth removed!! I don't know how I stayed conscious in front of my surgeon when he told me that!

After explaining to me that he had to remove at least both my lower wisdom teeth, because they were at the exact location where he had to cut my mandible, I figured out well that this removal was necessary. Although my upper wisdom teeth had erupted and they had enough space on the jaw, my surgeon preferred removing them as well. He told me that these teeth cause a lot of long-term problems and since I would undergo an extraction, we might as well take the opportunity to remove them all. I tried to find an easy way out by asking him if he could remove them during the orthognathic surgery and avoid undergoing the extraction while being conscious... He then told me that he preferred extracting them in the near future to avoid complications during the surgery and avoid having to recover from this at the same time as from the surgery. In short, I didn't have a lot of time to soak it all in, because he told me that he wanted to do it as soon as possible to let enough time for my jaws to heal before my surgery; usually, a 6-month delay is recommended, but in my case, all my teeth had erupted and had space, so their removal seemed easy with very low risks of complication. My removal appointment was then one week later!

When I arrived at my surgeon's clinic on the morning of my removal, I told his secretary that I was not too keen on the idea of having teeth pulled out. She told me that everything would go well and that at least, I had had the courage to come to my appointment! It seems like some patients are so scared that they cancel their appointment a few days before the planned date! My husband was with me, because my surgeon didn't want me to drive after the removal. First, I would undergo a surgical procedure, so it was not a good idea to drive afterwards and second, if I had to receive sedation to relax me, I would risk being dozy afterwards and I would have been a public hazard behind the wheel!

My surgeon's assistant installed me comfortably in a room where the removal would take place. My surgeon came to see me and first injected a local anesthesia to numb a good part of my face. I'm not afraid of needles that inject something usually, but I must admit that after a few injections in the mouth, I was looking forward for it to be all over! My surgeon even apologized at some point for "stinging me once more"! One thing is for sure, I didn't feel anything during the removal, because my face was numb completely after all that! I must not have shown signs that I was nervous enough for sedation, because he didn't give me any. He then told me that he would go talk to his secretary to find out when my surgery could be. The anesthesia kicked in quickly and I had already a hard time speaking intelligently when my surgeon came back to see me a few minutes later. He then asked me if the date of March 17 was OK with me. It was becoming really concrete with a date like that. I tried to ask him if it were possible to push the surgery to a later date. He then told me that his surgery schedule at the Charles LeMoyne Hospital was not available for April yet and that it was the only date that he could give me at that moment. I then accepted the date of March 17. He then left the room once more (probably to go confirm the date of the surgery with his secretary) and I must have stayed a few minutes alone in the room, because the anesthesia had to kick in completely before starting the removal. I then started thinking about my surgery and I told myself that mid-March would come fast!

I had brought my iPod filled with Bon Jovi music to listen to during the extraction, so I started listening to it at this moment to give me a little bit of courage... Wisdom teeth are so close to the ears and my father had warned me that I would hear removal noises... With earphones in my ears, I was hoping to avoid hearing these noises!

When I saw my surgeon and his assistant come back in the room, I knew at this moment that it would begin. I was pretty nervous! I must have turned up the volume of my iPod a little too much, because my surgeon told me not to put the volume too high so I could hear what he would have to tell me! By looking at my iPod, he saw that I was listening to Bon Jovi and he smiled at me while telling me: "Ah... Bon Jovi..." He had no idea yet how big of a fan I was!!

For my surgeon, the removal of my wisdom teeth was very easy, because he only had to pull hard on my teeth to remove them; he didn't have to go get them like when they are impacted in the gum. The extraction of the first tooth took only a few seconds. I felt that he pulled with pliers and I held on tight to the examination chair arm because I was so afraid that it would hurt! In the end, I didn't feel anything, but I heard a noise that I can compare to the noise teeth make when we bite into a Rice Krispies square. Not a very pleasant noise when I thought that it was one of my teeth, but still, it wasn't as bad and I had thought! My surgeon encouraged me after each tooth that he was pulling out by doing a countdown either by saying how many there were left or either by showing it with a number of lifted fingers... I thought it was very funny he did that! When he grabbed a lower wisdom tooth with his pliers, he said: "Phew! There is pus underneath this one! You would have had problems quite quickly if we had kept that one there!" I had no symptoms at that time, so indeed, I was spared of an emergency appointment with my dentist by removing my wisdom teeth! At the last tooth, I was already used to it and I didn't tense up as much as for the first one. I even told myself that he could have pulled out all my teeth at that moment and it would not have bothered me! haha

My surgeon did a few self-resorbing stitches in the extraction site of the lower wisdom teeth. I could see the thread pass by in my blind spot; I had never had stitches and the idea of seeing the thread pass by didn't delight me, because I knew what was happening in my mouth. Fortunately, I didn't feel anything for that either!

After the removal (or was it before?), my surgeon prescribed me ibuprofen and he left the room. His assistant made me bite into cloth pads to stop the bleeding and at the same time, she gave me instructions for the following days to go well. It's weird, I was very excited when I left the room, my husband made the comment that I looked drugged by talking with my numb face and by talking non-stop despite my cloth pads in the mouth!

My husband and I stopped at the drugstore on the way home to go get the ibuprofen which would help me soothe the pain. While we were waiting for the prescription, my mouth started bleeding; my cloth pads were now soaked with blood! I regretted talking as much after the extraction! The drive home was very fast, because I couldn't wait to change my cloth pads! I took my ibuprofen as a preventive measure, because I was still numb and I spent the rest of the day resting. My husband even went back to work, because I felt good. I continued bleeding very slightly after changing my cloth pads, but I was still able to drink liquids and eat soup to feed myself a little. The sensation of my face also came back slowly during the day.

My face didn't swell at all after the removal of my wisdom teeth. I even went to work on the next morning, but I came to the conclusion that I was not in enough shape to do a complete day. My coworkers saw well that I was not at the top of my shape, so I came back home earlier. It was a good coincidence, it was Friday, so I had 2 additional days at home to recover before I returned to work on the following Monday. Also, I could not do important physical efforts on the days following the surgical procedure and despite the snowstorm that hit a few days later, I was able to resist helping my husband with the shovelling! I recovered very well and I was able to come back to a normal diet within a few days. My stitches dissolved by themselves about one week after the removal.

Thinking back on it, I appreciated having my wisdom teeth removed before my jaw surgery, because I was able to see how my surgeon worked and how calm and in control he was during the surgical procedure. Seeing him work while being conscious made me trust him even more!

Marie-Hélène

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