Three Teeth Coming Out Tomorrow...

All lower molars, two on the left, one on the right. One of them has already partially broken off.
All root canals done a long time ago; none salvageable at this point. I'm at peace with that.
What I'm looking for is some general advice on "how to behave in the chair;" things that I can do to maybe relax, techniques on relaxing the jaw, or how to position the head and shoulders, how to support the jaw if I need to... stuff like that. There's no way around it; they have to come out; one already got infected and was treated with Amoxicillin; so I'm just looking for some overall advice on precautions/actions I can take myself to make this less complicated. The dentist I'm going to knows the issues I have, so that part of it is out of the way, but are there certain things I should ask, or do (or not do)? Hoping to get through this without complications of any kind.

Also, muffs, foam or silicone plugs, or cotton balls okay for protection during extractions? (I haven't decided on which method to use yet, and not sure if ear protection is even advised under the circumstances.)

Thanks for reading.

Mystery Reader

 

I try to think of a happy place or a happy memory and play it again and again. I also close my eyes so I see as little as possible of what's going on. They say almost everyone crosses their ankles in the chair, which is perfectly normal when we're anxious. Try to uncross your ankles so you don't reinforce the anxiety. If you need comfort by all means cross, but hold out a while if you can.

You're going to do great!

 

@New Guy
Hey! Great to have a message from you, kiddo, and thanks for the encouragement! Good advice on the ankles. I will remember that!

How're things with you?

Mystery Reader

 

@Mystery Reader
Don't do what I did and that is lifting your head off the headset. This caused muscles to straighten my C spine and blood flow slowed in several neck arteries causing somatic T.

The vertebral arteries in the neck (see above) can be compressed by the vertebrae (which they traverse --, or other structures (Kamouchi, Kishikawa et al. 2003; Sakaguchi, Kitagawa et al. 2003). Arthritis, neck surgery, and chiropractic manipulation are all potential precipitants of neurological symptoms including stroke. According to Bogduk, compression can be due to anomalies of the origin of the vertebral artery, an anomalous course between the fascicles of either longus coli or scalenus anterior, and bands of deep cervical fascia (Bogduk, 1986). All of these mechanisms would presumably be associated with blockage of flow on turning the neck to one side or the other. It is usually of significance only in persons who have a substantial asymmetry in their vertebral circulation -- one being much smaller, or one being absent or terminating in PICA.

It is presently considered a problem when there is mechanical compression during head rotation due to muscular and tendinous insertions, osteophytes, and arthritis around the C1-C2 level. As the vertebral arteries enter the vertebrae around C4, it can also occur at lower levels. As about 50% of cspine rotation occurs around C1, this is likely the reason for the predominance at this level. Araz Server et al (2018) reported reduced flow in the ipsilateral vertebral artery when the head was both hyperextended and rotated. Perhaps a position mainly encountered in dental offices ? Dynamic cerebral angiography is the preferred method of documenting this diagnosis, but this is almost never done as it requires a substantial amount of contrast and radiation, and it rarely results in a positive finding. One would think that MRA done in 3 positions -- head right, head center, head left, would also be diagnostic, but we have not seen any papers of this. In addition, while MRA does not have the radiation issue that CT does, it might require more contrast than reasonable.

 

How did you cope with root canal?

 

Make sure to not open your mouth too wide for too long. Ask for a towel to be placed under your neck, so that your neck is supported.

 

Thanks to all those who responded!

@Greg Sacramento, I took your advice (as well as @Bill Bauer); brought a pillow for support and did not lean forward or lift my head. I was very conscious of this during the procedure, and if I did somehow do it, then I don't remember doing so. "Don't lift off the headset!" was going through my mind my whole time in the chair!

@New Guy, ankles remained uncrossed!

@DebInAustralia The actual root canals were done years ago, before the issues started. As can happen, then all started to go at once, and when I had them looked at and was given options, I opted to have them removed. Apparently, there wasn't much there to work with, now.

The dentist was great. He used Novacaine and septocaine to numb (not sure if I have the spelling on those correct). I don't know about the potential ototoxicity of either of these, but couldn't worry about it; the teeth had to be removed, regardless. He was very understanding and accommodating to the problems; I even told him I didn't want the suction thing in my mouth during the procedure and it wasn't a problem. Both he and I supported my jaw during the procedure, and all three came out easily. Not sure how wide or how long mouth was open, honestly, but it didn't seem to be that long.

Stuffed with gauze, now, and biggest thing to avoid at this point is dry socket (a challenge for a smoker!) Luckily, so far, very little pain after the local wore off.

Ears feel a little sore after all this; honestly can't tell if there's a spike yet, as I've been hit with some impulse noises of late and the tinnitus has been all over the map. Hoping for the best with all of this, and that the soreness, tinnitus, and everything else will settle down.

So, again, @New Guy, @Greg Sacramento, @DebInAustralia, and @Bill Bauer, thanks for the responses and encouragement; I was a bit nervous about this. Hoping things settle down over the next few days. Will post and update, for those interested!

Mystery Reader

 

Glad to hear you made out ok @Mystery Reader !