12-14-2009, 08:00
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#16
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Auxiliary
Join Date: Jul 2008
Location: Atlanta
Posts: 97
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Points taken. Doing your research is essential but carefully consider your sources and tactfully ask your questions and gther information. Most Dr.s and PA's will take the time to answer your questions. If they don't then move on if your healthcare plan allows. If your concerned about potentially conflicting information then respectfully move on. I think the number of successful surgeries and care plans greatly out weight the unsuccessful. I guess I'm a bit narrow in focus as I work at a tertiary care facility. By the time the pt gets to me they've seen one or two other physicians. In my mind if the refering physician has confidence in our institution then that should lend itself to the pt's confidence in our institution. Getting back to the original point of the thread; make sure your intentions are truly info seeking. Some of my most humble patients are physicians.
Boomer
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Boomer-61 is offline
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12-14-2009, 08:06
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#17
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Area Commander
Join Date: Oct 2009
Location: Northeast Utah
Posts: 1,712
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Quote:
Originally Posted by Gypsy
Ah. I think you can speak respectfully while asking questions in an inquiring but direct manner.
If someone is offended and thinks you are questioning their knowledge whilst seeking information or discussion on what your reseach has yielded then maybe they're not the doctor for you.  |
I think this is the approach I appreciate most, but I've seen all sorts. I'm always happy to answer questions such as, "How do you know that x is what's going on?" or "Is there anything else that could be causing this?" It makes for a fun exercise in creating and prioritizing my differential diagnosis.
I also welcome "What are my options for treatment?" and "Why did you choose this particular treatment/medication?" Again - it makes me reconsider my current practice and consider at medications which I may not typically use but may be better for my patient. It also opens the door for further discussion os side effects, reason I use treatment "x" vs "y". Some times it reminds a patient to bring up an old medical condition or treatment reaction they had not disclosed previously.
If a doc can't justify his diagnosis and treatment decision he/she needs to take pause to figure out what was missed...
OTOH, there is a call to decrease the cost of health care - sometimes what we would feel is best for the patient medically is not what is best for them financially - I would not order a test that would cost a patient $5,000 out of pocket if it would compromise their financial stability. A physician should discuss this with the patient and let them participate in that decision. There are usually cheaper alternatives that are "good enough."
Thankfully, I have some good trump cards in my practice. I have yet to find an insurance company that will refuse a request for a diagnostic test that I consider "standard of care" for a child who has a chance to be cured from cancer. All I have to do is request the insurance company's name, the names of the people making the decisions about paying for testing or not, and let the person from the company that I'm talking with that I wil document all of those names in my chart as the reasons I am not able to provide appropriate care for the child. It seems they would rather pay for the $5,000 test than have the potential for a multi-million dollar lawsuit. 
Whether or not the test should cost $5,000 is another discussion for another day...
__________________
"The dignity of man is not shattered in a single blow, but slowly softened, bent, and eventually neutered. Men are seldom forced to act, but are constantly restrained from acting. Such power does not destroy outright, but prevents genuine existence. It does not tyrannize immediately, but it dampens, weakens, and ultimately suffocates, until the entire population is reduced to nothing better than a flock of timid, uninspired animals, of which the government is shepherd." - Alexis de Tocqueville
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PedOncoDoc is offline
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12-14-2009, 08:24
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#18
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JAWBREAKER
Join Date: Jan 2004
Location: Gulf coast
Posts: 1,906
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Eagle and PedOncoDoc have given great advice. Without all the specifics, no advice can or should be given for your specific case. As you know, drug of choice is a preference for each provider based on their experience and the patient's risk profile/med history. I do not mind having a patient that is well informed and full of questions. If the provider can not answer and explain any reasonable question... find another doc.
The use of sedation is not always mandatory for soft tissue impacted thirds. Some patients require a little sedation to tolerate the procedure, and the surgeon giving the choice of PO meds/Nitrous will save the patient significant expense. However, most oral surgeons will have no problem using IV sedation if it is your preference.
If your buddy is a general dentist, then he may not have the legal ability to administer IV sedation . If he is taking out the thirds instead of an oral surgeon, that may be the reason PO meds are being used instead of IV.
If you want IV sedation, then talk to your oral surgeon. There is not a right or wrong answer on your question. Good luck
and don't let all these horror stories get your scared. I take thirds out ALL THE TIME under local only. They never feel a thing.
Last edited by Sacamuelas; 12-14-2009 at 08:27.
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Sacamuelas is offline
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12-14-2009, 09:06
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#19
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Quiet Professional
Join Date: Jan 2004
Location: Free Pineland
Posts: 24,829
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Quote:
Originally Posted by Sacamuelas
I take thirds out ALL THE TIME under local only. They never feel a thing. |
As far as you know.
Seriously, thanks for your professional advice, as always.
Feel free to jump on one of the preparedness threads with some more post-Katrina lessons learned, if you have time.
TR
__________________
"It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat." - President Theodore Roosevelt, 1910
De Oppresso Liber 01/20/2025
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The Reaper is offline
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12-14-2009, 09:33
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#20
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Guerrilla
Join Date: Aug 2008
Location: Germany
Posts: 172
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Quote:
Originally Posted by Sacamuelas
They never feel a thing. |
True, till about three hours after the procedure
__________________
Nobody said it would be easy, they said it would be worth it.
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caveman is offline
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12-14-2009, 12:44
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#21
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JAWBREAKER
Join Date: Jan 2004
Location: Gulf coast
Posts: 1,906
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Quote:
Originally Posted by caveman
True, till about three hours after the procedure |
I have ways to manage post-op pain too. For the patients that I like.......LOL
Back when my thirds were removed, I let a classmate do them at a local oral surgeon's office. IV sedation, two large sinus exposures, and four mutant teeth  later (my upper molars had five diverging roots not the normal three converging to the tip)..... I woke up to a Rx for Tylox and lots of postoperative instructions to prevent sinus communication from opening.
Next day I was back at school... no pain. I never took a tylox after the first one on the day of surgery. You see....there could not have been more trouble or tougher extractions to have done and yet I had no postop pain.
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Sacamuelas is offline
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12-14-2009, 18:16
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#22
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Area Commander
Join Date: Jan 2004
Location: Midwest
Posts: 7,134
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Quote:
Originally Posted by Remington Raidr
I tell my dentist I don't wanna feel nothin'. I get the gas then the novacaine. My DDS rocks.
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That's my approach...my DDS rocks as well. The gas is the bomb as far as I'm concerned. I had 3 really old fillings she wanted to replace all at once.  A little gas and novacaine and I was good to go. The sound of the drill drives me over the edge otherwise.
Quote:
Originally Posted by PedOncoDoc
I think this is the approach I appreciate most, but I've seen all sorts. I'm always happy to answer questions such as, "How do you know that x is what's going on?" or "Is there anything else that could be causing this?" It makes for a fun exercise in creating and prioritizing my differential diagnosis.
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I'm sure! I ask out of curiosity and to learn more about whatever it is that's going on...
__________________
My Heroes wear camouflage.
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Gypsy is offline
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12-14-2009, 18:47
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#23
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Consigliere
Join Date: Jan 2004
Location: Free Pineland (at last)
Posts: 8,845
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Dentists don't cause pain. People who don't take of their teeth do. Suck it up, people!
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Roguish Lawyer is offline
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12-14-2009, 18:54
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#24
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Area Commander
Join Date: Nov 2005
Location: Cochise Co., AZ
Posts: 6,206
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Quote:
Originally Posted by Roguish Lawyer
Dentists don't cause pain. People who don't take of their teeth do. Suck it up, people! |
"Is it safe?
Pat
__________________
"Hector Lives!"
"The limits of tyrants are prescribed by the endurance of those whom they oppress." -- Frederick Douglass
"The bigger the government, the smaller the citizen." -- Dennis Prager
"The urge to save humanity is almost always only a false-face for the urge to rule it." --H.L. Mencken
Last edited by PSM; 12-14-2009 at 19:00.
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PSM is offline
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12-14-2009, 19:26
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#25
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Quiet Professional
Join Date: Jan 2004
Location: Free Pineland
Posts: 24,829
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Quote:
Originally Posted by Roguish Lawyer
Dentists don't cause pain. People who don't take of their teeth do. Suck it up, people! |
How do you "take care of" pre-emerging third molars, Counsel?
TR
__________________
"It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat." - President Theodore Roosevelt, 1910
De Oppresso Liber 01/20/2025
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The Reaper is offline
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12-14-2009, 20:16
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#26
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BANNED USER
Join Date: Jan 2007
Posts: 3,751
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Quote:
Originally Posted by PSM
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Poor Dustin, just couldn't answer that one, could he?
But THIS dentist met his match!
http://www.youtube.com/watch?v=iAKYQjpDtpA&NR=1
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Dozer523 is offline
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12-14-2009, 21:44
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#27
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Quiet Professional
Join Date: Jan 2004
Location: DFW Texas Area
Posts: 4,741
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I had my wisdom teeth (3rd molars) taken out one side at a time. They were infected, so several trips to the Doc were reqired!! It was done with just a local and after it was done I climbed on my '71 Bonneville, kick started it....and rode home, some 45 miles!! This process was repeated!!! 
Then again, some of us can simply ignore pain.
Later.
Martin
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Martin sends.
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Ambush Master is offline
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12-14-2009, 22:03
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#28
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Area Commander
Join Date: Aug 2007
Location: Page/Lake Powell, Arizona
Posts: 3,445
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Had wisdom teeth taken out under general at age 14 (hadn't come in yet).
Came to about 1300.
Told mom that I should attend basketball practice "just to watch".
She was skeptical. Wouldn't let me take my shoes.
Didn't notice the Chuck Taylors that were being worn.
Was practicing and having violent collisions with teamates at 1600.
(Bah...just call an ambulance if I start bleedin' too bad)
__________________
__________________
Waiting for the perfect moment is a fruitless endeavor.
Make a decision, and then make it the right one through your actions.
"Whoever watches the wind will not plant; whoever looks at the clouds will not reap." -Ecclesiastes 11:4 (NIV)
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GratefulCitizen is offline
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12-14-2009, 22:32
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#29
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Area Commander
Join Date: Nov 2005
Location: Cochise Co., AZ
Posts: 6,206
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Quote:
Originally Posted by Dozer523
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No Doz! Denton enjoyed it! Not the same.
Pat
__________________
"Hector Lives!"
"The limits of tyrants are prescribed by the endurance of those whom they oppress." -- Frederick Douglass
"The bigger the government, the smaller the citizen." -- Dennis Prager
"The urge to save humanity is almost always only a false-face for the urge to rule it." --H.L. Mencken
Last edited by PSM; 12-14-2009 at 22:37.
Reason: spellin'
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PSM is offline
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12-22-2009, 13:43
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#30
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Asset
Join Date: Jul 2008
Location: Sierra Vista, AZ
Posts: 8
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Teeth
SFC Macintire drank a bottle of Gin and dug his tooth out with one of then nut hooks.
Next.
Dogs
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Smithdogs is offline
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