General Anesthetic Dentist Chiang Mai

[JeffersLos]

I need to have some teeth removed and I want to be knocked-out when they do it.

 

I believe this requires a general anesthetic injection.

 

I'm not sure if street-shop dentists do this, but perhaps on the dental departments in hospitals?

 

If anyone has knowledge or experience of a general anesthetic for dental work in Chiang Mai, I'd love to hear the into.

 

TIA.

 

Jeffers, 

[canthai55]

For general you will need to be admitted to hospital, pay for surgeon and anesthetist.

Along with hospital admin charges, etc.

 

[Dante99]

7 minutes ago, canthai55 said:

For general you will need to be admitted to hospital, pay for surgeon and anesthetist.

Along with hospital admin charges, etc.

 

Dental clinics here use general for wisdon teeth removal sometimes, in their clinics where their oral surgeons operate.  Not necessary to go into a hospital.  Check out Dental World for one.

Edited December 22, 2019 by Dante99

[thaibeachlovers]

5 hours ago, Dante99 said:

Dental clinics here use general for wisdon teeth removal sometimes, in their clinics where their oral surgeons operate.  Not necessary to go into a hospital.  Check out Dental World for one.

Speaking with my theatre nurse hat on; anyone that chooses to have a general anaesthetic not in a hospital is crazy. GA is dangerous, and it is well advised to be close to an ICU when having one.

Perhaps the OP is confusing sedation with GA. IMO sedation is quite sufficient for a dental procedure.

I had my first wisdom tooth removed with a hammer and chisel by a dentist under local. It's really not that big a deal.

[canthai55]

Had 2 lower wisdom teeth removed years ago.

Great dentist - but a major doings

Had to cut an x in each tooth, extract 1/4 of each tooth at a time. Roots splayed out almost horizontally.

Made appointment to have both done in one day. When the Doctor finished the first, leaving what felt like a huge hole in my jaw, and asked 'Do you want to do the other today ?"

I said F no !!!

He laughed, said he made me an appointment for tomorrow for the other side when I made the initial appointment.

[canthai55]

1 hour ago, thaibeachlovers said:

GA is dangerous, and it is well advised to be close to an ICU when having one.

Agree 100%

Too many things can go wrong.

[thaibeachlovers]

14 hours ago, canthai55 said:

Agree 100%

Too many things can go wrong.

Anesthetists spend years learning how to do it. The idea that it can be done safely in some clinic is, to me, foolish at best.

[Sheryl]

Absolutely agree that in Thailand this should be done in a hospital only.

 

They can use a short acting anesthetic agent and you can then go home  shortly afterwards but should have someone with you and obviously not dtive.

 

[thaibeachlovers]

10 minutes ago, Sheryl said:

Absolutely agree that in Thailand this should be done in a hospital only.

 

They can use a short acting anesthetic agent and you can then go home  shortly afterwards but should have someone with you and obviously not dtive.

 

or so they say.

In London I had to have an out patient procedure done under GA. I just stayed in the lounge after till I felt OK and caught the bus home. I can't remember if I told them that someone was coming to take me home, but I would have if I had to.

As a registered nurse I made an informed decision to do so, but that would probably not be a good thing to do if old and infirm.

PS, I wouldn't have driven though.

PPS The drugs they used to put me under gave me such a buzz that I understand why people become addicts. Luckily I don't need artificial stimulants.

Edited December 23, 2019 by thaibeachlovers

[elektrified]

11 hours ago, Sheryl said:

Absolutely agree that in Thailand this should be done in a hospital only.

 

They can use a short acting anesthetic agent and you can then go home  shortly afterwards but should have someone with you and obviously not dtive.

 

Propofol is very popular here. I've had it administered to me a couple of times. Short acting, absolutely no hangover. Can't remember anything about the procedures at all. But the anesthesiologist was right by my side monitoring heart rate, BP, etc.

[amexpat]

I had wisdom teeth removed in a complicated procedure. 

 

The dentist gave me nitrous oxide. I laughed my ass off through the whole thing.

 

Available in LOS? 

[Lacessit]

AFAIK Ram Hospital would probably have the most dental practitioners, you could try asking there.

I have had good experiences with extractions at Elite Smile, Pantip Plaza. Local anaesthetic, felt nothing. Any reason why the OP could not have them done one at a time?

[Lacessit]

14 minutes ago, amexpat said:

I had wisdom teeth removed in a complicated procedure. 

 

The dentist gave me nitrous oxide. I laughed my ass off through the whole thing.

 

Available in LOS? 

I had wisdom teeth removed with Demerol, back when it was legal. 100 times more addictive than heroin. I was as high as a kite for hours afterwards.

[amexpat]

Maybe barely on topic:

 

I has some dental work in California where the dentist had prescribed diazepam (valium) for the appt.

Obviously not the only anesthetic - just to relax.

 

Nurse Ratched demanded to know who I had to drive me home.

To which I politely replied "Are you sh**ting me? I'm from the seventies - 10 mg of valium is nothing!"

 

But I had to lie about a friend coming to take me away in my "impaired state". 

Edited December 23, 2019 by amexpat
oops

[seasia]

On 12/22/2019 at 9:28 AM, thaibeachlovers said:

Speaking with my theatre nurse hat on; anyone that chooses to have a general anaesthetic not in a hospital is crazy. GA is dangerous, and it is well advised to be close to an ICU when having one.

Perhaps the OP is confusing sedation with GA. IMO sedation is quite sufficient for a dental procedure.

I had my first wisdom tooth removed with a hammer and chisel by a dentist under local. It's really not that big a deal.

Yes agree with you though my medical knowledge is limited at best.

 

I was offered GA for a difficult extraction ( in  a very highly regarded hospital in the UK, full ICU facilities available if needed )

 

No issue, friend drove me there and then back home. In and out in a long day.

 

I was impressed by the service, they checked I was OK and recovered from the GA before letting me go.

If they had suggested staying in overnight I would have obeyed the expert opinion.

 

No way would I have a GA in a clinic. Anywhere.

[JeffersLos]

On 12/22/2019 at 10:16 AM, canthai55 said:

For general you will need to be admitted to hospital, pay for surgeon and anesthetist.

Along with hospital admin charges, etc.

 

The cost wouldn't be an issue, and definitely wouldn't be a deciding factor. 

[JeffersLos]

On 12/22/2019 at 10:23 AM, Dante99 said:

Dental clinics here use general for wisdon teeth removal sometimes, in their clinics where their oral surgeons operate.  Not necessary to go into a hospital.  Check out Dental World for one.

Thanks, I contacted Dental World and they said I'd need to go to a hospital to be given a GA.

 

They said that they do give you laughing gas.

 

I don't know how effective that is. 

[JeffersLos]

On 12/22/2019 at 4:28 PM, thaibeachlovers said:

Perhaps the OP is confusing sedation with GA

Perhaps.

 

Due to a previous horrific experience, I wish to be unconscious for the procedure, if there's another medical way for that than GA, I'm happy to be educated. Cheers. 

[JeffersLos]

13 hours ago, elektrified said:

Propofol is very popular here. I've had it administered to me a couple of times. Short acting, absolutely no hangover. Can't remember anything about the procedures at all. But the anesthesiologist was right by my side monitoring heart rate, BP, etc.

Thanks, I'll read up on and enquire about Propofol. 

[elektrified]

13 hours ago, Lacessit said:

I had wisdom teeth removed with Demerol, back when it was legal. 100 times more addictive than heroin. I was as high as a kite for hours afterwards.

"Back when it was legal." Demerol is sill legal and used in many countries.

[JeffersLos]

3 minutes ago, elektrified said:

"Back when it was legal." Demerol is sill legal and used in many countries.

Thailand included?

[Lacessit]

4 minutes ago, elektrified said:

"Back when it was legal." Demerol is sill legal and used in many countries.

Fair enough. Although I'll bet it's not legal in Thailand - paracetamol seems to be the zenith of pain relief here.

[elektrified]

16 minutes ago, JeffersLos said:

Thanks, I'll read up on and enquire about Propofol. 

I have no idea if they use it for dental procedures.

 

The thing is that years ago, they had limited anesthetics available for dental work, namely "Novocaine" which hasn't been used in decades. Now they have many short and long acting anesthetics which a good dentist will mix a cocktail of 2 or 3 of them and patients don't feel any pain anymore. A good dental surgeon also knows exactly how to inject directly into the nerves. When I had my wisdom teeth removed in 1977, they used a cocktail of Nembutal Sodium, Sodium Pentothal and nitrous oxide (or some similar gas). I don't think any dentists use these anymore.

 

So if your bad experience was many years ago, then consider the new medicines as dentists in Thailand are very hesitant to use too much anesthetic - especially general anesthetic. C.M. Ram may be the only place that may offer it - I don't know. Good luck.

[elektrified]

8 minutes ago, JeffersLos said:

Thailand included?

Only used for certain types of cancer AFAIK.

[elektrified]

6 minutes ago, Lacessit said:

Fair enough. Although I'll bet it's not legal in Thailand - paracetamol seems to be the zenith of pain relief here.

Yes, available in Thailand for certain types of cancer only.

[JeffersLos]

14 minutes ago, elektrified said:

So if your bad experience was many years ago,

1 year ago.

 

LA was applied, but no types of other medicine for any type of sedation or calming or whatever. 

 

The dentist mentioned here already say that they provide laughing gas, I'm not sure how effective that is. 

Edited December 24, 2019 by JeffersLos

[canthai55]

1 hour ago, Lacessit said:

Fair enough. Although I'll bet it's not legal in Thailand - paracetamol seems to be the zenith of pain relief here.

Tramadol available here

Tramadol, sold under the brand name Ultram among others, is an opioid pain medication used to treat moderate to moderately severe pain.

https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=29&cad=rja&uact=8&ved=2ahUKEwj4lcKfu83mAhVSSX0KHe4pBsQQmhMwHHoECAsQAg&url=https%3A%2F%2Fen.wikipedia.org%2Fwiki%2FTramadol&usg=AOvVaw3X7WbdU4Lfv5BhAX5YFIlf

[ThaiBunny]

On 12/22/2019 at 9:38 PM, canthai55 said:

Agree 100%

Too many things can go wrong.

Not only that, a doctor needs to monitor recovery from the anaesthetic. It's common for anaesthetists to use "speed" to reverse the effects of the general anaesthetic. A patient who has undiagnosed sleep apnea may require oxygen (happened to me twice)

[FearAndLoathingInLOS]

12 hours ago, JeffersLos said:

Perhaps.

 

Due to a previous horrific experience, I wish to be unconscious for the procedure, if there's another medical way for that than GA, I'm happy to be educated. Cheers. 

As someone with multiple horrific experiences, both here and in other countries (including my own), i feel qualified to give you a suggestion. I used to have extreme dentist fear. Find a dentist that you can communicate with well, and one that is open to many alternatives.

 

About general anesthesia:

 

While general anesthesia is possible for tooth extraction,  it is not possible for things such as fillings, crowns and implants (you'll need those, down the road). Because you need to be conscious while the dentist drills them to fit your bite. And it's extremely expensive. The minimum cost for GA is 100,000 THB, you have ~32 tooth, that's ~3,2million baht.

 

Before i go to the alternatives,  i'd like to point out common problems with tooth extraction, as well as local-anesthetic problem in patients with dentist-fear.

 

a) the dentist didn't hit the nerve with the needle, or they started the extraction process before the local anesthetic started working.

b) he did hit the nerve, but the tooth cracked during extraction attempt prolonging the process. This happened to me, and because i have both hypertension, hyper-metabolism and a high-blood pressure, the local-anesthetic wore off while he was cutting the tooth in half (90 minutes for me, normal people wear off after 120-200minutes).

c) the dentist did hit the nerve but your stress level (fear) prevents the local-anesthetic from working. This one is a myth to people that don't have dental fear, we have the ability to wake up cells that are supposed to be asleep.

 

The alternatives to GA:

 

As i said in the beginning, find one that you can communicate with well, and one that has many alternatives. Here's a list of clinics/hospitals i've tried in reverse order of preference (not saying any of them are bad, just my own opinion):

 

Ram Hospital: Positive: Can do GA on site. Negative: While highly skilled mostly young and thus less experienced dentists (most that do well there, then go  ahead to open their own private clinics, can't blame them). Also doesn't do NOS (gas) (they told me because it's dangerous, lol). Doesn't offer any relaxing medicine to reduce anxiety before operation.

Dental World: Positive: Does NOS (gas), over 50 years old lots of experience. Negative:  doesn't offer any relaxing medicide to reduce anxiety before operation.

Kitcha Dental: Location: Saturday market (also known as chiang mai gate) head further west. Positive: Also offers NOS (gas), also lots of experience he's over 50 years old. Offers relaxing medicine before visit (xanax and a thai medicine i couldn't read, it worked really well).

 

My advice: try Kitcha, while not fully GA, the relaxing medicine will make you so relaxed you wont think about what the dentist is doing. And if you want they can also combine this withe NOS (gas). The medicine wont make you high, but just really relaxed, the gas may make you a little-bit high.

 

 

 

 

 

 

 

 

 

Edited December 24, 2019 by FearAndLoathingInLOS

[thaibeachlovers]

On 12/24/2019 at 3:20 PM, JeffersLos said:

Thanks, I contacted Dental World and they said I'd need to go to a hospital to be given a GA.

 

They said that they do give you laughing gas.

 

I don't know how effective that is. 

Nitrous Oxide is given to mothers giving birth, but I'd go for the GA if cost is not an issue.

My ward had Nitrous Oxide for patients having painful dressings and some of us used it for the buzz, which only lasts as long as one is breathing it and does not impair one at all. Contrary to the name "laughing gas" it doesn't necessarily make one laugh, just feel a buzz. I never had it for pain so don't know how effective it would be for tooth extraction. It's not the same as sedation as I was fully aware of surroundings when I was using it, so would still know what was going on.

Whatever, you can't change your mind mid extraction.