Wisdom teeth


(2Sweet4U) #1

Hi everyone...

Unfortunately I have to get my wisdom teeth out (all 4) at the end of June. I'm going for two consultations within the next month. I don't like dental work in the first place, and I'm worried something will go wrong with my blood sugar during the procedure. What should I do to make sure everything runs smoothly? Is there anything specific I should ask the doctors when I go to the consultations?

Also, what food is good to eat after the procedure? I know soft foods, but being diabetic I obviously can't eat a lot of sugary stuff like pudding. I can eat some sugarfree stuff but I don't like to eat a lot of it.

Thanks in advance for your suggestions!

Amanda


(joe) #2

Amanda,  I had my wisdom teeth out what seems like 2 million years ago, but I still remember.  The pain from surgery (my lower 2 were impacted and it required a lot of effort) lasted only a few days. 

for surgery I would try to be in my normal range.  The stress from surgery will likely make your blood sugar be higher than normal so you can test a lot afterward.  Don't worry too much about perfect control, but don't let your sugars go completely wild either because high blood sugar can make infections worse.  The pain killers will help, being in pain increases your stress and increases your blood sugar, but I would make sure the doctor knows that steroidal pain killers will make your sugars very high (increases your insulin resistance).  if you HAVE to be on steroids be aware your resistance will be a lot higher 75 - 200% higher for any corrections or carbs.

but look, aside from steroids and the things that can go wrong (if you count all of the remote chances), if you want ice cream, eat ice cream just bolus for it.

good luck, lots of us have had this surery!    Cheers!


(Eric_Carpenter) #3

I had my wisdom teeth taken out before they started coming in, and was on a mush diet for almost two weeks. I didn't need the painkillers though, if that makes you feel better.  I found that during the liquid diet phase I ate almost nothing, so I was living off Gatorade and popsicles and still running normal to low blood sugars.  Watch yourself closely and you should do fine.


(Marldance) #4

Before I give you any advice I'm gonna tell you that the guy who took my teeth out last summer was incredible. All four of my teeth were impacted and i got them all out at once which is supposed to be the most painful thing ever. I didn't get sick at all, hardly took any pain killers, and was eating popcorn the next week (even though I wasn't supposed to be) so my time line may be different than yours is. However i do have some very important tips. At least i my case I was not allowed to eat or drink anything for a certain amount of time before the surgery so I suggest getting it done early in the morning. It will suck getting up at 5 am or w/e but it will help prevent you from having any blood sugar issues because you won't be up and about all day waiting to go in for the procedure. Make sure the dentist knows you are diabetic b/c he may have experience with this situation and have some more tips for you.

In terms of eating it was pretty much all pudding, smoothies and soup for 3 or 4 days. My mom made me smoothies with fresh fruit (frozen works too) and plain yogurt. I also don't like sugar free stuff, however, there are some great low calorie puddings out that have sugar but alot less than the normal amount. After a few days you may be able to start eating things like mashed potatoes and very soft pasta and maybe even chicken if you cut the pieces up small and if the meat is very tender. Stay away from things like bagels because they can be difficult to chew. During this time it will be best to use juice for a low. I usually use life savers instead of glucose tabs so i got the gummy lifesavers and they worked out pretty well.

Now for some non-diabetes related stuff. Make sure you have someone to drive you to and from the surgery. Apparently my dad tried to drive himself home (he was 25 at the time) and all I can say is that did not work out so well. They are probably going to put you out and give you some very intense pain meds so you are going to be very lethargic for the rest of the day so rent alot of movies but none that require too much thinking. In my case my mouth was so numb so the point that i couldn't feel when I was drooling blood (yummy i know, but normal) so I kept a bucket in my lap. Also, they put gause in your mouth to make the bleeding stop and after a little while if you are still bleeding a warm teabag will work wonders. Best of luck with the procedure!


(puns_and_roses) #5

I was lucky when it came to my wisdom teeth. My doctor's son was diabetic, so he knew what to do about my blood sugar.  brought my meter in with me on the day of surgery and it was put next to table. He tested my sugars throughout to make sure that I was doing ok. I'm sure someone at your operation will know how to do that, so you should be fine.

Since I couldn't chew after, I lived off of sugar free jello, pudding, and regular applesauce. And one thing that worked for my brother and me was eating a pineapple the day before the surgery. There is an enyzme or something in it that prevents a lot of swelling.


(orange_mms) #6

When I had my wisdom teeth removed I ate sugar free jello, soup, mashed potatoes, applesauce pretty much the same as everyone else. I only ate a small breakfast and took half of my insulin that morning which was recommended by the surgeon. I had been sedated by an IV and given tylenol with codeine for pain afterwards. I don't know about you but pain killers and me do not get along. I took 2 (each at different times)and got sick as a dog, so I used aleve or advil instead. Most of the day I slept because I couldn't drive. As mentioned above have someone drive you to the doctor, you'll be too sedated to drive in a safe manner. I had trouble with the healing process, for me it took about 2 weeks maybe a little less. Everyone is different you may recover quickly or it make take a few extra days. Good Luck !!


(2Sweet4U) #7

Hi Joe, Eric, Marlee, Carrie, and orange mms--

Thanks so much for your advice! Your suggestions will be a lot of help. I'm already working on a list of stuff to get from the store...all the 'mush' food haha.

Talk to ya later!

Amanda


(system) #8

You're going to probably be sent to a specialist, and they are used to dealing with all types of people; including diabetics. when i got all of mine taken out..god two years ago as of August(god that seems so long ago!) they put me to sleep, and had someone from the hospital in the office during the procedure. they gave me instructions on what to do with my insulin dose that morning, etc, based off their own experience and having talked to my endo as well.

when you go in for your consulation, i would ask them about what they are going to do to ensure nothing goes wrong during the procedure with your levels, if they don't talk to you about it.

afterwards, i personally had a shitty time..i had an infection on the bottom right side in one of the holes, a canker sore on the top right side along the gum line fold, and a minor infection on the otherside as well. I was on anti-biotics right away, and saw no real increase in my levels through the whole thing. I only got the infections because the sunday after mmy surgery(had it done friday morning) I was at the coffee shop, meeting my dad for the first time in 13years..so I was talking..a lot...which you aren't suppose to do. when they say talk as little as possible...i suggest doing that! lol.

they are gonna give you t3's..which for me don't really work..but just remember to take the NEXT dose just before the one previous is going to wear off. the office told me to take my second dose of t3's about an hour before the first one was going to wear off..so by the time it does, the next dose is already kicking in. that helps a lot!

you shouldn't have any problems, but if you do notice any increase, it's just like anything else..call your doctor's office asap, even if you have to call the "emergancy" line. but as long as you keep an eye on things, and try to keep calm you should be fine! :) have plenty of popicles, ice cream, etc. follow their instructions and you should be fine!


(Danielle1090) #9

Hi Amanda,

I had all four wisdom teeth taken out a few weeks ago. I was asking the same questions then, too!

My nurse had me run a temp basal once I couldn't drink anything...I ran 80% until right before the surgery, then I turned it off and let my normal basals start.

In the morning I was 170 I believe, I did do a small correction to keep me from going over 200.

Before the procedure I was down to 140, they did give me IV sedation...I don't remember a thing from the procedure. Anyway, my BG was 370 afterwards. He told me the I.V was like gatorade...should have known then I would be high afterwards! I did a correction, and it came down just fine. Other then being high right after surgery, my BGs were fine the rest of the time.

I basically ate secure shakes, cream of wheat, pudding, and jello for an entire week. You can definitely eat pudding.....I even had Coldstone Icecream for lunch(LOL I never have stuff like that, no way would I pass up the chance)!!! I did not need any pain meds. I just took Ibuprofen and my antibiotics(four a day).

It really isn't too bad. You will be so happy once it is over with!


(Doesburg) #10

I just had my wisdom teeth out in April 2008.  My upper left tooth had suddenly broken through and was getting in the way - it was actually scraping my cheek.  OUCH!

I had them out first thing on a Friday morning so that I didn't have to go for too long without being able to eat/drink.  I was 170 in the morning before my 8:30 surgery time, which is exactly what I was aiming for.  I didn't want to be high, but my real goal was to not be on the verge of being low without the ability to eat or drink and fix it.  I lowered my basal rate for 2 hours, and the nurse had a BS meter to check me a couple times while I was knocked out, plus another IV ready just in case I needed some sugar.  The doctor and nurse were really great about assuring me that they were knowledgeable and familiar with diabetes and had experience with Type 1's.

My dad drove me home and took good care of me, watched Sweeney Todd with me.  I did have trouble getting sick from the pain meds, but once I was able to eat something along with it I was fine.  Did a lot of napping.

Especially for the first couple of days, I recommend Carnation Instant Breakfast mixes.  They're easy to drink and have more nutrition than just plain milk or juice.  I lived off applesauce, yogurt, and jello for quite a while, considering I was on a "mush" diet from the time my tooth started being painful until my entire mouth was healed.

I think the most annoying part were the stitches!!


(cobbie2) #11

Hi Amanda!

I had to get all 4 of my wisdom teeth pulled last summer. And I had no complications with diabetes. Let them know you have diabetes, so you can get the first appointment that day.  You'll have to fast because they have to put you to sleep, and that way your sugar won't drop as much.  I just took one less unit of lantus the night before my appointment, and my sugar was fine.

As for good food to eat...I think I actually did have a shake, and things like sugar-free pudding, eggs, and mashed potatoes.  You probably won't be wanting to eat a whole lot right away.

I hope this helps!


(stilledlife) #12

Yo Amanda,

Wisdom teeth are unlike any other dental procedure, #1, you won't be awake! YAY!

#2 I had an anesthesiologist on hand when I had mine out. But also just having them check your sugars during the procedure may work out fine. they can always treat a low it while you are out, but more then likely you'll be high for the next few days from the stress hormones that your body will be releasing.

#3  I didn't worry about food. Just had soup and  whined and complained cuz I'm a big baby.

You'll be awsome!

 


(2Sweet4U) #13

[quote user="Batts"]

they are gonna give you t3's..which for me don't really work..but just remember to take the NEXT dose just before the one previous is going to wear off. the office told me to take my second dose of t3's about an hour before the first one was going to wear off..so by the time it does, the next dose is already kicking in. that helps a lot!

[/quote]

Thanks for the advice. They said the procedure would only take about an hour so hopefully if I'm above range to start with, I won't go low.

This may sound like a dumb question but are t3's steroids? someone mentioned that they made their insulin resistance a lot higher; did this happen to you?


(2Sweet4U) #14

[quote user="Amanda"]

I had them out first thing on a Friday morning so that I didn't have to go for too long without being able to eat/drink.  I was 170 in the morning before my 8:30 surgery time, which is exactly what I was aiming for.  I didn't want to be high, but my real goal was to not be on the verge of being low without the ability to eat or drink and fix it.  I lowered my basal rate for 2 hours, and the nurse had a BS meter to check me a couple times while I was knocked out, plus another IV ready just in case I needed some sugar.  The doctor and nurse were really great about assuring me that they were knowledgeable and familiar with diabetes and had experience with Type 1's.

I think the most annoying part were the stitches!!

[/quote]

Hmmm. I think I should ask them if they would have a 'sugar iv' ready for me. That seems like a good idea. I wish my mom could be there and check my bg for me! I'm not sure if they will do that during the procedure.

They said the stitches would be dissolvable so I guess that's good...


(2Sweet4U) #15

[quote user="Kalin"]

Hi Amanda!

I had to get all 4 of my wisdom teeth pulled last summer. And I had no complications with diabetes. Let them know you have diabetes, so you can get the first appointment that day.  You'll have to fast because they have to put you to sleep, and that way your sugar won't drop as much.  I just took one less unit of lantus the night before my appointment, and my sugar was fine.

As for good food to eat...I think I actually did have a shake, and things like sugar-free pudding, eggs, and mashed potatoes.  You probably won't be wanting to eat a whole lot right away.

I hope this helps!

[/quote]

Thanks for the advice! I have the first appt of the day, which is unfortunately not until 9 am. But yeah I will talk to my cde and see what kind of basal pattern to run during the procedure, and before it.


(2Sweet4U) #16

[quote user="stilledlife"]

Yo Amanda,

Wisdom teeth are unlike any other dental procedure, #1, you won't be awake! YAY!

#2 I had an anesthesiologist on hand when I had mine out. But also just having them check your sugars during the procedure may work out fine. they can always treat a low it while you are out, but more then likely you'll be high for the next few days from the stress hormones that your body will be releasing.

#3  I didn't worry about food. Just had soup and  whined and complained cuz I'm a big baby.

You'll be awsome!

 

[/quote]

Uh yeah that's good I guess...but I am very afraid of iv's so...that's not so good. But I definitely wouldn't want to be awake! They said they would probably have to saw the bottom two in half so they can get them out and I don't want to experience that!!

I'm sure I'll be whining a lot. I'm kind of a wimp.

Thanks for the reassurance!


(2Sweet4U) #17

[quote user="Danielle"]

My nurse had me run a temp basal once I couldn't drink anything...I ran 80% until right before the surgery, then I turned it off and let my normal basals start.

In the morning I was 170 I believe, I did do a small correction to keep me from going over 200.

Before the procedure I was down to 140, they did give me IV sedation...I don't remember a thing from the procedure. Anyway, my BG was 370 afterwards. He told me the I.V was like gatorade...should have known then I would be high afterwards! I did a correction, and it came down just fine. Other then being high right after surgery, my BGs were fine the rest of the time.

I basically ate secure shakes, cream of wheat, pudding, and jello for an entire week. You can definitely eat pudding.....I even had Coldstone Icecream for lunch(LOL I never have stuff like that, no way would I pass up the chance)!!! I did not need any pain meds. I just took Ibuprofen and my antibiotics(four a day).

It really isn't too bad. You will be so happy once it is over with!

[/quote]

Obviously we are totally different people but I will let my cde know what you did with basals and see what she says about what I should do. Sounds like you handled it really well. I wouldn't have guessed that the iv is like gatorade...I guess I should take that into account the day of.

Ha ha coldstone. Nice. We don't have any good ice cream places around here-- no Coldstone, no DQ-- it really kills me. I'll just have my mom get the half-gallon containers at the grocery store :-D

Also good to know that you only needed the Ibuprofin and antibiotics. Hopefully I will be as lucky!

Thanks for replying!


(system) #18

[quote user="Amanda"]

[quote user="Batts"]

they are gonna give you t3's..which for me don't really work..but just remember to take the NEXT dose just before the one previous is going to wear off. the office told me to take my second dose of t3's about an hour before the first one was going to wear off..so by the time it does, the next dose is already kicking in. that helps a lot!

[/quote]

Thanks for the advice. They said the procedure would only take about an hour so hopefully if I'm above range to start with, I won't go low.

This may sound like a dumb question but are t3's steroids? someone mentioned that they made their insulin resistance a lot higher; did this happen to you?

[/quote]

I'm not sure if they are or not considered Steroids. They are really just painkillers. They are equal to roughly 4 Tylenol 1s or 2 Tylenol 2s. I've never noticed any change in my insulin resistance while on them.

To comment on your replies below, they will get you in first thing and 9am isn't so bad. I went in at 830am cuz they were doing the procedure at 9am. They will get you to test before hand, and they do test you during the procedure to make sure you aren't dropping(if you are, I think they just put some gluosce in the IV..), the person from the hospital administering the anaesthesia is trained to do it. After I woke up, they tested again, and made me wait about 45minutes before leaving the office to make sure my levels weren't dropping. I think I even took a shot during that period..but I can't remember now.

 


(Gina) #19

Oh man talking about wisdom teeth. For the last couple of days in spain my mouth w as throbbing like crazy, I don't want to have it taken out but, I think I will have too. ugh.

this same tooth has been giving me problems for umm... like 5 yrs. I guess you can say I am extremely stubborn!


(2Sweet4U) #20

[quote user="Batts"]

I'm not sure if they are or not considered Steroids. They are really just painkillers. They are equal to roughly 4 Tylenol 1s or 2 Tylenol 2s. I've never noticed any change in my insulin resistance while on them.

To comment on your replies below, they will get you in first thing and 9am isn't so bad. I went in at 830am cuz they were doing the procedure at 9am. They will get you to test before hand, and they do test you during the procedure to make sure you aren't dropping(if you are, I think they just put some gluosce in the IV..), the person from the hospital administering the anaesthesia is trained to do it. After I woke up, they tested again, and made me wait about 45minutes before leaving the office to make sure my levels weren't dropping. I think I even took a shot during that period..but I can't remember now.

[/quote]

Ok. I'm going to try to go without the steriods and just take Tylenol or Ibuprofin. I've heard from a few people now that the iv solution can have sugar in it...so I guess I should just expect to be high afterwards.