National Dental Centre Review 2017 and Post-op Advice for Wisdom Tooth Removal

three days ago, I had two wisdom teeth removed from the right side of my jaw.

the pain has come and gone intermittently the past few years in progressive strength from annoyance to unbearable, a point where I cannot allow my ignorance or complacency to shun it aside any longer as it was starting to impact the quality of my work

at first, i booked Q&M but my helpful colleague advised me to go SGH as they can provide proper pain relief and a referral letter to NDC and that means a subsidized fee and after that also a chance of paying most by ur medisave. thank God for friends with experience on such things as I didn't do it during my NSF days like some of my camp mates wisely did.

the one at bottom was what i paid for my visit to SGH

while the top one was what i paid for my visit to NDC

total upfront cash made: SGD $199.48 or RM $618.39

there's more payment to be made which i'll share later

the counter staff, oral surgeons and nurses were really amiable and accommodating to me and i'll briefly say why. i arrived 5 mins before the opening hour of 8am and the information counter lady helped me to get a registration slot anyway even though it was walk-in. i made no appointment prior to this since the doctor at SGH advised to simply walk-in and even stated it in the referral letter.

x-ray and consultation with the first doctor went really smoothly. he explained to me the reason for swelling and inflamation of my right gum and the future implications of decay and infection for the bottom wisdom tooth. the picture of the x-ray also aids in absorbing the explanation better. he'll also ask for your allergies and other questions which i'll advise to answer as honest as u can because the medication used during and after operation, if unsuitable, will cause more harm than good.

after payment for x-ray and consultation, i proceeded to make payment first before waiting to go into another room to book a surgery timeslot. the head nurse was so understanding as she saw my pain level was 9/10 without painkillers so she brought me up to level 3 to wait for a slot under emergency allocation. meaning as long as someone cancels their appointment, i can take their spot. she also advised me on the charges, that if i remove my top wisdom tooth together with my bottom, it can both be paid by my medisave account since the bottom wisdom tooth requires surgical removal.

fastforward to surgery. it was such an intimidating feeling as I've not visited a dentist for almost 17 years. first, they would cover your eyes and lay a thin-layered blanket over your body as well. then they will clean your face and sanitize the entire inside of your mouth. i instantly felt super disinfected already needless to say super clean lol. then there was four-five injections of the local anesthesia at various angles of your gums. top-side was the most painful no idea why.

after a while, they began removal on my bottom right by surgery. there was some cutting of gum skin to reveal the impacted tooth #48. since i was fully awake, i could hear every sound like the drilling to break up my tooth into smaller pieces, only that you minimize the tremor of the drilling sound and increase the pitch. thank God for the injection so I couldn't feel the pain *phew* there were also multiple plucking and pushing effect which u'll feel. obviously it's quite standard u would think like duh right? haha yup that's right they had to hold my other teeth or jaw so they can apply force with the extraction of the bottom wisdom tooth. in between all of the cutting, drilling, and fiddling, there were also times where u'd feel some water or liquid being sprayed over the area like small-radius, medium-pressure and sparse-output type of spray. probably to help clear away the mix of waste and blood. after the bottom was done, the top wisdom tooth was quite simple. probably just a really light tad of drill and a plucking sensation. then stitching and whala all done.

another round of disinfection then a whole bunch of gauze was placed almost perfectly inside for me to bite on while the gums take some time to fill the gaping holes etc. throughout the whole surgery, i could feel that the surgeons were super calming toward me, were also perceptive and had service like 5-star air stewardess simply impeccable imo. i reckon i had prayed to Jesus more times in my head at mach speed during the operation than a whole month combined tbh! lol ok moving on..

after all that is standard procedure. they discussed when I needed to return to remove the stitches etc and from there I proceeded to pharmacy to collect my prescribed medication. I was also given a 5-day hospitalization leave, understandably so due to post-op trauma and implications which may occur. 

so as you can see, after government subsidy, the surgery and medication amount has been reduced to $578 excluding the payment made in cash before this. on top of that, as explained above, this full sum can be paid by my medisave account as I tagged the manual removal of my upper right wisdom tooth to do in the same operation as my bottom right wisdom tooth. really nice of the doctors and nurses to give me this tip.

2 teeth removal total cost: SGD $777.48 or RM $2410.19

now i'll guide you on the medication below and show you what i've done for myself the past 48 hours.

the two-tab 4mg dexamethasone is like steroid in very tiny dose. it helps to reduce inflammation and to prevent jawlock etc. only two issued because the first 12 hours postop is most crucial. however, u may expect some side effects from this and have to avoid anyone with illness or have infections. more common side effects like swelling of certain parts of ur body, shortness of breath, mood change, aggression or troubled breathing while rest etc. 

the 30-cap amoxycillin 250mg are antibiotics. i've never taken antibiotics due to the arduous task of finishing them all the moment i begin ingestion but this time round i will give a one-time exception for my own sake and try it. these antibiotics are the upgraded version from Alexander Fleming's inital discovery. so as I read briefly, this amoxycillin is effective against a broad spectrum of bacterial infections from operations done to your teeth or body in general. for side effects you may expect to experience an upset stomach, diarrhea, vomiting, hives, mild-to-severe rash, seizure and/or difficulty breathing etc.

this mouthwash is made in italy. it seems quite effective as I could not rinse my mouth until one night of full sleep is completed. prior to this I had to keep swallowing saliva including any blood residue from the accidental reopening of wounds from the gums etc. i would highly suggest to follow the nurse's and doctor's advice to NOT rinse your mouth until next day as it will SURELY reopen the gum wounds if u do so lol. at least for one night just endure only trust me it'll be worth it. swallow everything from ur mouth including the saliva that is produced from ur saliva glands. next day you can finally brush your teeth and gargle the mouthwash for the first time. it feels like the more intense cousin of Listerine.

the 5 tab arcoxia 120mg is really effective. it stems the pain that is being produced and signaled to your brain every millisecond so take it as soon as u can after the surgery because once the local anesthesia that was injected during operation wears off, the pain will be felt like a mudda bullshit especially the initial 16 hours. the 120mg one will help reduce the pain level from 9/10 to maybe about 4/10. i'm quite impressed by how scientists can create something that is fast-acting and long-lasting. uncommon side effects that u may expect are shortness of breath(again this one sian..), chest pain, chance of increasing blood pressure if u accidentally take more than once within 12 hours and cannot take if u have liver or heart disease.

then the 30-tab panaco is simply paracetamol or panadol that is non-obligatory. i only needed it for the first 36 hours as I could still feel pain to my cranial region or brain during that time. one thing i've observed is that it helps numb the pain that your brain is receiving but it doesn't numb the pain that is caused from the trauma of ur gum and teeth operation. so that's why u need combine this with arcoxia. if u don't believe, u try it next time, u'll still feel immense pain in ur jaw unless u take the 120mg arcoxia. on top if it, u can only minimize until a full night's sleep is completed. 

to my surprise, my fantastic mum cooked for me heaps of porridge that can last for days due to my inability to consume solids for at least two days. one reason why i like eating pork or beef that is made in australia is because although the protein and fat content is quite similar, the atoms and molecules feel a lot more uniform and somewhat cleaner than the ones made in malaysia. not really a must to do so but if u wan to try for fun, take some time to observe ur body after eating the meat that is made in australia. u'll notice a very slight difference in mood and testosterone expenditure as ur body denaturizes the food thru the enzymes in ur stomach and smaller intestines. it works the same way for vegetables too.

ok enough sidetrack my brain starting to get influenced by watching season four of sherlock holmes tv series haha.

my own simple recordings for ur usage or comparison in future

2 Tab Dexamethasone 4mg/tab

16 Jan 17 - 2350 hr - 1st ingestion

18 Jan 17 - 0453 hr - 2nd ingestion

Arcoxia 120mg/tab - recommended once per day

16 Jan 17 - 15:30 hr - ingestion of 90mg tab proofed insufficient

16 Jan 17 - 2350 hr - 1st ingestion

17 Jan 17 - 1600 hr - 2nd ingestion

18 Jan 17 - 1313 hr - 3rd ingestion

Amoxycillin 250mg/cap - recommended 2 cap per 8 hours

16 Jan 17 - 2355 hr - 1st ingestion (00 hr 00 min difference)

17 Jan 17 - 0830 hr - 2nd ingestion (08 hr 35 min difference)

17 Jan 17 - 1600 hr - 3rd ingestion (07 hr 30 min difference)

18 Jan 17 - 0451 hr - 4th ingestion (12 hr 51 min difference)

18 Jan 17 - 1313 hr - 5th ingestion ( 08 hr 22 min difference)

so far no serious side effects. only a little stomach ache, very little difficulty in breathing when heart rate is at rest time and some swelling on the operated region of the jaw. plus signs will be no noticeable bacterial infection, no lockjaw, no excessive bleeding or vomiting, pain levels from the jaw has been brought down to 2/10 with just arcoxia ingested. brain function not hindered anymore hence, my ability to type out this blog post and also think normally. 

overall as a virgin to National Dental Centre, I would rate my experience there as extraordinary. it is the sort of standard that u would expect no less of our government body(and appreciate too). of course, please get a referral from SGH or our local polyclinics if u're Singaporean like me. it really helps to be able to tap into ur medisave account and enjoy some of the subsidy provided by our understanding govt in health department.