But how long does it last? It does not appear that anaesthetic agents have teratogenic effects in humans. Local anaesthetic without any sedation: you will be fully awake during your treatment, but will be comfortable. The dental treatments in the study included tooth extraction, endodontic treatment, and tooth restoration. You will not need to stay in hospital and can go home the same day. Sometimes a vasopressor such as epinephrine is added to the anesthetic to increase its effect and to keep the anesthetic effect from spreading to other areas of the body. The birth of a baby is a real happiness and great joy for young parents. Some men have ongoing pain in their testicles. Anesthesia means a lack or loss of sensation. Let the doctor or nurse know if you feel any discomfort during the procedure. For example, if your partner has just had a baby, or has just terminated a pregnancy. All the presently used local anesthetic agents in the increasingly popular modalities of obstetric regional anesthesia cross the placenta readily, governed only by two factors that the anesthesiologist has any control over (1) dosage and timing of doses and (2) uterine blood flow as it relates to the development of . When I went for my check up last month and he told me I needed a filling, I did ask him then for his reassurance that it was ok to have the local anaesthetic. According to the American Pregnancy Association (APA), pregnancy hormones can actually affect the way your body responds to bacteria, which can lead to periodontal infection and you guessed it sore teeth and gums. The epididymis is the long, coiled tube that rests on the back of each testicle. %PDF-1.7 % (2019). You may need more local anaesthetic. Most people dont experience adverse reactions with local anesthesia. Get Started To Read . 20 December 2022, Feedback display message, this and the title will be overided by Javascript. For a spinal anaesthetic, the anaesthetist will inject a small amount of local anaesthetic into the spinal fluid in your back. To obtain Watson A K . All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Sir, the use of local anaesthetics (LA) in the treatment of pregnant women is a difficult area as there is an absence of evidence because of ethical constraints . Akpinar H. (2019). Local anaesthetics and pregnancy. This can sting for a few seconds before the area becomes numb. H\n@CXBg#?Zg oSJVaj>Nw}N.1!Lvm;s%Yj/q~e,]3N^MI}lvgkwxt6%t[5V\:/{7qOq!|3}CU! Learn more about the different, Laughing gas is commonly used at the dentists office to help you relax during certain procedures. Try home remedies for toothaches like clove oil to numb the gums. In most cases, you'll be able to return home the same day. The doctor will feel the vas deferens underneath the skin of your scrotum and then hold them in place using a small clamp. Anesthetics work in different ways depending on whats used. A colposcopy is usually carried out in a hospital or clinic. Take over-the-counter pain medication like acetaminophen. Theres also an increased risk with a history of bleeding disorders or with medications that increase the risk of bleeding like aspirin. 30 0 obj <> endobj Click here to toggle the visibility of this menu. The pain is usually the result of a pinched nerve or scarring that occurred during the operation. If you're not sure about wanting children in the future, don't have a vasectomy. Lim MAWT, et al. Most people will only need a local anaesthetic. (Anaesthesia is a state of carefully controlled and supervised unconsciousness and means you are unable to feel any pain). Never use more than the recommended amount on the products label. The only time that a professional will not be able to keep confidentiality is if they believe you're at risk of serious harm, such as abuse. CX!MZ?48&54QCB >elYoB?-'C4cv>Yamh21o/LU]OSe7d\mom=79L6um;Kf|ildtrO;)>.#"g*xYbYpKp/KxK--iS% ;OIZ'z2]{^| k^+^zE+Z./kN^sz#95G6Y7# j=(9NSwa0 KI The colposcope does not go inside your vagina, You may feel a little uncomfortable, but you should not be in any pain, The doctor or nurse will put liquids on your cervix. A sample of affected tissue is taken so it can be checked under a microscope. endstream endobj 31 0 obj <> endobj 32 0 obj <> endobj 33 0 obj <>stream If you have any doubts, consider another method of contraception until you're completely sure. Most people will only need a local anaesthetic. There are different risks with general anesthesia. Several of these procedures, such as cataract surgery, can be done with either type of anesthetic. Following a vasectomy, you may develop a haematoma inside your scrotum. Br Dent J 1989; 166: 36. Local anesthetics are generally safe and usually dont cause any side effects, aside from some tingling as it wears off. Anaesthesia: LA in pregnancy. The medication might be given orally (tablet or liquid), inhaled, intramuscularly (IM), or intravenously (IV). DOI: Kumar M, et al. A screen can be placed to stop you seeing the procedure. Provided by the Springer Nature SharedIt content-sharing initiative, British Dental Journal (Br Dent J) If you have a coil (IUD or Mirena coil) the doctor or nurse will try not to cut the threads. Avraamides E J, Craen R A, Gelb AW . Healthline Media does not provide medical advice, diagnosis, or treatment. Try to be mindful of the affected area while the anesthesia wears off. Gently floss to remove food or plaque between teeth. DOI: clevelandclinicmeded.com/medicalpubs/pharmacy/JanFeb2001/allergicreaction.htm, 10.2344/0003-3006(2006)53[98:eolap]2.0.co;2, minervamedica.it/en/journals/minerva-anestesiologica/article.php?cod=R02Y2005N03A0059, 6 of the Most Painful Surgeries and Procedures You May Experience, Everything You Need to Know About Dental and Oral Health. The use of general anesthesia to facilitate dental treatment in adult patients with special needs. There are two main types of local anesthetics, depending on how theyre administered. A spinal anaesthetic is a single injection into a similar space in the back. I called my doctor and he said it was fine for the antibiotics and when I asked him about . A surgical termination of pregnancy (STOP) means you will go to the operating theatre to have the pregnancy tissue removed under local anaesthetic with sedation or general anaesthetic. While you shouldnt feel any pain, you might still feel sensations of pressure. After a vasectomy, some men may develop the sensation that their testicles are 'fuller' than normal. How can I sleep with a toothache while pregnant? Up to 15 weeks this can be done with sedation (relaxed and sleepy) or under general anaesthetic. This usually only takes a few minutes. hb```a``2eahP') .p30Fti }A$,F~D More blood circulation means experiencing more tooth pain than if you were standing. This can cause your scrotum to become very swollen and painful. Slightly painful conditions, such asmouth ulcers andsore throats, can sometimes be treated with over-the-counter gels and sprays that contain a local anaesthetic. Injections of a local anaesthetic and steroid medicinemay be used to treat more severe conditions, such as long-termjoint pain. They'll provide you with contraception as long as they believe you fully understand the information you're given and are able to use the contraception safely. The procedure is very safe, but afterwards there is a small chance of: If anything like this does happen, the healthcare team will be there to look after you. While the connection between oral bacteria and preterm births has been established for over a decade, Hans study provides the first direct human evidence that oral bacteria can also cause stillbirth. Can You Eat Firehouse Subs While Pregnant? We break it down so youll feel more confident before your next dental appointment. There is no evidence of passage into breastmilk and therefore no reason not to continue breastfeeding. The most common causes of sensitive teeth during pregnancy include: Hormones. If you have any bleeding, discharge and pain: Page last reviewed: 24 May 2022 This may be due to both the mechanical effect of the enlarging uterus and hormonal changes, increasing sensitivity to local anaesthetic agents. Internet Explorer). Most other anaesthetic medications, including barbiturates, propofol, opioids, muscle relaxants, and local anaesthetics have been widely used during pregnancy with a good safety record. 44 0 obj <>/Filter/FlateDecode/ID[<0F0260AFB7087DC678893FD8121F5F8A><312AF39B85B33540B67A1EFF81C3E3EA>]/Index[30 25]/Info 29 0 R/Length 77/Prev 62260/Root 31 0 R/Size 55/Type/XRef/W[1 2 1]>>stream Local anaesthetics are administered near the site of surgery or procedure and do not normally enter the bloodstream in significant amounts. You should move carefully until the anaesthetic has worn off as you may not notice if you injure yourself. Injectable anesthetics are typically used for numbing during procedures, rather than pain management. Where you shouldn't apply it: Do not put numbing cream on skin that is red, swollen, sore, cracked, or scraped.Also avoid the skin around your eyes. "I'm at the dentist on Monday to have a small filling done and have been worrying about it for ages. You can often go home to rest soon after the treatment is finished. Hold in the area for a few minutes until the pain subsides. When you arrive at the hospital or clinic, you'll speak with a nurse about what's going to happen during the colposcopy. Your dental provider will give you instructions to follow before and after the procedure. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. You can ask to have your information moved to another provider (data portability) You have the right to ask for your personal information to be given back to you or another service provider of your choice in a commonly used format. You will first have an injection of local anaesthetic to numb your cervix so you should not feel any pain. What can you do for a toothache when your pregnant? However, in some cases, a vasectomy can cause more serious problems. If you do need pain relief, discuss these remedies with your prenatal medical professional: Patients should be counseled to transition to non-narcotic pain relievers, such as plain acetaminophen, as soon as possible. Is local anesthetic safe during pregnancy UK? LLETZ is often done at the same time as your colposcopy. Adverse drug reactions in dental practice. It can happen immediately, a few months or a few years after the operation. It may be occasional or quite frequent, and vary from a constant dull ache to episodes of sharp, intense pain. ;py#2>W,/`{@OH#`4hFGys? It takes an average of 20 to 30 ejaculations to clear the tubes of sperm. They can tell you what the local arrangements are. Its very easy to accidentally injure the numbed area in the few hours following a procedure. You can have sex again as soon as it's comfortable to do so. In deep sedation, youre generally not aware of your surroundings and can only respond to repeated or painful stimulation. You shouldn't experience any significant side effects. View our YouTube channel - (This will open in a new window). This blocks the pain nerves very quickly and makes you numb from the breasts down. These are some reported side effects of anesthetics. If you do not wish to be pregnant following implant removal, it `APZ bZ $ @d,e *#H4!;@ y: If a reversal is carried out within 10 years of your vasectomy, the success rate is about 55%. This isnt harmful. The Department of Health and Social Care advises that amalgam fillings should not be removed during pregnancy. Search NHS Inform - Click here to submit this form. A vasectomy does not protect against HIV infection or any other STIs, so you should still use condoms with any new partner. x#iF Y3J >- The incisions are stitched, usually using dissolvable stitches, which will disappear naturally within about a week. Page last reviewed: 23 January 2022 In the meantime, to ensure continued support, we are displaying the site without styles You can self-refer through local NHS services, . Most men will be fit to return to work 1 or 2 days after their vasectomy. The success of dental anesthesia depends on: Other things that may effect dental anesthesia include the timing of the procedure. Becker DE. Local anesthesia is used to numb a small area before minor procedures, including dental work and some skin treatments. Apply pressure with the cold compress on the swollen area. What are the effects of a general anesthetic on someone who is pregnant? However, speak to your GP if you are still experiencing fullness after this time. (2017). They can often be treated using anti-inflammatory medication, which your GP will prescribe. Keep reading to learn more about the different types of local anesthesia and when theyre used. Infection A deep cavity that leads to an abscess can affect not only your health, but that of the baby, especially if the pain is severe enough to cause significant stress. Up to 14 weeks, this can be done with local anaesthetic. Swishing warm, salty water (1 teaspoon of salt added to a cup of warm water) around in your mouth can help reduce inflammation, which might offer some relief. Topical anesthetics come in the form of: In some cases, your doctor might use a combination of local anesthetics for a more long-lasting effect. It helps to transport and store sperm. Article You'll be asked to sign a consent form. Local anaesthetics are generally very safe and serious problems are rare. Each has specific uses. During a no-scalpel vasectomy, there will be little bleeding and no stitches. LLETZ takes around 15 minutes. Whether for dental treatment, removal of a mole, or something more serious, its difficult not to worry, but, MFMs GP Dr Philippa Kaye says local anaesthetic are safe for mums-to-be. If you are trying to become pregnant, the sperm may not be able to get to the womb. And, according to the British Journal of Anaesthesia, "local anaesthetics have a good safety record for use during pregnancy". Topical anesthetics like lidocaine, prilocaine, and benzocaine are generally considered safe during pregnancy when used topically. "In fact, epidurals for pain relief during labour are a form of local anaesthetic," she says. Reactions also vary based on individual factors. Male sterilisation is considered permanent. If you wear a loose skirt or a long jumper, you may be able to keep this on during the procedure. y?M64+1U8MpN/Yf&0+KKbZX{1{E_~DkQRF'"PGK_LDZ8ug0)`}f1VI:J@\&]N8Sc4w)(}:Qi3;dpzO+JsE~RUp[e) l>.v|KLd_`(g J|(R[2z/>L Pv)R!(`>W*y&[7HWdEH \#mQD>93A 8]Uki]n[Xoiq$mcVFmFt5p' + Sometimes, light sedation is added to local anesthetics to help relax a person. Local anesthesia refers to using a drug called an anesthetic to temporarily numb a small area of your body. 17. Special precautions when taking dental anesthetics, chronic obstructive pulmonary disease (COPD), nigms.nih.gov/education/pages/factsheet_anesthesia.aspx, ada.org/en/member-center/oral-health-topics/anesthesia-and-sedation, mouthhealthy.org/en/az-topics/a/anesthesia-and-sedation-for-your-child, ada.org/~/media/ADA/Education%20and%20Careers/Files/anesthesia_use_guidelines.pdf, anesthesiology.pubs.asahq.org/article.aspx?articleid=2670190, Side Effects of General Anesthesia: What to Expect, Going Under Anesthesia May Impact Your Memory. For this reason, many healthcare providers recommend avoiding bupivacaine injections during pregnancy whenever possible. Your doctor might use a local anesthetic before doing a minor procedure, such as a skin biopsy. You shouldn't make the decision about having a vasectomy after a crisis or a big change in your life. Oxford University Hospitals NHS Foundation Trust, 2019. According to the American College of Obstetricians and Gynecologists (ACOG), local anesthesia is considered safe during pregnancy because it does not enter the bloodstream in any significant amounts. (2018). This is usually caused by the epididymis becoming filled with stored sperm. You will be conscious and able to communicate when you get a local anesthetic. Yes, but if you're under 30 many surgeons are reluctant to do it in case your circumstances change and you regret it later. (2014). Recent data has shown the combination of Advil (ibuprofen) and Tylenol (acetaminophen) is as effective as prescription opioids for tooth pain. If you have a vasectomy, and then decide later that you want a child, there may be the option of doing so by IVF (in vitro fertilisation). Ask if you need to arrange for transportation after the procedure and any other information you need to know. Evaluation of general anesthesia and sedation during dental treatment in patients with special needs: A retrospective study. Use a condom to protect yourself and your partner against STIs. ho0IT!-PJU?A$~wNV}wG;4pPeA*)qJ@Eha9ac6,JWniSrcYg bT &IaPKE1!UUNSn]wz{63Phry?\^{\`ir&W%]VZ}g 57aouG'ly . We'll go over the symptoms of an allergic reaction to anesthesia as well as those of nonallergic. Its sometimes used with a sedative. Some medicines containing mild local anaesthetic are also available on prescription or over the counter from pharmacies. Ask questions about risks and safety precautions that will be taken to ensure a positive outcome. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are not recommended during pregnancy. To do this, a surgeon would retrieve sperm from your testicles and use this to fertilise your partners egg. Vasectomy is usually carried out under local anaesthetic, and takes about 15 minutes. The American College of Obstetricians and Gynecologists (ACOG) has concluded that the use of local anesthesia during pregnancy does not increase the risk for adverse fetal outcomes or miscarriage. endstream endobj 421 0 obj <>stream Contraception tries to stop this happening by keeping the egg and sperm apart or by stopping egg production. Here's what you should know before heading into surgery. However, there are some risks associated with this type of anesthesia that could affect your baby if they occur at certain times in your pregnancy; therefore, its important to speak with your healthcare provider before receiving any form of anesthetic while pregnant. How do you make homemade breast milk lotion? Researchers conclude that middle-aged people have a higher risk of memory loss and cognition decline after undergoing surgical anesthesia. Each tube is cut and a small section removed. But how long does it last? Contraception is free to all women and men through the NHS. hb```nVO eah0aB @d'j&@Y The incisions allow your surgeon to access the vas deferens. Be sure to let your dental team know if you have a hiatal hernia, acid reflux, infections or open sores in the mouth, allergies, severe nausea and vomiting with anesthetics, or are taking any medications that can make you drowsy like opioids. Most dental services and procedures, including dental x-rays, tooth extractions, dental fillings, and dental cleanings, can be done during pregnancy safely, with tooth extractions recommended during your second or third trimester. But if this happens the coil can still be removed safely without the threads when needed. Yes, you can get local anesthesia while pregnant. The American Dental Association (ADA) and American Congress of Obstetricians and Gynecologists agree that root canals can be safely performed during pregnancy. No. If you're under 30, particularly if you do not have children, your doctor may be reluctant to perform the procedure. Child Custody Lawyers in OKC: A Comprehensive Guide, 9 Reasons To Choose A Stroller Wagon Over Baby Strollers, How To Create A Sleep-Friendly Environment For Your Baby, Stress-Free Strategies For Sending Out Your Babys Birth Announcements. Anesthesia allergies are rare, but they can happen. You may be given a sheet to cover yourself. PubMedGoogle Scholar, Markose, G., Graham, R. Anaesthesia: LA in pregnancy. While battling with her own demons she continues to be the voice for others unable to speak out. You can ask to stop at any time. %%EOF endstream endobj 422 0 obj <>stream Anepidural anaesthetic, often referred to as an epidural,is where a local anaesthetic is continually injected through a tube into an area of thelower back called the epidural space. (2017). This means that only your scrotum and testicles will be numbed, and you'll be awake for the procedure. Doctors and nurses have a responsibility to make sure that you're safe and free from harm. The vas deferens (tubes that carry sperm from a man's testicles to the penis) are cut, blocked or sealed with heat. The reason for this is that in the first trimester organogenesis occurs and small degrees of insult may lead to significant damage to the developing foetus. You will not feel any pain but it may feel slightly uncomfortable. However, it should only be done under the supervision of an experienced medical professional who is familiar with all of the risks and benefits associated with this procedure. Local anaesthetics are administered near the site of surgery or procedure and do not normally enter the bloodstream in significant amounts. The NHS website provides more information on this topic so its worth checking out if youre looking for further advice.if(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[580,400],'classifiedmom_com-medrectangle-3','ezslot_3',111,'0','0'])};__ez_fad_position('div-gpt-ad-classifiedmom_com-medrectangle-3-0'); Credit: www.healthline.com if(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[336,280],'classifiedmom_com-medrectangle-4','ezslot_5',112,'0','0'])};__ez_fad_position('div-gpt-ad-classifiedmom_com-medrectangle-4-0'); No, local anesthetic is not known to cause miscarriage. You might also receive local anesthesia before a dental procedure, such as a tooth extraction. A doctor has the right to refuse to carry out the procedure if they do not believe that it is in your best interests. This is because people under 30 have higher rates of regret about having the procedure. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Examples of procedures that might involve topical anesthesia include: Over-the-counter (OTC) topical anesthetics, such as benzocaine (Orajel), can also help manage pain from: Local anesthetics can also be given as an injection. There are conditions and situations in which you and your doctor or dentist will discuss if dental anesthesia is the best choice for you. "However, as with any medication or procedure do tell your medical team that you are pregnant so that only pregnancy safe medications are used. This will also help to identify the rare cases in which the tubes naturally rejoin themselves. The sedative will help you feel calm and relaxed. ISSN 0007-0610 (print). How do I know if my toothache is serious? The level of anesthesia depends on the procedure and the individual patient. What is the best painkiller for severe toothache? Get the facts on all, Childbirth requires your participation, so its rare to receive general anesthesia during vaginal delivery because it makes you unconscious. DOI: What are the types of dental anesthetics? Long-term testicular pain affects around 1 in 10 men after vasectomy. DOI: Facco E, et al. Children and those with special needs require careful evaluation of the type and level of anesthetics they need. Can you use allergy eye drops when pregnant? A heated loop of wire is then used to remove the tissue. 0 Fillings should be discussed with your dentist beforehand. MAC anesthesia also called monitored anesthesia care or MAC is a type of sedation during which a patient is aware and able to breathe on their own. You can learn more about how we ensure our content is accurate and current by reading our. You have a toothache that lasts longer than one or two days. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. The type of anesthetics used also depends on the age of the person, health condition, length of the procedure, and any negative reactions to anesthetics in the past. Make sure you dry your genital area gently and thoroughly. During a conventional vasectomy, the skin of your scrotum is numbed with local anaesthetic. Pregnancy outcome after in utero exposure to local anaesthetics as part of dental treatment. Here are six of the most painful ones. Recommendations Some reported side effects with sedation and general anesthesia medications include: Vasoconstrictors such as epinephrine added to anesthetics can also cause heart and blood pressure problems. If you have periods, they might become irregular or painful. As it wears off, you might feel a tingling sensation or notice some twitching. All rights reserved. 0J l A colposcopy should not be painful, but it can sometimes feel uncomfortable. ?7611D _E In most cases, it is recommended that pregnant women should avoid general anaesthesia. Some evidence suggests a mutation that causes red hair is also involved in response to pain and anesthesia. People with liver, kidney, lung, or heart problems might need dose adjustments because the drug might take longer to leave the body and have a more powerful effect. If you do not have a further implant fitted, or if you are not using any alternative contraception, your fertility will return immediately. Do I need to tell my dentist Im pregnant? You may have: some discomfort when the injection is given a tingling sensation as the medicine wears off possibly some minor bruising, bleeding or soreness where the injection was given You shouldn't experience any significant side effects. If youre pregnant and need a filling, root canal or tooth pulled, one thing you dont have to worry about is the safety of the numbing medications your dentist may use during the procedure. Transperineal template biopsy and mapping of . The amount of radiation used in a dental X-ray is very low and, according to both the American Dental Association and the American Pregnancy Association, is not enough to cause any harm to a pregnant woman or her baby. Some peopleexperiencetemporary side effects froma local anaesthetic, such as: These problems will usually pass, but you should tellthe healthcare professional in charge of your careif you experience any. View our Facebook page - (This will open in a new window). Just make sure to tell your doctor if you: Youll be given local anesthesia shortly before your procedure to give it time to start working. Your sex drive, sensation and ability to have an erection wont be affected. Last medically reviewed on January 26, 2018. It can be toxic if too much is absorbed in your skin. Once the operation has been carried out successfully and semen tests have shown that there is no sperm present, long-term partners may not need to use other forms of contraception. It can also be expensive as it's not available on the NHS. This is to minimise the risk of developing complications. Please do not change the dressing. Learn which might be best for you. Some people might experience delirium or confusion and memory problems after surgery. It's usually safe for you to have a bath or shower after your operation. It has a slow onset of action, taking up to 30 minutes for full effect. DOI: Guidelines for use of sedation and general anesthesia by dentists. Although prostate cancer and testicular cancer can occur in men who have had a vasectomy, research suggests that vasectomy does not increase your risk of cancer. (2016). If the granulomas are particularly large or painful, they may have to be surgically removed. The concentration in the foetal circulation in descending order are by prilocaine, lignocaine and bupivacaine.3,4 In addition the dose of adrenaline used in lignocaine is so low that it is unlikely to significantly affect uterine blood flow and the benefits of its incorporation justify its use.5,6. At least 8 weeks after the procedure, you'll need to produce a sample of semen, which will be tested for sperm. Thank you for visiting nature.com. If youre taking pain medications such as opioids or gabapentin, or anxiety medications like benzodiazepines, let your dentist or surgeon know so they can adjust your anesthetic accordingly. . In some cases, having a local anaesthetic can reduce the risk of complications during labour or delivery. Magda Ibrahim is a freelance writer who has written for publications including The Times and Sunday Times, The Sun, and the London Evening Standard, as well for MadeForMums. The NHS advises: "Let the person fitting your IUD know if you feel any pain or discomfort while you are having it fitted. 448 0 obj <>stream These liquids help them see any abnormal cervical cells, You may feel a mild tingling or stinging sensation when the liquids are used, A small tissue sample, around the size of a pin head, may be removed for testing. Most men feel sore and tender for a few days after the operation, and will usually experience some bruising and swelling on or around their scrotum. Most local anesthetics take effect quickly (within 10 minutes) and last 30 to 60 minutes. What are the side effects of dental anesthesia? Sedation has several levels and is used to relax a person who may have anxiety, help with pain, or keep them still for the procedure. Also, the inflammation and resulting fever can cause stress in the growing fetus. 437 0 obj <>/Filter/FlateDecode/ID[<1DEEE8B86EB75D418152BE7D0B33095B>]/Index[417 32]/Info 416 0 R/Length 96/Prev 161754/Root 418 0 R/Size 449/Type/XRef/W[1 2 1]>>stream Its important to discuss all your concerns about the procedure and your expectations with your dental care team before.

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