Well, I think you are an extremely exceptional dentist to put up with
that! Good for you!

I think I was an exceptionally good patient to put up with 1 and 1/2 -
2 and 1/2 hours of implant surgery and then on another occassion, gum
surgery, with NO break, and choking on saliva or whatever it is
causing it.

Next time I'm going to say, before we get started, that if I start to
choke, he is to give it to me at the earliest possible time after I
start to choke. I would have thought that need not be said, but....

Definitely--I was replying only to your prior post.  As far as choking,
it is sometimes difficult to interrupt surgery at a particular point.
Some surgeons may be more or less sensitive to discomfort of any kind
esp. intraoperatively.  Certainly if there is debris causing discomfort
it should be possible to have it syringed and suctioned away.  It should
also be possible to give the conscious patient a few moments to rest at
various points during the procedure.  It's a matter of degree--I have a
patient who demands to be able to rinse every 10 seconds--I'm trying to
decrease this interval and she's trying to decrease it.  In this case
I'm clearly dealing with something other than a dental issue, but I (and
she) still have to deal with it; we try to compromise to the extent that
neither of us are TOO unhappy.  I usually finish the visit with a knot
in my stomach though.

Steve

p.s. Dr. Bornfeld, is it possible you did not read the OP and just
assumed this was about the sinus lift operation?
In reality, this post was specifically about the idea of my surgeon
not stopping to let me swallow or rinse when I was getting my gum
surgery this time, or my implant surgery last time.
It wasn't about whether he did a good job on the implants or sinus
lift.

However, your comments on that were still welcome! ;-)

    There really is no way to know.  And as a gp I really don't have the
professional standing to pass judgement on surgeons who presumably know
the ins and outs of this procedure.  IOW, I could just shoot my mouth
off, but what good would it do?
    OK, I'll shoot my mouth off.  I haven't had that many patients going in
for sinus lifts.  I tell them that the attitudes about entering the
maxillary sinus have changed tremendously in the 31 years I've been out
of dental school, and the success rates for this kind of surgery are
reported to be high.  BUT::
    Given my cautious nature, and my training that inadvertently entering
the maxillary antrum during an upper molar extraction was one of those
things to recoil in horror from, I also tell my patients that implants
are wonderful things, and I would not hesitate to have one placed in my
mouth, nor would I hesitate to get a bone graft.  A sinus lift however
is where I PERSONALLY would draw the line, because sinus sufferers seem
to be such a miserably suffering lot that I don't wish to tempt fate.
This is a PERSONAL, not a PROFESSIONAL judgement that I would make for
myself.
    When you add to the mix the existing history of sinus problems, it is
something that just seems like looking for trouble here.  Everything may
have been done perfectly according to Hoyle (or not) but I wouldn't look
for tsuris in this way.
     I hope you recover promptly.

Steve

Why won't anyone touch this thread?
It leads me to believe that it IS the mistake of an inexperienced
surgeon, and no one wants to come out and say that.
or...?

Whenever I get gum surgery or implant surgery from my grad-student
dentist, I always end up choking towards the end of the session - an
hour and a half or so...

I always seem to get a lot of saliva and/or crap from the surgery
(blood, etc.?) in my throat and I find it difficult to swallow and end
up coughing/choking. I do my best to control it as he is suturing or
finishing up but it becomes very uncomfortable.

Should I demand to let him let me get up and rinse/spit, or what?

I have only had this problem with my implant and related surgeries by
this grad-student dentist and I don't know if it's because I've never
had such long sessions before, or if it's his or the assistant's
inexperience in getting me "suctioned" properly or ...?

Yesterday I had the gums cut open to reveal the 4 implants I had in
July (to prepare for crowns, finally!) and I was choking like crazy at
one point so he said, "Do you need to rinse?" and before I could say
yes, he said "We're almost done..."...

so I waited... another HALF HOUR of choking!

I hate to be a difficult patient so I just put up with it, but this
seems somewhat abusive and in retrospect I think I should have
demanded to get up and spit...

What is a patient to do?