Wisdom Teeth Surgery - Advice

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Hello everyone,

Looks like I have to get all 4 of my wisdom teeth out friday. The bottom two are impacted and are below the gums, and the top two are already in straight. Here's my dilemma...

I have never undergone anesthesia before and as much as I hate to admit it, I am nervous as all heck about getting put under. The pulling and cracking noises don't bother me nearly as much as the thought of being put to sleep. My thinking is what is the point of getting the general anesthesia if that's what I fear the most of the whole procedure? So I am thinking about asking for local anesthetic only (lidocaine or septocaine).

Has anyone had this surgery using only local? What was your experience like?

Thanks
  • Profile picture of the author cashtree
    I don't remember what they gave me when they pulled my wisdom tooth, but my advice is just let them inject what they want. The needle doesn't look very pleasing but it's really not that bad after the first couple of times they inject it, as your mouth will be numb by then. You really don't want them drilling in there without it being numb, and to be honest I think the worse part is afterwards. For two reasons, one if you don't keep ice where you need to, there's a high chance your face will swell up like a ballon(happened to me :\ ) an two, this is a personal thing but I really can't stand gauze, the feeling of it even between my fingers makes me really uncomfortable(maybe childhood trauma or something IDK) and having to bite down on that stuff to soak up the blood for days, and take it out when your mouth is sore...really not fun. Lastly you should really stock up on jello, and similar things, because you won't be able to eat anything harder than that.
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    • Profile picture of the author Kay King
      You do NOT want to be awake. The anesthesia puts you to sleep in a few seconds; it takes a little time to fully wake up - and the procedure is over when you do.

      This is surgery - not just tooth extraction. Just be sure to stock in some soft, non-acidic foods to eat for the first few days after surgery.

      This is a rather common surgery and just something you have to get through - I wouldn't even consider doing it without anesthesia.
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      • Profile picture of the author Matt Attack
        To the first response....I fully intend on letting them numb the area with local anesthetic....no way I would do this without that!

        But as I said I don't care about the pulling, drilling, cracking - it's being put to sleep that scares me. So it seems paradoxical to go there and undergo the thing I fear the most in order to relieve the thing I fear the least?

        BTW - I'm 26 years old
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  • Profile picture of the author seasoned
    Matt,

    I think cashtree misunderstood you. If the teeth are not that well supported and/or clearly exposed, they may not even use an anesthetic. They could also use a topical anesthetic, and then give you a shot that is relatively painless because of the topical. It CAN be scary because, given the position, and placement, that needle is generally HUGE! BTW this generally affects up to half of the jaw and, only one, and is certainly NOT general, so they call it local.

    *****BUT***** given what you describe, unless you are younger than maybe 25 and they feel those teeth may come in, they COULD put you under a GENERAL anesthesia. It IS amazing what they can do and STILL having you eating solid food quckly, with no apparent sign of any work. Get a good orthodontist, and you will likely be fine. There is *******NO******* way they will work on those unexposed teeth without general anesthesia. Just FORGET IT!

    I have had BOTH! I forget why I got the general, but I DID get it at a dentist. My orthodontist practically BEGGED me to have my wisdom teeth removed, and SWORE he would tell his BROTHER to do the same. I gave in. Luckily, they were exposed though, and all went smoothly. I was SHOCKED how smoothly it went. Of course, a pocket was left, and I had to constantly rinse with salt water, but it healed well, like the teeth were never there.

    Steve
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  • Profile picture of the author derekwong28
    The problem are with the bottom impacted and non-erupted teeth. Quite a lot of cutting would be required to get them out. But I wonder whether you need to take them out in the first place. I still have mine in place but the top ones were extracted one at a time.
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  • Profile picture of the author Alexa Smith
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    Originally Posted by Matt Attack View Post

    I have never undergone anesthesia before and as much as I hate to admit it, I am nervous as all heck about getting put under.
    Don't be embarrassed about it. Different people react very differently to different aspects of medical/surgical procedures. For some people it's the prospect of discomfort/pain that's terrifying. For others it's the idea of general anesthesia. You are by no means alone.

    All you can do is try to look at it completely rationally, discuss it with the surgeon, and eventually, I think, reluctantly accept that millions of people have wisdom-tooth extraction performed this way every year, and that however you feel about it yourself, there are good and valid medical reasons why multiple extractions are usually done under general, rather than under local.

    I haven't had this. But I've had many general anesthetics and (at other times) plenty of root canals and so on, done under local. Personally, I wouldn't dream of having multiple wisdom-tooth extractions done without a light general anesthetic (and a light one is all you'll get from them, I imagine - it's only a small step up from "sedation" to a "light general", you know?).

    Good luck and good wishes!
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  • Profile picture of the author seasoned
    Matt,

    It is hard to know. I actually kind of agree with Derek. Dentists are some of the most dishonest people out there. They are TRAINED to lie! What have dentists done with ME?

    1. Removed teeth I felt to be FINE!
    2. Given me mercury by LYING to me.
    3. Filled teeth I felt did NOT have cavities, with MERCURY!
    4. Spaced my teeth to "give me minor alignment", and the jerk then made me believe he was an IDIOT! I was CONVINCED that two teeth were STRATEGICALLY changed to cause me future trouble, BY HIM. The problem didn't exist before the work.

    So what happened after that? Well, the spaces closed, so a lot of the benefit there is gone. NO teeth underwent structural failure EXCEPT for the two I felt, FOR DECADES, were on borrowed time. One failed a few years ago, with "CTS"(Cracked tooth syndrome). I had to have it ground down to a nub, and capped. The cap was set off center so that it NOW appears straight, so the stress it had undergone for almost 40 years and caused the CTS wouldn't happen again. The other has gradually gotten worse, and the dentist only a few weeks ago basically said it was on borrowed time.

    With my wisdom teeth? Well, they WERE way back on the hinge of my mouth, and a bother to clean, but that was it. Still, I am happier without them.

    Steve
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    • Profile picture of the author ThomM
      Matt, they don't use an anesthesia, that would require a breathing tube (ventalator) which would be in the way of the doctor.
      What they do is shoot you up with liquid valium so you are actually awake, just totally unaware and you can't feel anything at all.
      WHen I had all my teeth yanked for dentures I started coming out of it while the doctor was still pulling. I remember him yanking at least 2 teeth out before he realised I was aware
      It was after I came around that he explained the valium thing. He even said he could tell me what to do (as in open wider) while under and I would respond. He said the biggest problem he had with me was, apparently I get real chatty when I'm on valium and he had a hard time making me stop talking

      EDIT: Just wanted to add, my mother had issues with any type of anesthetic in her mouth and had all work done without it.
      I have a big, big, big, issue with needles in my mouth and was in my 40's before I found a dentist who could work with me on that.
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      • Profile picture of the author Matt Attack
        The needles don't bother me, I've had probably 30+ lidocaine shots in my mouth before. Usually the first couple never get it fully numb.

        It's being put out that bothers me :-/ I know it sounds strange - probably the opposite of how most people feel.
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        • Profile picture of the author ThomM
          Originally Posted by Matt Attack View Post

          The needles don't bother me, I've had probably 30+ lidocaine shots in my mouth before. Usually the first couple never get it fully numb.

          It's being put out that bothers me :-/
          I got goosebumps just reading that
          I understand what you are saying but like I said, technically you're not put out, just made not aware
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        • Profile picture of the author seasoned
          Originally Posted by Matt Attack View Post

          It's being put out that bothers me :-/ I know it sounds strange - probably the opposite of how most people feel.
          HECK NO! About the three biggest reasons for deaths on anesthesia are probably:

          1. Drowning through regurgitaton.
          2. Overdose.
          3. Oxygen depletion.

          THAT is why they tell you not to like eat or drink anything prior, monitor you, and have oxygen ready. It is UNLIKELY to happen today, but some quacks, like that doctor of MJ, may STILL have a problem.

          Think of it THIS way though. If you are out, they can restrain you and do FAR more than they could if you are awake.

          Steve
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      • Profile picture of the author seasoned
        Originally Posted by ThomM View Post

        Matt, they don't use an anesthesia, that would require a breathing tube (ventalator) which would be in the way of the doctor.
        What they do is shoot you up with liquid valium so you are actually awake, just totally unaware and you can't feel anything at all.
        WHen I had all my teeth yanked for dentures I started coming out of it while the doctor was still pulling. I remember him yanking at least 2 teeth out before he realised I was aware
        It was after I came around that he explained the valium thing. He even said he could tell me what to do (as in open wider) while under and I would respond. He said the biggest problem he had with me was, apparently I get real chatty when I'm on valium and he had a hard time making me stop talking

        EDIT: Just wanted to add, my mother had issues with any type of anesthetic in her mouth and had all work done without it.
        I have a big, big, big, issue with needles in my mouth and was in my 40's before I found a dentist who could work with me on that.
        They never shot ME up wth valium. Not all anesthesia requires a breating tube.

        I was ALWAYS against such needles, but they were quick and good. almost until the day my mother died, she STILL laughed at the memory of the time she took me to a quack. They didn't wipe the alcohol off, didn't catch a vien, and were persistant, so I ran away, and they tried to catch me. I was about ready to start sticking THEM with needles! That was the ONLY time I had such a problem though.

        They look scarier than they are.

        Steve
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        • Profile picture of the author ThomM
          Originally Posted by seasoned View Post

          They never shot ME up wth valium. Not all anesthesia requires a breating tube.

          I was ALWAYS against such needles, but they were quick and good. almost until the day my mother died, she STILL laughed at the memory of the time she took me to a quack. They didn't wipe the alcohol off, didn't catch a vien, and were persistant, so I ran away, and they tried to catch me. I was about ready to start sticking THEM with needles! That was the ONLY time I had such a problem though.

          They look scarier than they are.

          Steve
          My fear of needles in the mouth started when I was a kid and had to get a tooth pulled. The doctor was named (no lie) Dr. Ripp. Every time he stuck the needle in my mouth I would bite down and break it. Finally he pulled out this needle that looked like a darning needle and said if I broke one more he would use that one Put a fear of needles in the mouth in me that never left.
          It's been 17 years since I had my teeth pulled. I know then it was valium they used for the reasons I stated above, I really don't know what they do now.
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  • Profile picture of the author derekwong28
    Matt, I am a doctor and I wish I could assure you 100% but I can't. I refused to undergo a nose operation under GA when I was 18 and will not allow myself to undergo an operation under GA unless it is absolutely necessary.

    The greatest risks are with your first GA, after that the risks are very much reduced. Anesthesia today is much more advanced today and the risks are absolutely minimal. I would make sure that no one in your family has had an adverse reaction to GA. If you are going to have all 4 wisdom extracted, you will probably need GA.
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  • Profile picture of the author waterotter
    Matt, my orthodontist sent me to a specialist as my bottom wisdom teeth were impacted.

    I gladly let him put me under. When I awoke, I had stitches right to the front of my mouth, on both sides. My roots were very long and some of the root couldn't be extracted. This could be a factor in the decision to put you under.

    I agree with Kay, you do NOT want to be awake regardless.

    Be sure to follow post-op procedures - do NOT use a straw when drinking, and if you smoke, consider quitting until you have healed. If not, you run the risk of developing 'dry sockets'. Narcotics are about the only type of pain med's that will provide some relief.

    Best of luck to you!
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    • Profile picture of the author Sheryl Polomka
      Originally Posted by waterotter View Post

      Matt, my orthodontist sent me to a specialist as my bottom wisdom teeth were impacted.

      I gladly let him put me under. When I awoke, I had stitches right to the front of my mouth, on both sides. My roots were very long and some of the root couldn't be extracted. This could be a factor in the decision to put you under.
      I had all 4 wisdom teeth out under GA and also woke up with stitches right to the front of my mouth. I was so glad that I had chosen GA and not just a local.

      Different people react to anaesthetic in different ways (I can't even spell it). I've had numerous surgeries and have had different reactions. Regardless of how many surgeries I have had, I still hate it and get really scared about going under a GA.

      But..... it is over before you know it, the teeth have been pulled and you're on your way to recovery. There is no way that I could sit in a chair and be awake during such a procedure.
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  • Profile picture of the author LeeLee
    I thought they used nitrous oxide for dentistry.

    Matt I share your fear of anesthesia but as has been pointed out to you here, not all anesthesia is created equal.

    Nitrous oxide or valium are not the same as general anesthesia. For one thing, you wake up much more easily from dental anesthesia. If you have doubts, you should really talk with either your dentist or general physician.

    I had my wisdom teeth extracted surgically. It is not fun. You are out but when you come fully awake, you wish you had a bit more "out" left.

    I also had a tooth extracted with a local only. Like you the sounds do not bother me but my roots are stubborn and my mouth is small. It was almost cartoonish how the dentist was trying to get in there to pull that puppy out.

    Given a choice going forward should I ever have to go through this again, I would take the anesthesia. I went through hell to get one tooth out. I would never have survived 4.

    Take the anesthesia. Then use whatever pain killers they give you for a few days. Don't be a hero.
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    • Profile picture of the author Matt Attack
      I'm not trying to 'prove' anything by asking for local only, but rather avoid the risks associated with nitrous or IV sedation.

      I guess I will see what the surgeon recommends at the consultation tomorrow, but it's going to take a lot of convincing to get me on gas.
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      • Profile picture of the author LeeLee
        Originally Posted by Matt Attack View Post

        I'm not trying to 'prove' anything by asking for local only, but rather avoid the risks associated with nitrous or IV sedation.

        I guess I will see what the surgeon recommends at the consultation tomorrow, but it's going to take a lot of convincing to get me on gas.
        I'm sorry, I think you are responding to what I said about not being a hero. I didn't mean about the anesthesia, I meant about the post pain meds. A lot of people avoid pain meds. When used properly, they are well worth the relief. I personally believe when you are not all tense from pain, you give yourself a chance to heal more readily.

        I hope you come back and tell us how it all goes.
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        • Profile picture of the author Matt Attack
          Will report back friday after surgery...If they absolutely insist on using sedation then nitrous is my limit. I don't want any type of IV sedation.

          Thanks for the input guys
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          • Profile picture of the author Matt Attack
            Hey all,

            Finished up with the surgery around 9:30am this morning, everything went great...I've literally had cavities that were more painful to fill than getting my wisdom teeth out, and according to the surgeon my bottom two teeth were deeply impacted.

            The surgeon and all of his assistants thought I was crazy asking for local anesthetic only and really tried to push IV sedation but I declined. He did however get me to agree to nitrous gas which literally had no effect on me for some reason.

            I just closed my eyes, turned up the Ipod and let him do his thing. All in all not too bad, about 10 injections total. He did break one of his tools trying to pry one of my teeth out lol!

            Right now my mouth is full of gauzes. My younger sister had the surgery at the same time as myself but she opted for IV sedation. She got through it fine as well - she's just a little groggy.

            Overall it wasn't a fraction as bad as I thought it was going to be...
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            • Profile picture of the author Brandon Tanner
              Originally Posted by Matt Attack View Post

              Hey all,

              Finished up with the surgery around 9:30am this morning, everything went great...I've literally had cavities that were more painful to fill than getting my wisdom teeth out, and according to the surgeon my bottom two teeth were deeply impacted.
              I can relate to that. I had all 4 wisdom teeth pulled (2 of which were very impacted) while on a combination of Novacaine, Valium, and laughing gas, and I felt zero pain. I can't say that for some of the single cavities I've had filled (while on just Novacaine). The Valium and laughing gas make a big difference!
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  • Profile picture of the author seasoned
    Matt,

    Basically, if you are like most likely are, the wisdom teeth that are showing will likely be pullable with a local, and maybe with NO anesthetic. The ones that are hidden ******WILL****** require general anesthesia. However, as I said, I agree with derek in that you might not need that done. So it is up to YOU! The surgeon will say you need a general because you need that for him to do HIS work! A dentist can do the other. It isn't considered surgery. There will almost certainly be blood. There MAY be some pain. It is NOT surgery though. And YEP, I HAVE had that done with a local. I walked out of the office, and drove myself home.

    BTW the lower the level of skill, the cheaper the doctor. So a dentist that just pulls the teeth will likely be cheaper than a surgeon.

    Steve
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    • Profile picture of the author Matt Attack
      This is not a dentist but rather an oral & facial surgeon performing the work. The doctor graduated top of his class.

      I have had so many injections and drilling done that it doesn't phase me anymore. I understand that in countries such as the UK, nitrous is (or was) banned for use as an anesthetic.

      The needles, no big deal...blood, no problem, cracking and pulling is not an issue, but being put to sleep knowing there is a chance (even if it is a small one) of major complications...I'll pass.
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      • Profile picture of the author seasoned
        Originally Posted by Matt Attack View Post

        This is not a dentist but rather an oral & facial surgeon performing the work. The doctor graduated top of his class.

        I have had so many injections and drilling done that it doesn't phase me anymore. I understand that in countries such as the UK, nitrous is (or was) banned for use as an anesthetic.

        The needles, no big deal...blood, no problem, cracking and pulling is not an issue, but being put to sleep knowing there is a chance (even if it is a small one) of major complications...I'll pass.
        OK, glad to hear it. It will cost more, and he will lead you to GA. Tell him you definitely DON'T want GA, and he may backtrack on the unexposed teeth. Taking care of the exposed ones might be surprisingly easy.

        Yeah, I said the needles aren't a big deal. The blood is not an issue. After a couple hours, you may hardly notice it. It could totally heal within a few days. I forget how long the bone takes to heal(fill the empty socket), but I seem to recall it was measured in weeks. I don't know the whole process, but drilling is too risky, etc! They would have to run the drill a LONG time in various directions, with frequent pauses, and with different diameters of bits. Some directions would be impossible to do without more damage. It would ALSO have to be done at SLOW speed, etc.... ONE mistake, and bone can die, which means it won't heal properly.

        ALSO, ONE millimeter too far can leave you with a condition known as BELLS PALSY! Bell's palsy - Wikipedia, the free encyclopedia Although that article doesn't really cut to the chase, basically there is a branch of a nerve that goes through your jaw AND, if it is hurt, it can lead to partial paralysis of the face.

        So you can BET they are NOT going to do that! They generally use the drill for small things and areas where you DON'T need to heal, like fillings. Exposed teeth are simply PULLED! The ones that are hidden are going to have to somehow be accessed, and pulled out. THAT is the reason for the GA!

        Steve
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  • Profile picture of the author alistair
    I know it's easy to say because I'm not having it done but I would try not to worry about it. I know it's hard to get it out of your mind but in my experience nothings ever as bad as what you imagine and only going over the same thoughts and concerns make things worse.

    I know you're probably thinking you wish today was this time next week because everything would be done and dusted but you'll probably be in and out before you know it and wonder why you worried so much.

    Then again I'd probably be crapping my pants as well. Nothing but misery and pain and that's just their record collection. I hate dentists.

    Good luck.
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  • Profile picture of the author rondo
    I had all 4 out using local. I went there to get one out, then the dental surgeon said "while we're at it let's take all 4 out". It seemed to take a long time and it was pretty rough, but I wasn't given the option of GA at the time so I never even considered it.


    Andrew
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    • Profile picture of the author seasoned
      Originally Posted by rondo View Post

      I had all 4 out using local. I went there to get one out, then the dental surgeon said "while we're at it let's take all 4 out". It seemed to take a long time and it was pretty rough, but I wasn't given the option of GA at the time so I never even considered it.


      Andrew
      Same here, but MINE, and obviously yours, were all exposed. He just pulled. There were a couple false starts, but I bt I could have done it WTHOUT local.

      Steve
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      • Profile picture of the author rondo
        Originally Posted by seasoned View Post

        Same here, but MINE, and obviously yours, were all exposed. He just pulled. There were a couple false starts, but I bt I could have done it WTHOUT local.

        Steve
        Nope, only one of them was exposed.

        Andrew
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        • Profile picture of the author seasoned
          Originally Posted by rondo View Post

          Nope, only one of them was exposed.

          Andrew
          Wow, how did he remove them?
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  • Profile picture of the author TopKat22
    They gave me something ahead of time so was so in la la land didn't remember getting the shot to put me under or anything. And I understand there were some complications once they were in there so per to surgeon, he said it was a good thing I was totally under.

    As far as I was concerned, nothing happened, that is until the narcotics wore off, pain, swelling and nausea for a week.
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  • Profile picture of the author seasoned
    I'm shocked to hear that the nitrous didn't work, and you had unexposed ones removed under local, but I DID say the exposed ones may not be much to worry about, and that you would likely be fine.

    I'm glad to hear it went well.

    Steve
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  • Profile picture of the author LeeLee
    Great report. Glad to hear all went well.
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  • Profile picture of the author laurencewins
    I am glad it went well for you. I had all 4 out at once under general anaesthetic and I couldn't get the bleeding to even stop for 3 days. The pain was horrendous and they gave me morphine to take home for a few days until it eased off.
    But that was nothing compared to having 14 teeth out in one surgical procedure.
    Unfortunately I had been seeing a bad dentist who used dodgy fillings and so my teeth turned to crap. Now I have none at all but am used to it.

    I highly recommend being knocked out completely for wisdoms or major teeth work because I think one of the worst things is hearing the dental drills and stuff.

    Anyway, I am glad all went well for you and now just rest and you'll have to stay on liquids and very soft food for a while.. Jelly, scrambled eggs and mashed potato will be your favourite foods for a week or so.
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  • Profile picture of the author derekwong28
    I am glad it went alright for you. I have heard of an 18 year old who died under GA while having all his wisdom teeth extracted. His father who was present in theater tried to attack the anesthetist. However, that was over 40 years ago and the chances of that happening is very much reduced.
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