Dental Issues

[sj75]

i posted a while ago about wether sedation or a general would suit me better the dental work i need doing. The problem i have is that i get a little anxious going to the dentist and since my pots flare up my body doesnt seem to cope with that so well. I get a surge of adrenalin which triggers my arrhythmias and makes me pass out. My normal dentist referred me to a specialist dentist who could do the work under sedation or general and i had my appointment today.

He has said a general is out of the question as the nhs will only do extractions under anaesthetic not fillings. He said i cant have sedation as if my arrhythmias start up they would have to call an ambulance and being sedated would cause too many problems. They are going to write to my cardiologist to see if it would be better for me to be at a hospital dentist in case of any problems but they think nitrous oxide and 'wand' local anaesthetic would be best for me as apparently nitrous oxide relaxes the heart?? (not sure if thats a good thing or not??). The wand local anaesthetic is administered via a computer so that it goes in really really slowly through a really fine needle and that way if there are any reactions to it they can stop it immediately, but i dont think that would help if there is a delayed reaction?

Any one any ideas as im completely clueless and just want to get my teeth sorted. Its so annoying to think i used to just book my appointment at my dentist and get everything done without any hassle but these days everything seems like such a song and a dance and its getting me down. The dentist had never heard of pots and just didnt get it (in fact trivialised it)and seemed to think it was something to do with the anxiety?

[potsgirl]

I can relate....I have a root canal and three crowns that need to be done, and it looks like I'll do the usual novacaine with nitrous for my anxiety and pain control. I've tried to find someone that what 'put me under' for these unpleasant procedures, but it's hard to find, and I'm scared to death of the dentist. Thankfully, after resting the next day or two I'm usually fine with the shots and nitrous.

You may want to ask your cardio about options. Good luck!

Jana

[issie]

The gas makes me really sick. I tend to get easily nauseated any way. As for the wand anesthesia - I didn't find it to make any difference. In fact, if a doctor administers it very slow and puts the numbing stuff on your gums - I thought that was less painful. If you have the hyper POTS have them not put the epinephrine in the shot - they can do it - but, it won't last as long or work as good. They will have to keep giving you more if it takes too long. The epinephrine makes me start shaking like a leaf. But, it does numb you up more. I have taken an anti anxiety drug before going and making sure it's taken effect before I get there. That does help allot - because your whole body will be in a calmer state. There is a paper written about dentistry and POTS - but I don't know how to tell you to find it. It's in relationship to EDS and the connection there.

Hope it won't be too bad. If the dentist is good - it won't be. I had a crown and had hardly no pain or issues with it at all. Haven't had a root canal done - I think that's a whole other issue. I think you'd want to just go ahead and take the regular kind of numbing stuff and just sit there and shake. Hopefully, your BP and pulse will not flare too badly. Make sure you take your meds in advance and maybe ask for an Ativan or something.

[Noreen]

One thing that helps with anxiety at the dentist is distraction from listening to music. Many dentists offer headphones but you could bring your own MP3 loaded with whatever music is soothing or an audiobook if that distraction would work better for you.

[jenwic]

I have been having a lot of issues with numbing shots too. I get the kind without epinephrine but it still makes my heart race. Usually about 3 or 4 minutes after the injection my heart rate starts flying and I get the urge to get up and move around (it's hard to sit still when your heart is racing). Then about 10-15 minutes after the injection my heart rate comes down some. I think the kind of med I get is mepevicaine (sp?). It doesn't numb as well or as long. I had it with a root canal and I needed a second shot of it before he could finish the procedure.

One thing that helps me some is a dose of Benadryl. It doesn't really help my heart no to race, but it relaxes me some.

[potsgirl]

Good point! I'm finally going to a dentist with music and movies.

[Noreen]

Good point! I'm finally going to a dentist with music and movies.

Movies?! What do they do project them on the ceiling - I'd have to get contacts -LOL

[lissy]

Hey all,

I've been putting off the dentist for awhile now I have gum disease and my teeth really bother me. I always knew something was wrong in the past because my heart would race when they give me the shot and I'd feel really panicky. SO I stopped letting them give me anything or do any work! I need that deep cleaning so bad and some other work also but I'm am terrified. Dys-Doc just said to have the shot with no epi but from what one of you said it still makes your heart race so I'm very concerned now.. I've had 4 consults with dentists and everytime I tell them my condition they don't know what it is so I lose confidence in them ( I know not even GP's know about it so I don't know why I'd think a dentist would LOL..So I am in the same boat I don't know what to do. Maybe the hospital setting would be best because at least they can monitor and give fluid if needed.

[sj75]

Im so glad im not on my own with this. Its so scary when people dont understand your condition and fail to even bother trying.

I think i am going to push to have it done in hospital for safety sake and because my arrhythmias are bound to start off if im anxious or stressed and i dont really fancy him calling 999.

I also worry that nitrous wont actually reduce anxiety or reduce what drilling/pain i experience and i dont remember it helping me much when i was in labour either. I actually wonder if the sedation might be my best option at preventing the stress reduced arrythmias.

has anyone else heard that nitrous relaxes the heart?x

[giftcreations123]

hi

When you get novacain, you must ask for ephedrine free..

the epenephrine in the injection makes our heart race crazy..

good luck

[comfortzone]

Do you have hypermobility syndrome or EDS things as well?

It's pretty common for EDS'er's to have the issue where local anesthetics just don't work as they do for the normal population. It usually will require more medication than usual - it just doesn't seem to work until you get multiple injections in the gum for say a root canal.

I guess the reasoning goes along the lines of the collagen matrix is different and so the absorption rate of the med is different. The medication is absorbed I've read much more rapidly....so that leaves you with no numbing medicine left in the area that needs numbing - hence more shots.

My experience in my 20's was NO medication worked so I ran right out of the dentists chair and down the road - he was torturing me in an extreme manner. I found another dentist who believed that the infected tooth's PH was off as happens with infection so no amt. of numbing medicine would have worked.

Late though in my 40's after having 8 crowns and the root canals under them....I still always needed more shots. One time I was taken to the ER by ambulance when a procedure took 2 hours or more.... I started shaking like crazy and my heart was pounding like crazy. Overnite observation showed all was well - but I scared the heck out of everyone there and myself too!

Then in my 50's I learned I had hypermobility syndrome - and all about how it's pretty usual to need many shots.... Well if the shots have epi in them - you absorb the epi super fast - faster than usual and get symptomatic. The dentists like epi though because it's better to control any blood or bleeding.

Now I get super anxious just for a teeth cleaning. I try not to be - but that's a vicious cycle. If they are matter of fact and do things quickly and efficiently I do pretty well......but always feel on the verge of a panick attack. I tell them what happened that one time so they don't wig out if it happens again. Why I would feel that way without any shots is now beyond me.... But it is what it is...

So again while I don't have pots I do have the hyperadrenergic responses and other things - perhaps related to hypermobility syndrome....or some neuro things.

Some dentists have TV's at the ceiling -- pretty cool the one's I've seen! I think I will opt to ask for Ativan or some such thing for my next dental appt. in a new city....I'm tired of having to 'be brave' LOL Good luck to you :-)

[skyblu]

I have been having a lot of issues with numbing shots too. I get the kind without epinephrine but it still makes my heart race. Usually about 3 or 4 minutes after the injection my heart rate starts flying and I get the urge to get up and move around (it's hard to sit still when your heart is racing). Then about 10-15 minutes after the injection my heart rate comes down some. I think the kind of med I get is mepevicaine (sp?). It doesn't numb as well or as long. I had it with a root canal and I needed a second shot of it before he could finish the procedure.

One thing that helps me some is a dose of Benadryl. It doesn't really help my heart no to race, but it relaxes me some.

I get the no eppi numbing shots as well (carbocaine) and I too have noticed my heart races when I first get the shot. I think in my case it's anxiety. I always end up needing a second shot before the procedure is over but it beats having novocaine.