Nervous About Dental Work

[julieph85]

My dentist told me I need a deep cleaning. This will require local anesthetic. I've heard us potsies can have a bad reaction to novocaine/ epinephrine injections. Will I be okay? Has anyone else had dental work done with pots? I'm so nervous.

[MomtoGiuliana]

I also cannot tolerate epinephrine. Hopefully they can do it epi-free.

BTW, did they explain why this is necessary? Just another thought, you might considering getting a second opinion on the deep-cleaning/planing. years ago I went to a new dentist who told me this and I just couldn't believe my teeth and gums were this badly off--I was only 26 at the time and had regular dental care, etc. I went back to my old dentist from childhood for a 2nd opinion and he said I did not need this. Apparently there can be legitimate difference of opinion among dentists on this matter, but there are also cases of dentists doing unnecessary procedures, particularly this one, from what I have read and what my old dentist told me.

[AllAboutPeace]

Julie,

I haven't had dental work done (I actually put my dentist on hold for a little while). I have had a local anaesthetic for a biopsy though and I got along fine with that. I had asked prior to receiving it and they assured me there was no adrenaline. (I'm not confident that she knew that for sure though )

Here is a link to an article re: dental considerations for POTS patients. I plan to give it to my dentist before my next appt.

http://www.dynakids.org/Documents/Brooks_April_2006_JADA.pdf

[Ashelton80]

I agree with the poster above. I had a consultation with a holistic dentist to remove 2 amalgam fillings and came out with 8,000 dollars worth of work to be done starting with dental planing/scraping with anesthetic. I looked at my husband and wondered why I had bothered going to the dentist in the last 28 years if it all just needs to be replaced. I went back to my regular dentist and he said the normal cleanings were just fine. I am now very leery of dentists who try to push unnecessary procedures. Especially with having an underlying condition, unless it is absolutely no doubt needs to be done I won't do it or I put it off until I feel strong and confidant that it won't set me back.

[MomtoGiuliana]

For some reason there is a lot more epi in the anaesthetic used for dental work than in the anaesthetic used for other small surgical procedures. I don't know if it has to do with bleeding or what the reason is. But this is what the surgeon who removed a cyst on my back told me a couple of weeks ago.

[bellgirl]

Lidocaine sometimes has epinephrine in it, but you can ask for the kind without it. They use the epi in the Lidocaine for vasoconstriction to stop the bleeding in vascular areas. Novacaine is a stimulant as well. I've read that Marcaine is the best to use for local anesthesia for us with dysautonomia.

[julieph85]

Thanks guys. What has me confused now is would it actually be safer to get it with epi? The reason I say that is because the dentist told me that they actually use the epinephrine with the procaine to keep the procaine from leaking out of your gums and into your system. You actually absorb way more procain if you don't use the epinephrine. Procain is a sodium channel blocker and is a cardiac depressant. It can dramatically drop blood pressure and heart rate and even cause cardic arrest in some people. So what do I do?! Tachy and anxiety with the epi or risk bradycardia and hypotension with the procaine?

[bunny]

Add one more vote for "get a second opinion". I went away to a Uni far from my hometown, so eventually I needed to see a dentist. I think I was 24 at the time. I set an appointment for what I thought was a cleaning/x-rays. Instead, it was a "consult" appointment where they took x-rays, made moulds, etc. I then had to come back for a 2nd appointment for the results of what was needed. The dental assistant walks me to the room and the first thing she says/asks is "I didn't see any dental insurance on your forms. How's your credit?" Bad sign #1. I sat in the chair for awhile, waiting for the dentist, who was running late because he was too busy talking with the granite contractor on replacing the countertops in his dental office. The existing cabinetry looked only about 2-3 years old to my eyes. Bad sign #2. So, he basically wanted to remove every filling I had, do about 8 crowns, a couple of root canals, a few extractions (tooth removal) etc. Grand total: $28,000.

I left there stunned. I was only 24 and didn't have great teeth, but didn't think there was THAT much wrong either. So I called a good friend who was in dental school at the time and told him the findings. He was in disbelief as well and strongly suggested a 2nd opinion. I saw another dentist the following week who looked at the x-rays the 1st dentist had done, pronounced them as useless, took his own x-rays (and didn't charge me for them), then showed me the difference. The digital x-rays the 1st dentist took were so grainy it was difficult to tell what was going on. The 2nd dentist's film x-rays made it quite clear even to my untrained eyes -- One crown needed, nothing more. I believe it was approx $300 with insurance.

As far as the epi / non-epi goes, I've had it both ways and I'm very hypotensive when laying flat (~85/35 most nights). For me, the non-epi does flow out so fast that they might as well not use it. Any pain relief is gone within 5 or so minutes as the drug gets washed out. My current dentist uses the procane+epi and I haven't had any issues from it. We usually start without it and see how much pain I can take before resorting to it and then he uses it sparingly. My pain tolerance is relatively high so they can usually "ouch" me a few times and it won't bother me too much. Any tachy I have is usually from the anxiety of having sharp, whining instruments being poked and prodded into my mouth, as once they're done with the drilling part, my heart rate drops substantially.

Also as an aside, good oral hygiene practices go a long way to avoiding/reversing scaling. I do have the electric toothbrush & prescription toothpaste my dentist recommends. I don't floss, but I do use an oral irrigator (waterpik) 2-3x a day. I have a regular-size Water-pik at home and a Panasonic portable I use at work (after lunch) and on the road. Just had a cleaning last month and the dental hygienist was having trouble finding anything to scrape.

[bellgirl]

Phillips Sonicare tooth brushes are great, too!!

[misstraci]

hi julie. i actually went this more as a matter of fact, to the dentist. my whole life, i've never had a cavity, well guess who has 3 all of sudden? ..... this girl. well, i had them filled this morning and i was not looking forward to it, i was so scared and terrified of what the experience was going to be life. the numbing gel and shots (not sure exactly the names of them) didn't cause me any discomfort or side effects. my only three complaints from the experience were.

1. they had me practicaly laid down but then my head was even more tilted back, it was crazy and i couldn't swallow becuase your mouth is jacked open and i kept feeling like i was going to choke

2. once it was over and they put the chair upright. they said, "ok, you're good, you can go" hahah, i was like, ok thanks,, but i had to sit for awhile because i was terribly dizzy and lightheaded from being almost upside down in that stupid chair

3. my mouth and lips were numb for quite some time and i was starving as i had not eaten breakfast and now it was on into lunchtime and so i attempted to eat out at my fave restaraunt but my numb lips made me go slow and spit my drink (accidentally of course)

I wish you luck if you end up doing it. I don't think a reaction is likely!!!!

[WyomingGal]

After reading on this site and doing some research, I told the dentist that I have tachycardia and need to medication without the epinephrine, even though they will say it only has a tiny amount in it, i just say no thanks. I used to get whatever their regular stuff is before POTS, but haven't since, and have had 3 procedures with the non-epinephrine numbing medication in the last 6 months and everything was fine. I did have anxiety, but that's just anxiety. I always treat myself to a nice iced coffee or mocha, etc afterwards as a treat!

[blinkofani]

Before I was diagnosed with POTS I had a few fillings done and every time I had a horrible reaction from the epinephrine. I became very nauseous, tachycardic, and dizzy. It wasn't until someone finally explained to me that it was from the shot that I was able to make it a point to tell them NOT to use it. I recently had a filling done and must've reminded them 1000 times that I can't have anything with epinephrine in it lol unfortunately, the stuff they did give me refused to numb my mouth so I had to have several shots.

[L4UR3N]

Unfortunately there is no way to know without trying it . I agree with the others though- you might think about asking for an injection without epinephrine. I have had my own personal nightmares with dentists and gum surgery-- please learn from my mistake-- do not just endure the pain.

[abbyw]

Before I had POTS, I always had bad reactions to the novacaine shot, until I once asked my dentist if something he was giving me could make me feel shaky and jittery all day. He sais "You must be sensitive to epinephrine", from now on I'll give you the shots without it. Well, from that time on, I am always careful to tell any dentist that I am sensitive to epinephrine and I wouldn't say that going to the dentist is a pleasue , it never is, , but now it is just regular numbing and stuff, not jitteriness. The dentist did warn me that the other shots wear off more quickly and are not as effective, so sometimes you have to get more shots, but I think that is better than jittery all day.

I would also ask them to lean you back as little as possible, I agree that the almost-up-side-down thing for an hour or so is not good when you sit up.