Dental Procedures

[db2504]

I was wondering if anyone has had any issues with having dental procedures, such as; fillings, root canal, or even cleanings. My daughter is worried about worsening of her symptoms from any of the mentioned procedures. Thank you.

[ks42]

I don't have exacerbations from the procedures themselves, the only thing that sometimes bothers me is if I'm having a day with a lot of adrenaline surges, it's hard for me to lay still for so long - I need to fidget.

However, keep in mind that the novocaine that dentists prefer to use contains epinephrine, which is pure adrenaline. In normal patients, that can cause tachycardia, shakiness, sweating, etc which can be particularly problematic for some POTS patients. I'm prone to adrenaline surges, high adrenaline levels, and have severe intolerance to any stimulants (caffeine, etc) so I get the novocaine without epi - this is usually carbocaine or mepivicaine. All dentists are able to accommodate this request, as the use of novocaine with epi is contraindicated in many other conditions, so they should have plenty on hand. It's just kind of a pain for them because they have to use more non-epi novocaine to get the same effect as the novocaine with epi.

[Anoj]

^ agree with above statement about NO EPI. it is written on my chart.

i went to the dentist a few weeks ago and had a problem. the "stimulation" from one of the drills did me in. it felt like my entire skull was vibrating. i made them take my BP, and it was elevated. they had to stop the procedure, and i had to go back a few weeks later, and they finished successfully. they asked me if i had anxiety. *eyeroll*

[kellygirl]

I have been undergoing dental procedures over the past month. My EP instructed my dentist to use nothing with EPI for numbing. The only thing I have noticed is an increased sensitivity to pain during procedures, not sure if it is from using non-epi based products which are longer lasting or if I have decreased pain tolerance due to dysautonomia (I will speaking with my EP on the 26th about this at my next appointment). For now I have root canal on hold because the dentist could not numb me enough to do the procedure. I always make sure to drink at least 2 liters of fluids before the procedure and the dentist keeps me as reclined as possible.

[fitnesskelly]

I think dentists use Lidocaine and not Novocaine these days. At any rate, I think the Lidocaine is still mixed with Epinephrine.

I had a procedure just about a month ago (fix a filling) and I felt spacey the rest of the day and my BP was increase (slightly over normal for once), but I did ok with the shot I was given. I didn't ask the dentist what he used, but I would imagine he used whatever is the standard. I did feel like I would have been safer if I'd had a driver to take me back home...luckily, the dentist is right around the corner, so I did ok myself.

[ks42]

fitnesskelly - yes, you're correct, technically Lidocaine is what we use now in the dental industry instead of novocaine, even though most of us still call it novocaine (novocaine's become sort of a general term for "dental anesthetic", lol, even though that's not technically the correct usage). And yes, lidocaine does contain epinephrine.

kellygirl - that's the downside of using non-epi based anesthetics for many people. The epi was added to make the anesthetic numb you more effectively. Without the epi, dentists generally have to use a lot more anesthetic to get you numb. And then there are just some people who don't numb as well with non-epi anesthetics, no matter how much is used, especially for the more invasive procedures like root canals and surgeries. I'm sorry it doesn't work as effectively for you - dental pain during procedures is no fun!

[bigtrouble]

I don't have exacerbations from the procedures themselves, the only thing that sometimes bothers me is if I'm having a day with a lot of adrenaline surges, it's hard for me to lay still for so long - I need to fidget.

However, keep in mind that the novocaine that dentists prefer to use contains epinephrine, which is pure adrenaline. In normal patients, that can cause tachycardia, shakiness, sweating, etc which can be particularly problematic for some POTS patients. I'm prone to adrenaline surges, high adrenaline levels, and have severe intolerance to any stimulants (caffeine, etc) so I get the novocaine without epi - this is usually carbocaine or mepivicaine. All dentists are able to accommodate this request, as the use of novocaine with epi is contraindicated in many other conditions, so they should have plenty on hand. It's just kind of a pain for them because they have to use more non-epi novocaine to get the same effect as the novocaine with epi.

I did mention to my dentist that I take a betablocker for tachycardia and palpitations. Novocaine is one of the first chemicals used in the old days. He says they use lidocaine now with epinephrine.

They can use mepivacaine (aka carbocaine, aka polocaine) instead. The effect seems to be 2 or 3 times shorter. The effect goes away in 2 hours. I had to go multiple times for different teeth and it was always 2 hours.