Those Of You With Eds And Pots-----dental Work---

[Maxine]

I may have to have some major dental work done. Very bad timing with all the stress I have had lately from my mothers recent passing-----and the neglet from her physicians. Anyway, I have to do what needs to be done.

I have a bridge covering the space of the tooth that was pulled in Dec. 2000----(which by the way started this whole mess)----or so I thought................... Actually all my molars are messed up one way or the other--------------always my nemesis----these molars of mine. My maiden name is Mohler----pronounced the same way--- -----maybe--LOL----but not really in the mood to laugh....

I have great problems with lidocaine-----even without the epi. My system seems to absorb is more then it should-----from the EDS maybe, and the POTS doesn't help. Plus I have this stupid cold I can't shake---------------------fun, fun, fun.

Basically this puts me at risk for a nice POTS crashing--------------------------

Here's that article someone posted earlier--------------

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

Any ideas-?

Maxine :0)

[Maxine]

any help?

I just found out I need a tooth extraction----(we went to the dentist late today at aroun 4:00pm.)-----------that molar isn't terrible as far as decay, but it's turns out that the fillling under the bridge is breaking away, and the bone support around the tooth is poor, and she said it's not worth the root canal, as the tooth is starting to split right down to the roots due to the filling being so close to the nerve. She said pull it out, and have a partial since there will be no molars left on that side, and then crown the tooth on the other side of the already missing tooth. The bridge will have to be cut.

What would be the best route to go with this?

Not thrilled----as I'm really stressed with my mothers recent passing------still in shock, and trying to process all of this. So basically, my POTS is being affected aleady.

I need some reassurance-------------and a little courage. Of course I'll look in the search engine under dental---or extraction to see what I can find.

Maxine :0)

[flop]

Hi Maxine,

sorry to hear you having trouble with your teeth on top of everything else that you are dealing with right now.

I asked my cardiologist for advice about dental work a few months back as my dentist is advising me to have impacted wisdom teeth removed. Personally as I am not getting any pain I have decided to leave them alone for the moment but it sounds like your problem does need fixing soon. His advice was that local anaesthetic (LA) is the worst type of anaesthesia for a POTS patient to have followed by epidural and the general anaesthesia (GA). Basically he told me that a GA was the best option as it would be least likely to trigger a POTS flare. I know I went into a POTS hole after the LA to insert my cardiac Reveal device last year.

I don't know how dental care in the US works but in the UK you can have procedures done under GA by hospital dentists in a main hospital which would make me feel a bit safer than at the dentist's office. I would call the doctor that looks after your POTS and ask him/her about dental anaesthesia. Either way avoid the epi and stay well hydrated / have an IV.

Good luck,

Flop

[Tanzanite]

Because of the EDS Ive lost most of my teeth. They tend to be looser and decay rapidly so I've had all but 8 extracted. I have it done at home as I'm too ill to go out. Althought it does upset the POTS somewhat for a while after, it doesn't seem to be a long term thing and I'm sure the florinef helps with this. I just load up on salt and fluids before and after too.

Because of the EDS the local anesthetics don't always work on me and yes I've had teeth pulled when they haven't worked. It's painful for a short time but not as much as you'd expect. The POTS did flare up 10mins after (prob due to the shock!) and I almost passed out (I'm not a fainter, at least not so far). But it didn't put me in a POTS hole.

I'm not suggesting you have it done with no anaesthetic but perhaps you can ask if there is a different type you could have instead.

[Guest tearose]

I am sorry you have to loose another tooth.

I wish there was a way to make dental work truly painless and worry free!

I have had many root canals and the dentist uses septacaine.

It will only last about 20-25 minutes in my body and then I need another injection but at least it doesn't trigger my POTS.

tearose

[mkoven]

Flop,

Can I ask what it is about local anaesthetic that is bad for pots? I'm supposed to have a bunch of injections next week, and I usually get a lot of local first...

Michele

[MightyMouse]

Michele, flop is probably referring to local that includes epinepherine--which is often added to help control blood loss from the area being worked on. However, in some folks with POTS, or other autonomic issues, it can provoke tachycardia. This doesn't happen to everyone though--for example, I've never had any problems with local anesthetic at all and I've had TONS of dental work.

I was in a serious car accident at age 10, and had most of my front teeth knocked out of my mouth and then reimplanted in the days that followed. From that incident foward, I've had many, many procedures in my mouth--from extractions, to braces, to bone grafting, to dental implant, and just the regular everyday care.

If you've not had issues with dental work in the past, you'll probably be fine. I usually have more symptoms in the days that follow dental work, but it mostly has to do with me really stressing out because I'm petrified before and during dental work....

Nina

[flop]

Nina / Michele,

my cardiologist was referring to lidocaine without epi when he was telling me that local anaesthesia is not good for POTS. When I had my reveal inserted it was lidocaine without epi that the cardiologist used as he was aware that epi can cause heart rates to soar in POTS patients. I don't know if it was actually the LA or just the stress of having a minor procedure but I vomited all afternoon and then was really dizzy / wobbly for several days.

That said it might just be a weird reaction of my body. If you've been ok with dental anaesthetic in the past it probably won't be a problem this time. I didn't mean to scare anyone by telling you what my doc said - just sharing info. Hope everything goes smoothly and is not too painful. Blackcurrant electrolyte mix to sip through a straw if your moth is sore might be a good idea for afterwards.

[Maxine]

Thanks flop for the information----

I had the same type of weird reaction. Dr. Grubb inserted the loop recorder in me. He pumped a lot of lidocaine in me. I imagine he was afraid to cause me any pain when inserting the loop recorder-----so he wanted to make sure I was numbed well enough. During the injections I felt a electrical impulse near my heart----------I yelled at him saying "that's enough". I didn't mean to snap at him as he was just trying to help me avoid pain, but I knew this was too much, and would rather deal with the pain----AND PAIN IT WAS----especially when shoving the thing in there to make the pocket. He offered to inject more lidocaine, but I opted for the pain. It didn't last long----then he sewed me up. He said I was a bleeder, and he had to cauterize small blood vessels several times before closing the small wound.

When he was done he said I was free to go----no recovery--------just get off the table and go about my business. I imagine he didn't want me to worry, and thought since it was only local that was used I'd be good to go. NOT.

My son and his girlfriend and I walked to the cafeteria to grab a bagel or something as I had not eaten anything since the night before in case Dr. Grubb would need to sedate me for the procedure. Well----the floor started to come up at me, and I got really dizzy. Then I was nauseated---and I could only take tiny nibbles of my bagel, and just gave up. I had tremors, and I was disoriented------------which affected me to the point of being so out of it that I hung around a bathroom that was near the gift shop that had only one toilet----------- ---and I felt on the verge of puking. Very dumb---as I would be out of luck if someone was in there--- I was really tachy----but never took my pulse to see how bad it was, as this would only make me more anxious. It was a terribly rough time, and I felt like I was going to crawl out of my skin. finally at around 8:00pm-----8 hours after the procedure I was having some quieter moments, and y body calmed a little. We went home, and I still had tremors on and off all night until I finally slept about 3 hours. I could not sleep well that night, but was able to catch a couple naps the next morning.

I'm really struggling to keep my fears to a minimum--------it's hard because my body has not yet recovered from the stress of my mother's passing. Her passing was a terrible shock to all of our family. We knew she was pretty sick, but never imagined a terminal cancer diagnosis on the 23rd of Feb.---and her dying by the 25th. The doctors missed a lot-----she had several CT scans and others tests over the last several months. Then they put her in rehab the same week she died----trying to rehab a dying woman that was full of cancer because the right hand didn't know what the left hand was doing----and all the Docs were screwing up. All those clots she was throwing were a result of the cancer. The night before last I was dreaming that they tried to put her in the rehab pool and she just sank to the bottom. I always knew there were docs that were dismissive, but---my GOD---------------------how many neon flashing CANCER lights does a doc need before he gets it. She was already diagnosed with one tumor in her bladder that they thought was cancerous--------but yet they didin't think to biopsy those "lesions" in her lung and liver--------------THAT WAS CANCER, but they said it was lesions---(nothing to worry about.)

So here I sit recovering from a bad cold that I got during the funeral services, and trying to help my Dad from feeling the terrible guilt we all feel from trying to push her so hard to move because we were told the blood clots were from inactivity------Well, we just haven't processed all of this yet....... So now I fracture a tooth at the same time my POTS is caving in on me from all of this stress. I'm trying to figure out how the heck I'll get through this. This is not just about a broken tooth getting pulled-----it's the timing-----------it's the mess my whole jaw, neck, cranial area is in--on top of the POTS crashing.

Sorry to carry on----this is a bad time, and I just need some help getting through it. I was with my Dad a lot through all the hospital stays and the funeral arrangements ect. Everyone else in the family is working---but they helped whenever they could. So I guess it;s more stressful for me because I saw her suffer so much----and none of the Docs were helping her.

I see my neurologist tomorrow so maybe she can give me some idea's. My neurosurgeon said pressure should be avoided when pulling the tooth due to my cervical/cranial instability. He told me people with EDS suffer tooth decay-----even if we brush, floss---rinse-100 times a day. I also read where local anesthetic---lidocaine can be absorbed more systematically due to the streachy vascular system that comes with EDS. My vascular system is affected by the EDS along with my joints/ligaments and skin.

Maxine