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Sensitivity to Meds & Anesthesia: Dental Question

Discussion in 'Hypersensitivity and Intolerance' started by creekfeet, May 2, 2010.

  1. creekfeet

    creekfeet Sockfeet

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    Eastern High Sierra
    My ME/CFS kid has a chipped tooth and needs to see the dentist. I'm afraid there may be lots of caries needing fillings, too.

    The question is: given our sensitivity to medicines and anesthesia, what to do for comfort during dental work?

    What's safe? What's effective? Please post advice and/or share experiences, good and bad. I'll be calling our (new) dentist on Monday to make an appointment.

    Thanks, all!

    ~ Creek
  2. caledonia

    caledonia

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    Cincinnati, OH, USA
    I do fine with the novocaine that does not have the epinephrine. I believe it's called carbocaine. The epinephrine is an extender that makes it last longer, so it may wear off before the procedure is done, and you may need another dose. On the other hand, you won't be spending the rest of the day drooling with numb lips.

    The reason I avoid epinephrine is because it's a stimulant and I'm prone to anxiety.

    If your dentist is good and gentle and especially if the cavities are small, you may not need novocaine at all.

    In general, PWC's can have dry mouth and eyes due to adrenal fatigue. The dry mouth causes a great increase in cavities. A temporary solution is to do mega doses of pharmaceutical grade fish oil. Another temporary solution is to use an artificial saliva rinse, which I'm sure your dentist can recommend, assuming that is tolerated.

    A permanent solution would be to get your adrenals working properly again.
  3. brenda

    brenda Senior Member

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    Hi Creek

    It is really important not to have adrenaline or epinephrine as it is known in the US. Anyone with ME should not have this. The plainest anesthesia possible is best without preservatives. I have a letter saying that I shoul dbe given CITANEST with 4% OPRILOCAINE C but I don`t know what that is called in the US. If you do a search on MCS sites in the US you will find out the names of the best ones to use.

    Brenda

    here is one site

    http://www.cfsnova.com/qnaAnesthesia.html
  4. creekfeet

    creekfeet Sockfeet

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    Thanks folks.

    I'm doing pretty rough at the moment so research is near impossible but will gather what info I can to take to the dentist.

    Brenda's link leads to among other things this article on POTS and dentistry http://jada.ada.org/cgi/content/abstract/137/4/488 which I think could be valuable to us all, and mentions cfs, if someone can get access to it.
  5. bee33

    bee33

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    I tend to be sensitive to meds, like antidepressants for instance, but I have never had any problems with the medications used in a dental office. I recently had a root canal and crown, and I have also had "sleep dentistry" where you are essentially out, and the dentist can to many fillings at one sitting without a problem.
  6. Tammie

    Tammie Senior Member

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    Woodridge, IL
    carbocaine is not actually the same thing as novocaine at all, but it does work similarly and does not have epinephrine

    for me, it's the only way I can have dental work (& I am also very very sensitive to almost everything, inc most meds, novocaine, etc)

    it is not as strong and takes a little longer to work, and they may have to give more injections part way thru the dental work, depending on how long it lasts, bc the carbocaine also does not last as long....but it does work
  7. brenda

    brenda Senior Member

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    Due to extreme chemical sensitivity so that I cannot even use anti-biotics, I carry a letter which I got a GP to write, for use in an extreme emergency which says :

    It is preferable that I have a local anaesthetic rather than a general and Carbocaine and Halogenated or Fluorinated Hydrocarbons should not be used although Carbocaine may possibly be safely used.

    It is suggested that Thiopental Sodium (Pentathal) or Brevital preceeded by 100% oxygen be used to induce anaesthesia. Succinyl Chlorine Chloride (Anectine) or Curare be used for paralysis : Sublimaze be used to erase memory and Innovar Demoral or Nisentil be used for pain.
    This information is supplied by Pamela Reed Gibson PhD in Multiple Chemical Sensitivity - A Survival Plan

    I have also added myself I have had a serious possible reaction to Benzalkonium chloride and perfumes on staff are likely to cause a reaction. During and after any medical procedures, I must be kept warm preferably with a source of heat.

    Even if someoine with ME has been able to take a normal dental anaesthetics in the past, does not mean that it is safe to do so as a sensitivity can develop without knowing it and anyway, pumping unecessary chemicals into the body when one has faulty detoxification pathways is a bad idea and can cause a relapse lasting for a long time. Better to be safe than sorry.

    Brenda
  8. bluebell

    bluebell Guest

    The last time I went to the dentist I forgot to ask him to leave out the epinephrine. As soon as the drug hit my bloodstream my heart literally stopped (I was listening to it beat, the way one can do when nervous). At the same time I felt a weird sensation in my head - a feeling of sort of descending quickly. I cannot accurately judge how long it was before I heard my heart start up again...probably not long in actual time, but long enough for me to have some thoughts about the indignity of dying in a dentist's chair. When I was myself again, I realized that both the dentist and the nurse were staring at me. I described what had happened, and the dentist's only comment was "wow, you're sensitive." ;-). My mom has fibro and cannot tolerate epinephrine either. Avoid, avoid. But it will be okay.
  9. creekfeet

    creekfeet Sockfeet

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    Thank you all so much! I managed to get the JADA article and print it out, and will definitely avoid the epinephrine. I'm making a habit of telling every doctor or dentist we encounter that we're sensitive and require the lowest possible doses.
  10. creekfeet

    creekfeet Sockfeet

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    The Outcome... so far, so good!

    Finally back to report on the outcome of the dental appointment.

    We had to go to a brand-new dentist, and brought the article Postural Orthostatic Tachycardia Syndrome: Dental Treatment Considerations by John K. Brooks and Laurie A.P. Francis, J Am Dent Assoc 2006; 137; 488-493.

    To my delight, the dentist was delighted that I brought that info and spent a lot of time going over it and asking me questions!

    The dental assistant was thrilled too. She said she had never known a patient to bring in an article before, and the dentist said he had only rarely seen it and wished more people would.

    Poor kid will need a cleaning, some fillings, a several-hundred-mile trip to see a dental surgeon for extraction of a rare horizontally-impacted wisdom tooth, and someday some orthodontistry. But before anything more can happen, the dentist sent us back to the pediatrician to ask for cardiac tests to determine the necessity for antibiotic prophylaxis before invasive treatment. Wow.

    In spite of the horrible exhaustion from this one appointment and anticipation of many more appointments to come, my kid agreed that this was the best dentist ever.

    I'm now printing out the POTS article and a pile of articles on Pediatric ME/CFS for the new pediatrician we'll be seeing. Hope we strike it just as lucky there!
  11. Gudrun

    Gudrun Guest

    My teeth have gone horrible since I got sick. As I went in to get more and more work done my pediatric dentist noticed she was having to use more and more novacaine and that I was really hypersensitive. Finally after having to send me home half-done one day after giving me the maximum dose and still not being numb enough to work on she tried a newer anesthetic called Septocaine (generic name articaine) and it has worked wonders for me ever since. I still often take 2-4 pricks to get fully numb but I can finally get numb without overdosing! For certain nerve blocks septocaine can't safely be used in which case they use lidocaine, which works a little too great because it's slow to take effect, so they probably tend to give me more than I really need out of impatience, and leaves me numb for hours and hours after I've left the office. But a lot of us have lowered thresholds of pain and I know it's worth the trouble after I went to a dentist who didn't believe me that regular novacaine couldn't get me numb and had her assistant physically restrain me while I was sobbing, shaking, and thrashing from the pain as she drilled merrily away. (Make sure you're in the room to advocate for your kid at least the first visit to make sure the dentist is patient and responds immediately to their pain. Sounds like that wouldn't be a problem with this one, but there are some real monsters out there.) Afterward I usually feel a little extra bad (the epinephrine can make a really unpleasant... vibrating sensation throughout your body) but nothing a good long nap doesn't fix and I already get worse from most excursions, much less stressful excursions where drugs that affect my already fried central nervous system are injected directly into my mouth!

    Another weird dental quirk you may need to watch out for is what materials they use. A lot of us have chemical sensitivities besides just weird drug reactions. Personally I had to stop getting metal amalgam fillings because they were hyper sensitive and I would get shocks of pain like chewing on tin foil all the time. My current dentist thinks that's weird because the plastic resin fillings I get now are meant to transmit heat faster and cause more sensitivity but for me they've been just fine.

    I guess the bottom line is- our nervous systems are out of whack, or circulatory systems are out of whack, and we process chemicals in weird and exciting ways- so tread lightly and expect the unexpected! Sounds like this dentist is up to the challenge.

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