• Welcome to Phoenix Rising!

    Created in 2008, Phoenix Rising is the largest and oldest forum dedicated to furthering the understanding of and finding treatments for complex chronic illnesses such as chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), long COVID, postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and allied diseases.

    To register, simply click the Register button at the top right.

Can dental injections cause a crash?

daisybell

Senior Member
Messages
1,613
Location
New Zealand
I have seen various posts relating to the use of epinephrine in the dental anaesthetics, but am not sure exactly what the contraindication is...
Just wondering if the fact that I have had several fillings replaced recently could be a contributing factor in my extreme fatigue at present. Currently even sitting quietly feels like too much...

Any advice/info appreciated!
 

AndyPandy

Making the most of it
Messages
1,928
Location
Australia
Since becoming ill with ME, I have consistently relapsed after dental treatment. This is with and without injections.

More recently, I have started reacting immediately to dental injections, experiencing rapid heart rate, shaking and feeling weak and deeply ill. I am sensitive to lots of medications and have MCS which has become worse with ME. It's the epinephrine that I am reacting to.

I understand that dentists can provide epinephrine free injections, which is what I will be having in future. I don't think that this will stop me having a relapse though.

Did you have amalgam fillings replaced? You might want to research dental amalgams and mercury release.

I am currently looking into having my amalgams removed safely by a dentist who specialises in this.

Best wishes
 

Gingergrrl

Senior Member
Messages
16,171
@daisybell Many years ago when I was healthy pre-CFS, I had a horrible reaction to a novocaine injection during dental work that contained epinephrine.

I got tachycardia and shortness of breath and was still feeling ill the next day. I saw my then PCP who said for all future dental work to request the injections without epinephrine in them which I have.

I am also very sensitive to medications especially those that are activating or stimulating and have developed a complete intolerance to caffeine. I cannot even have decaf coffee.

So I do think there is a connection as our systems are more sensitive than other peoples to process things in our bodies.
 

Kati

Patient in training
Messages
5,497
Epinephrine in the local anesthesia has been known to cause relapses in many, many patients with ME. i have had such experience a couple years ago, I receive the freezing and I got into a bad crash that lasted 2weeks, on top of feeling really weird rught after the injection, heart racing, pressure to chest, etc.
A month later, I needed another dental procedure requiring freezing and asked for plain freezing, no epinephrine. I did not experience relapse after this dental procedure. So from now on I will not take any local freezing with epinephrine.

For me it is really clear that i need to avoid epinephrine.

i would suggest you try for yourself.
 

minkeygirl

But I Look So Good.
Messages
4,678
Location
Left Coast
I avoid epinephrine, not because I crash but because it amps me up too much.

I'm going through a series of dental appointments and I have not crashed from them.
 

daisybell

Senior Member
Messages
1,613
Location
New Zealand
Thanks everyone for your advice and information!

I did notice that whilst in the dentist chair, I could feel spasms of tremors. I couldn't control these, and they continued for a good half hour or so afterwards.... It was like spasms of shivering but I wasn't cold. I guess this was a reaction to the epinephrine.

My dentist needs to give me far more anaesthetic than for other people as my teeth are very sensitive, so I can get up to four times what she gives another person. Next time, I'll ask about having an injection without the epinephrine and if necessary, go to another dentist (I suspect she will not believe it is a problem).

Hopefully I can get back to my previous level of function..
 

Kati

Patient in training
Messages
5,497
Hi @daisybell, just so you know, if your procedure is long, you will need to get reinjected 30 minutes after the first set of epinephrine-free freezing, because that's how long they usually last for.

The epinephrine in the lidocaine makes it last longer and concentrate the freezing where it is injected.

However for me, it is all worthwhile, because I cannot handle the crashes- it was most horrible.
I too am in a time where I need a few dental procedures.

Fingers crossed for you.
 

Sushi

Moderation Resource Albuquerque
Messages
19,933
Location
Albuquerque
Carbocaine is one name for the epinephrine-free dental anesthetics. Every dentist I have gone to offers them but Kati is right--it doesn't last as long and sometime they have to give you a larger dose than they would with the epinephrine type.

Sushi
 

Gingergrrl

Senior Member
Messages
16,171
Wow, I had thought at the time it was only me who had the terrible reaction to the epinephrine at the dentist and this thread is very interesting! I have a new dentist (since the time that had occurred) but when I told him that should I need future dental work, I would need injections without any epinephrine, he said that would be no problem. So hopefully, most dentists would not have an issue with that.
 

Helen

Senior Member
Messages
2,243
With COMT-polymorphisms the enzyme activity to break down epinephrine/adrenaline is lowered, so having problems with dentist anaesthetics containing adrenaline is probably caused by that enzyme defect.

If the symptoms are caused by mercury release I highly recommend learning about safe amalgam removal and how to protect from exposure, as extra mercury exposure can cause serious health problems.

Released mercury "consumes" glutathione so if Rich Vank´s hypothesis is right, extra mercury exposure worsens ME/CFS.
 
Last edited:

taniaaust1

Senior Member
Messages
13,054
Location
Sth Australia
Wow, I had thought at the time it was only me who had the terrible reaction to the epinephrine at the dentist and this thread is very interesting! I have a new dentist (since the time that had occurred) but when I told him that should I need future dental work, I would need injections without any epinephrine, he said that would be no problem. So hopefully, most dentists would not have an issue with that.

Its a quite well known fact that those who have ME should avoid injections containing epinephrine. There is a good article article somewhere on this and also talks about other factors for us as far as anesthetics go (It was done by a ME/cfs specialis if Im remembering right). Unfortunately I hadnt seen it before I had an injection with epinephrine in it so found out the hard way.
 

taniaaust1

Senior Member
Messages
13,054
Location
Sth Australia
The result of a dentist giving me a lidocaine injection with epinephrine in it was so bad that we almost rang an ambualnce (but I wasnt being sensible and avoiding doing so so wouldnt allow one to be rung.. instead I just prayed I'd get better enough to get myself out of the dental clinicbefore they shut).

For myself, this injection sent me into constant tremoring/shaking and severe body jerking and almost seizures and I couldnt support my body weight on my legs either after it. I was left stranded at the dentist for well over an hour as I couldnt even walk the few steps or so out to get a taxi.

To top that off, the injection site went into severe pain which was far worst then all 4 places I'd had my wisdom teeth out at the time! The pain of the injection site was like something was drilling throu me and it was still there the next day too. It was agony.

Next time I went (after finding out after this experence to avoid epinephrine) I asked them for one without epinephrine in it so they gave me lidocaine again withou tthe epinephrine, I was to that completey fine, no probs at all.

You should be easily able to get a dental injection without epinephrine, it just isnt worth the risk.
 

ahmo

Senior Member
Messages
4,805
Location
Northcoast NSW, Australia
Thanks so much for the info on this thread. Today was my first dental appt w/ a non-epinepherine anaesthitic. I was so relaxed I had to work at not dozing off!:lol:

The dental assistant asked whether my request was due to a problem with sulfa. So there's another element to beware of. In fact, I have sulphur intolerance. Some references say sulfa and sulphur intolerances are not related, others disagree. My mother wore a mediAlert bracelet for sulfa. I'd never considered it before uncovering my intolerances in the last few years.
 

Gingergrrl

Senior Member
Messages
16,171
@ahmo do you mean that all dental injections with epinephrine also contain sulfa? Can a dentist give you an antibiotic without your knowledge or consent?
 

Kati

Patient in training
Messages
5,497
Glad you had an uneventful experience. Make sure to mention 'no epinephrine' every time you get a procedure to make sure they don't forget.
 

ahmo

Senior Member
Messages
4,805
Location
Northcoast NSW, Australia
@ahmo do you mean that all dental injections with epinephrine also contain sulfa? Can a dentist give you an antibiotic without your knowledge or consent?
That's what the response from the dentist seemed to imply. They seemed to think my interest in epinepherine was inconsequential. Not that they downplayed it, but asked nothing about me and epineph. Rather, they (DDS, assistant) asked me about my reactions to sulfa.

I doubt that they give antibiotics. In my experience, if they feel one is needed, you're sent home with an rx.
 

ahmo

Senior Member
Messages
4,805
Location
Northcoast NSW, Australia
Glad you had an uneventful experience. Make sure to mention 'no epinephrine' every time you get a procedure to make sure they don't forget.
Yes. On his way out, the DDS said, "Be sure to remind me about this every time." I turned to asst, and said 'Surely you can mark this on my notes.' She said she had, it would always come up flashing in the future.
 

Kati

Patient in training
Messages
5,497
It's just that the assistant routinely preps the anesthetic for the dentist and they routinely use the regular stuff. It's like a habit.

The dentist will not investigate your reaction to epinephrine. They only care about getting the work done, and if you react bad to it, then the will do without.

You could mention it to your GP but I would be very very surprised if your GP was interested in that fact. And I would fall off my chair (or bed) if it triggered your physician to order any kind of testing in that regards.

Sorry to sound negative, it's just that I've been there, done that.
 

daisybell

Senior Member
Messages
1,613
Location
New Zealand
Has anyone else had major pain problems following root canal work? I am in the middle of this, and feel like my face has been hit with a hammer... My dentist has referred me to a specialist, as she doesn't know why I've got this pain. Appt first thing tomorrow morning.....