caine allergy

I have what my physician calls Caine's Mutiny.  The use of any caine-type drug, or derivative (amides or esters), even used topically, causes me to go into anaphylactic shock.  

I have been to allergists and they have all said that it's not the preservative in the drug that is the problem and they were unable to find a safe alternative.

I have not had any dental work done for years hoping they would eventually find a suitable alternative.  Now, my teeth have reached the point that I must do something.  There are no dentists within 100 miles that use a general anesthetic.  My dentist is unable to find anyone willing to come to his office to administer a general anesthetic. So, a trip to the hospital operating room appears to be the only option available.

I had my dentist work up a treatment plan. Six hours in the OR, to complete everything I need done, comes to $12k.  This included a remote link to someone to design the Cerec crowns.  Add to this, the hospital costs, and I'm looking at close to $20k.

If I do proceed with his treatment plan, I still do not have any way to get local treatment for major issues except for the hospital OR.  Oral surgeons here do not do normal dentistry.  If I proceed, I will have repaired my teeth, but have no way to maintain them.

My brother had implants put in several years ago and swears by them.  My dentist says I'm not a candidate for implants because my gums and jawbone are in great shape, he is not supportive of the idea of implants.

Any suggestions would be appreciated.

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[Jerome Bogin, D.D.S.]

It seems you have exhausted all your options. You can maintain the work you have done by visits to the hygenist and your dentist for cleanings and x-rays. If you need more work you will have to find a dentist that dentistry using sedation techniques.

[nocaine]

Oops. I hit the Post button too quickly.  I really want to thank you for providing such a tremendous resource.  It's really great that you take the time to answer questions.

[nocaine]

I guess I am wondering about implants vs. the repair work.  From a cost standpoint, I imagine they could be very similar.

If I have the repair work done, the next time anything beyond cleaning needs to be done, I must find a sedation dentist, the closest of which are in Omaha, which is over 100 miles away. That seems awful far to go if you're in pain.

If I do the implants, it's a one-time procedure, that with care, should last me the rest of my life (I'm 58).

Any thoughts?

Thanks

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[katmeup7]

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If anyone can sympathize with you, I can.  I've had three major caine reactions, the last landing me in the ER and everyone around me thought I had a stroke.  I was pretty scared. That was after allergy testing, and an MD who when called, said "I would have no way of predicting that reaction."

Two other allergists have suggested using Lidocaine with no epi or preservatives and premedicating with steroids and benedryl the day before and day of....

But I've discovered that Benedryl injected is a viable option (according to a professor of anesthesia at U of Florida) but I can't find a local dentist to do it...

I need two crowns and am trying to pre-emptively do something before they become emergent, but like you, I don't find much sympathy or help out there in the community of dentistry.