Dental anesthetics, epinephrine

[CFS56]

I have to go have a tooth filled tomorrow and I'm somewhat apprehensive about the anesthetic.  I know most often the ones they use contain epinephrine because it's a vasoconstricter and causes the anesthesia to work longer. I know you can request the anesthetic without the epi but then it wears off quickly (like when they are drilling on your tooth).  I asked my cardiologist and he said if I didn't get a big dose of the epi, if it was mixed, with the beta blockers I should be ok.  But I'm nervous and I know nervous alone can cause my heart to get weird.  Curious what others do when they have to have a tooth filled or something?

[DeltaDawn23]

So sorry you had that terrible experience.  I tell the hygenist and dentist EVERY time I cannot tolerate the epinephrine.  I have heard so many stories of problems after a dental visit.  Your anxiety is shared by many people.  I didn't go to the dentist for a year because I was afraid, but finally went and it was fine.  I opt not to have a shot at all if it is a small procedure.  Good luck to you.

[turningpage]

Hi

I was 47 years old had no history of heart problems, very low cholesterol and normal BP.  I went to have a tooth pulled and was given a shot but when they started pulling the tooth it hurt so I was given another shot.  My hands and knees started tingling my heart rate increased immediatly and I could not breath.  they pulled the tooth and quickly sent me on my way.  On the way home my heart spasmed and I had a heart attack.  15% heart damage.  The ambulance did not believe it was a heart attack, the emergency room did not believe it was a heart attack so I was not being treated for it as fast as I could have been .  In the end the blood work did not lie and my enzymes were 37, I did have a heart attack so please be cautious I have dental work to do and am feeling very anxious but I have to get it done not sure how to proceed.  Good luck to you all I hope this helps.

[CFS56]

Your wife needs to be seen by a doctor as soon as possible.  Epinephrine can cause increase in heart rate and blood pressure.  With the symptoms of slurred speech and impaired memory I would go sooner rather than later.  

[DeltaDawn23]

I think your wife should see her doctor right away.  The symptoms you are describing sound serious.  Better safe than sorry.

[Tim471]

hello all the reason im on this site it for info.me and the wife has a problem. my wife 46 just went to the dentest about a week ago before she went in she was fine. the day of the oral sergury she had to have 4 teeth pulled #2 #15 #19 #30  after filling out the paper work she marked that she did have aniexity , migranes and high blood presure. then she went to the back and i was in the wating room. acording to her before they started the oral surgean ask her if she had these 3 things and she told him yes  then he told the asst to get the shots with EPI which didnt make sence my wife knew what is was she works as a pharm tech and thought he knew what he was doing . during the admin of the shots all of a sudden her heart rate went up presure went up and a migrain from hell whitch brought teares to her eyes.the oral surgian called for a crash cart. ofcorse im in the wating room having no clue of this.they got her calm without the crash cart and pulled the teeth.after we went home she got sick upchucked had a migrain her mouth was numb ect several days have passed now her bottom lip and toung is still numb ,she still have migranes, her speach is impared and she is having a hard time thinking and remembering. now what im wondering is could the EPI in the shots could have made her have a stroke what i dont understand is that the doc gave her 3 shots pur tooth thats 12 shots for god sakes is that many normal  please help with info and please only answer if you know forshure. thank you tim.

[Madge270]

I have the kind of reaction you described to just about all antibiotics.  And they close my throat too.  It's very bad for me when I need an antibiotic!  I have to be really careful, especially about getting something like strep throat.

[DeltaDawn23]

I avoid the epinephrine.  My personal experience is that it brings on tachycardia.  I know others who've gone into Afib from it.  The short acting variety works fine and you can have an extra shot.  I wouldn't chance it.  Years ago, before Afib, I experienced an elevated hr and had to ask the dentist to stop.  Now I know it was the epinephrine.  It's not worth the chance it might throw you into an arrythmia.  I, too, calculated the odds I might need medical help and the distance to the hospital -- not so strange if you've had problems before -- I'd do almost anything to stay out of the hospital.  Why take a chance?

[Mags010]

Had 2 fillings today. Have a history of palpitations and high blood pressure at just 23 years old. After he gave me the local I started to shake and my heart started really racing. More than anxiety alone could cause.  He claims it was near a vein and has adrenaline in so can cause that. I'm starting t wonder if he just missed? With my medical history it really scared me and has never happened before!

[bbxx]

thats horrid! sorry to hear what you went through!

[bbxx]

First--I read cipro is not recommened for people with heart rythm issues.
Second--I hate the dentist--although I love the guy I see. Hes great because he is soooo
    patient with me. He always laughs every time he sees me and says "every time I see you I feel so bad for you because you look so scared"
Cindy---I too have more root canals and caps than one should--and I always took great care of my teeth.
Whenever I would go to the dentist--the shot would make my heart race--so I he said no more epi for me. Then I started researching meds and of course--not the good side of the them lol--so when I got there I asked to have my cavity drilled/filled without a shot. He looked at me and said "boy, I dont know if its a good idea for you" I asked him how deep the cavity was--how much of a chance of him hitting a nerve--(thats the killer)--and he said he didnt think he would hit it. So we made a deal---no shot---but if I felt he was getting too close to hurting--he would give the shot. It turned out I didnt need the shot--It was teh best visit ever! But--I did get dizzy after from holding my breath and shallow breathing the whole time! lol

[KisekiShiawase]

so how long does the epi last? is it really needed? dont they got another thing thats not contraindicated with beta blocker and not caused palpitation and racing heart?

[beema36]

My Dr says epi with betablocker is contraindicated. They gave give u more if the med without if u need it. I ended up in ICU once after having epi at dentist. Lost consciousness went into arrythmia. I will chance some pain.

[KisekiShiawase]

Hello,
i experianced different situation.
it's been 2 days since my 2nd appointment on root canal. And ever since i went home from the dentist my heart problems getting worse. I don't know what to do :(
Has anyone experianced similiar situation?
Does anybody know any information about it?
Your help means a lot to me.

[cindy707]

Funny you should post that about Cipro CFS56...i found out the HARD way that i am suddenly totally allergic to it and it causes me to have a severe allergic reaction that caused me to go to the E,R, and i ended up with six injections of benedryl in one arm and sic injections of steroids in the other...i swelled up like that girl in the movie Shallow Hal within minutes...was that ever scary...yep now i am staying super pro active w. my teeth altho i have always been super good about it ....must be my age or something that all of a sudden during the past couple of years i am having issues....i think i am the root canal queen at this point....

[CFS56]

OMG, me too Cindy.  I have spent a huge amount of money on my mouth, couldn't believe I had a stupid tooth abscess.  Interesting the afib went away when you had your tooth pulled. That's great that it did. My doctor told me  a while back that any infection can aggravate your heart and make it act weird.  Also, some antibiotics cause me to have more palpatations...cipro seems to be the worst for me.  

[cindy707]

Okay adding to the mix here.....for the past couple of weeks i have been having issues w. atrial fib suddenly...went to the dentist...infected molar....went to the heart doc....said get it out now and put me on heavy duty antibiotics.....had the molar pulled a week ago...no more atrial fib....the heart doc said definately yes....an infected tooth has a direct impact on the heart and with atrial fib causes the heart to become irritable because it is fighting too much...i was never so happy in my life to get that back molar out of there....within hours i physically felt 100% better and not a single issue of atrial fib since....now i listen a little closer to what my doc says about teeth....i think i could buy a Porsche with what i have put into my mouth these last couple of years.....crazy

[CFS56]

Well, I just had to have a root canal done on Thursday.  I did not want to do it without the epinephrine.  The epi makes the anesthesia last longer, if you use the anesthesia without, it wears off in a very short time.  I called my EP and he said it would be ok to take up to 10 mg of my beta blocker (I usually take 5) and to be sure I took it at least 2 hours before the procedure.  So I did that, took an ativan and I was fine(except for having a root canal).

[Skywatcher]

Funny you should be talking about epinephrine.  I had a skin cancer removal and they used epinephrine on me twice during MOHS surgery (they leave you in the office for a couple hours while the biopsy goes to pathology), then shoot you with epinephrine again.  Well.......my body did not like it and I had a major problem, lost consciousness, etc.

Maybe it has it do with the heart?  This was not an experience I EVER want to go thru again.

[Barbarella]

I have severe "white coat hypertension" which causes my BP to rise very high when going to the doctor.  A Dentist told me a long time ago to always tell the dentist to give me a shot WITHOUT epinephrine.  In the meantime I got on BP meds which controls my BP but when going to the doctor it still goes up, but not as bad as in the past.  I double checked with a new dentist I am seing now and he told me "that he will continue giving me the shots WITHOUT epinephrine, and to remind him whenever I see him even though he wrote it in my chart.

Since I also have occasional PVC's (skipped heartbeats which are benign I was told by a cardiologist)  the dentist said "epinephrine was a no, no" for me, it can bring on PVC's or make them worst, or it can also cause a rapid heartbeat in "some" people he said.  I do not want to be one of the "some" people to end up in an anxiety hell hole. Been there done that!

[cindy707]

OMG that was the funniest post i have read all week.....keep up the good work because after a tough day today you just made it alot easier <3

[LindaTX]

I never had a problem with novocaine at the Dentist's but I had a horrible reaction when an ENT Dr sprayed a mixture of lidocaine and epinephrine up my nose to look at my sinuses and within 20 minutes I was in a-fib.

[bypeep]

I recently went through a similar experience with lidocaine.  I had a ruptured cyst in my breast and as it had broken through one of my milk ducts it had developed an abscess.  The doctor wouldn't let me leave without having a butt shot of antibiotics - she wanted fast acting because I had a high fever and my breast was the size of Mount St. Helens.  When the nurse came in to inject me she made the mistake of telling me that it was antibiotic PLUS lidocaine.  I refused the shot, terrified that it would send my heart for a loop.  The Dr. came back in after the nurse left the room and after looking over my chart, told me that during my gallbladder surgery in 2000, I'd received a similar drug and had "tolerated it well."  The issue was that I'd received lidocaine during another procedure as a teen and as I was laying on the table, I suddenly felt my heart just take off like I was running a marathon.  It freaked me out!  But, I had no palps during it, just a really rapid heart rate for a moment or two.  

On another note, I had a miscarriage in 2001 and was given an injection of morphine which had epinephrine in it and I never experienced any side effects whatsoever.  My heart didn't freak out and the rate never increased.

I know this sounds terrible, but I really think that sometimes it's all about the particular day you're having - meaning that if you're already having a day where your heart is agitated for some reason, you react to these things more.  Luckily for me, each of these times coincided with a good heart day.

[Jerry_NJ]

I don't know about epinephrine (looks like I must have had some - is it the stuff that makes the jaw numb?) , but I have had crown work and other serious work done, must have gotten some.. and since I had open heart surgery in 2007 I have been required to take  (4) 500 mg capsules Amoxicillin 1 hour before dental work, even just cleaning.  This is an antibiotic.

I have never noticed any heart reaction to a dental visit, including root canal, which I am happy to report I have had only one.

[Barbarella]

Dentists DO have the shots WITHOUT epinephrine.  Just ask to have a shot without it, and they will give it to you.  They have to have these shots available (without epinephrine) for people who have serious heart problems, blood pressure problems when having high anxiety like some people have when they go to the dentist.