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?

[cindy707]

Boy o boy am i going to weigh in on this one....no worries...i think the doc is right.  I have had 6 root canals plus fillings, etc. and on top of that i have them numb me for the cleanings as well since i am such a baby at the dentist.  I am on a beta blocker now and have been for about 3 years after my ablation was done and for a time before.  About two weeks before the procedure when my heart was doing that atrial fib dance and knocking my heart rate up into the 300's i unfortunately had to have my last root canal.  Talk about scared!!  I almost asked them to call my heart doc to be on stand by i was so worried...but no worries...i had it done w. the anesthesia and was absolutely fine.  I know everyone is different but i think the incident rate from what i understand is incredibly low .....i just let the doc do their thing and figure that dentists actually go to school longer than a GP and know their stuff...good luck CFS but i wouldn't worry about it...what i also did as a safety measure tho was to ask the doc to give me an antibiotic for a couple of days after "just in case" some little bacteria was travelling around in my body to stop it in its path...i figured it was better to be safe then sorry....good luck at the dentists office and i don't envy you!!!  I think i was responsible for buying him his latest space looking chair..LOL....

[CFS56]

Thank you Cindy.  You made me feel better.  A fib is so scary and when it's gone you really want to keep it that way.  I have had visions of being wheeled out of the dentist's office with my heart going crazy! And earlier I was thinking to myself that it's not too far from my dentist to the heart hospital!  I am such a worry wart.  I have some ativan so I guess I'll just take one, suck it up and go.  Cavities don't fix themselves unfortunately.

[tanns]

I do all dental work without epi and my dentist knows I will let her know if something starts to wear off.  She's great at asking me as she goes along if I am doing ok.  Have you been to this dentist before?   I am sure even if you go with the epi, you'll be fine too.  Lots of people are!

Good luck!

[kay2486]

talking about dentist, ive got to go for a check up and i know im gonna need a filling or even the tooth out, i get pvcs especially when im anxious so will i be ok if i get them whilst in the chair?

the last time i went i had three teeth out and i wasnt bothered but since ive had panic attacks im scared quite a bit, the way  i get rid of anxiety is make myself do whatever makes me panicky its the only thing thats worked

[chuparosa]

I had a tooth pulled a week ago and spoke with the dentist (oral surgeon) who said the dose of epi dentists give is too low to cause any problems. I had no heart problems at all during my time at the dentist. You should be ok.

[CFS56]

I did fine.  The cavity was so little and superficial it took all of about 5 minutes to drill and fill it.  I felt really silly, all the worry that preceded this visit.  

[cindy707]

Man that was a crazy one...look how many of us weighed in on our experiences w. the dentist....i seriously wonder if they are the most unloved medical professional out there...they cause us pain but the results are amazing...its just the thought of it ewwwww.....knock on wood i have great teeth now but wow that creaky sound when they pull a tooth...congrats CFS56 i totally related to your answer and laughed for the first time today about thinking about how close the hospital was and being wheeled out...been there for sure in thought.....

[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.  

[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.

[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.

[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.

[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

[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!

[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.

[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).

[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]

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]

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....

[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.

[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]

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?

[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

[bbxx]

thats horrid! sorry to hear what you went through!

[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!