dentist

I have been to the dentist today, having been last week for my broken tooth to be examined and xrayed (which she failed to position correctly). She was to try again for another xray today and decide on her treatment, however she decided against this when I said my gum had been very sore and bleeding from what she had done in the last appointment. Eventually after consulting with her boss it was decided to fill the tooth and I would have an injection for a deep filling. Before she started I mentioned the AF again and injections. The dentist said it was necessary to have two injections, However before she had finished the second one, my heart started racing and i gt chest pains and started to feel sick. when i asked had she given me an injection with adrenaline in despite me mentioning I couldn't have one she said yes. when I asked her why she said its ok and normal to do that.. when I complained she went to her boss and asked his advice, he said she had done right and he gave them to his angina patients so it should be ok. I ended up in A & E on the advice of my GP to be checked out. luckily things settled down after a few hours. I asked at the hosptal re the adrenaline as I had been told in the past not to have this type of injection and was told by the Dr it is ok for somebody with AF to be given them. I have started to question myself since I got home, first the dentist, now the hospital says its ok but clearly it wasn't as it made me ill. I've seen posts from a few years ago regarding this and wondered if anybody recently had been through a similar experience. How do I get a new dentist to take my concerns seriously?

51 Replies

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  • You have to state clearly that you must NOT be given an injection with adrenaline in it as it is a trigger for your AF and that you have been told that you must have an adrenaline free one. [You don't need to say by whom or what the latest hospital doctor said]. The boss probably backed her up because he is scared you will complain and / or sue. If they are still not budging then throw in the fact that the last time (ie the recent visit) you ended up going to your GP and he sent you to A&E. You don't need to go into any more detail (sometimes less information is more beneficial).

    Look up the main AFA website. Also the new AFA newsletter has a feature in it about dentist visits but I haven't read it yet so I don't know the content.

    You can also refer them to NICE and dental association.

    My dentist went to great lengths to stress how important it is that I do NOT have an injection with adrenaline in it under any circumstances and to repeat that each time and especially if I have to see one of the other dentists.

  • I tried Peter, hadn't realised she had done it despite what I had said thats what made me question how to deal with it. I won't be going back. I left the hospital at 5pm and when I turned my phone on she had left a message asking how I was, no sooner had I heard it my phone was ringing again. When i told her I wasn't in a position to speak to her as I had just left the hospital, her response was I will ring back in an hour then, when I said no she said ok two. It was hard to stay polite and not stressed as she wasn't listening. In the end I said I have been through enough for one day and goodbye and ended her call. what I don't want is her hounding me. I have had two different dentists since my AF started and this is the first time somebody hasn't listened. I will be looking for another dentist as I can't trust her and need somebody to put my health first. Thank you for the information re Nice and the dental association and also AFA , I will give them a read. Thank you for responding so quickly as well.

  • The guidelines in AFA news letter clearly suggest no adrenaline. What I do know is that adrenaline free injections are not as affective as those with so you may need more. I found this out having a toe nail removed some years ago at the doctors and after four injections and me still climbing the walls they gave up and I had to go to hospital and have it done there.

    If she rings you again tell her you are contacting lawyers ( just watch any day time TV program long enough and you will find a number to call.) Even if you don't it may make her stop and think about her actions and hopefully give her the odd sleepless night.

    Bob

  • Thank you Bob, I have never had an experience like this before and still have the broken tooth to sort out. I just need to find a dentist in Newcastle that is as understanding as my previous ones and listens.

  • The fact that she has tried to contact you so many times is in reality an admission of guilt that she was in the wrong.

    I did mean to say before that it is totally irrelevant that the boss gives adrenaline injections to people with angina as it is a totally different affliction

  • I asked her did she actually know what Af was and she said yes, by then I didnt believe her, I forgot to say before her reason for disregarding what I said to her at the start about the injections was apparently giving it in the gum is not the same as Iv as its a muscle and doesnt react in the same way,

  • Did she know before or afterwards?

  • before Peter, I discussed it the week before and yesterday

  • Regardless of AF or any other affliction. Medics may only give treatment and drugs WITH THE PATIENT'S permission.

    As a patient you can refuse treatment but you cannot demand them.

    You did not give that permission so of course she is terrified of the consequences if you are not OK - which you are obviously not!

  • I was in too much of a state to notice her behaviour yesterday, but your right. why would she keep going next door to her boss for confirmation she was doing the right thing.

  • Change your dentist - angina is not an arrythmia. Contact the dentists' professional body and make a complaint for negligence and incompetence - would be my reaction. Disgraceful behaviour.

  • It was a new dentist, never had a problem like this before and I am going to look into reporting this today. her arrogance was unbelievable yesterday, especially when she rang later.

  • So sorry you had this experience, angry on your behalf. We don't need this sort of behaviour,

  • we don't and thank you. I still have a broken tooth to deal with and another new dentist to find. I'm going to ask my local friends who they use this time.

  • Why not ask your GP to refer you to the maxillofacial unit at the Royal Victoria Hospital.

  • we have a dental hospital attached to the rvi, I'm going to look into seeing if I can get referred until I can find another dentist. thank you.

  • Just see about walking in as an emergency. Don't forget about getting it fixed properly.

  • its no 1 on my list to do on monday. thank you for your concern

  • I think the lack of education for somebody in that position is astounding this morning. the arrogance of trying to say I didn't tell her when I did, plus the phone calls and the insistance she will ring me back to speak to me.

  • This is all so totally unprofessional it is frightening. Definitely tell them you are contacting YOUR solicitor.The YOUR bit always 'puts the wind up' people.Sounds like the whole est. should be closed down. Do hope you will be contacting the Dental Association to report all this.

  • I will be putting a review on the nhs website and also reporting it. thank you

  • I think closing down the practice is too drastic and could be very counter productive for hundreds if not thousands of patients and for Sapphy.

    I strongly think that this has to be followed through down four or five different avenues.

  • To be blunt, for the dentist to completely ignore your instructions beggars belief. She shouldn't be practising, total arrogance. If the result was more serious I would certainly threaten them or at least write a letter that will make them change at least for future patients who are unfortunate enough to be treated by them.

  • it worries me she didn't listen and what could have happened, it was bad enough for me spending the afternoon in A &E. I have to say though the hospital were brilliant and had an Ecg done within 10 minutes of arriving at the Gps request.

  • I go to a dentist who works for a large dental company which advertises on TV. I have been very surprised about the information they check regarding my health and medication. They always run through computerised details before treatment starts. And this is despite me being seen once every 3 months because of receding gums and not much treatment being needed. They are totally unfazed by my anticoagulation but on alert when I had a steroid injection into my shoulder.

  • My dentist does the same and that would be considered good practice. They are meticulous about recording allergies, medications and the like and always ask 'has anything changed since your last appointment' and then go through the list and get me to sign it.

  • My last dentist was a large company and totally on the ball. when I told him I took Dabigatran (when it first came out) he hadn't heard of it so rang to find out more from a drugs line they used. I have never had an experience like this, I could understand if I hadn't told her. I have learnt a lot from people here since I joined and telling people what you can't have is one of the main ones.

  • Gums a muscle?

  • Thats what she said when I was asking why she had given me the adrenaline despite discussing it before hand. by that point my head was not in the right place to argue any more.

  • Thank you all your replies, i think last night I needed the reassurance that this was wrong. when you tell somebody in that sort of position what you can have and can't have and why they should listen to you and not carry on regardless.

  • sapphy - your experience is the result of arrogance, both on the part of your dentist and her boss. Both assumed they know best and that you, the patient, know nothing.

    I would advise to change your dentist and put the reasons in writing, together with the temporary damage done to your heart health and the visit to A&E. I like Bob's suggestion of also saying that you are contacting a lawyer. There certainly is enough there - ignoring your health issue, causing pain, distress, damage, making incorrect assumptions about one medical condition based on evidence from another, A&E, etc.

    First priority, I assume is to get that tooth seen to by finding a dentist who will listen to you and take your knowledge on board. I've had a filling and a large extraction both with adrenaline-free injections. They are slightly less efficient and long-lasting as the adrenaline helps the anaesthetic to stay in the tissues, but neither procedure caused pain for me. I had to have an adrenaline anaesthetic when I had a nosebleed packed and the adrenaline was essential to shrink the tissues. Within minutes my HR was through the roof and I was talking rubbish - it was almost as scary as the nosebleed. Some people with AF don't have an issue with adrenaline but if your AF is made worse by it, then it must be avoided.

    I hope you don't lose confidence in your own self knowledge because of this incident and that you get rid of that toothache, as well as kicking the offending dental practice in the rear - if you can be bothered.

    Best wishes

  • thank you, I do intend to follow this up. today I feel so drained and can't focus on anything for long and I'm getting annoyed with myself. Haven't felt this bad in a while. my previous two dentists took my concerns seriously and I never had a problem with them listening and doing what they should to protect me.

  • DON'T get annoyed with yourself. You did nothing wrong. You should never have to argue as much and remind so many times.

    Also they both need to be put on a training course regarding heart issues, dealing with patients and, probably, a few other things besides!!!!

  • thank you

  • I had a tooth pulled by surgeon last week and asked for shot without adrenaline . The Dr made the adjustment without conversation. I had two injections and no problem. Shame on your Dr to give you a shot that you stated could harm you. You need to find a new dentist . There is never a time that you should feel not heard by your Dr. Good luck

  • thank you, my last dentist sent me to the dental hospital to be sorted out. I asked her after all this yesterday if she would refer me, point blank no .. there is no need..

  • I suspect that this may be because she is scared that her actions and those of her boss will come out in the open..

  • I have written a review for the nhs website and intend to complain formally as well. Her boss did ask me not to write a review that was before I said, sorry I've already done it

  • I do hope by now sapphy that you are feeling better and understand that it is them that need a good kicking and that you are the victim.

    Dentists do need to be proactive where heart health is concerned. Mouth infections can be very dangerous for those with heart issues as infections can quickly enter the heart via the mouth. A young man in the bed opposite me at Royal Brompton was there for three months with endocarditis following a botched wisdom tooth extraction and was lucky to survive. Rare indeed but it happened and my own dentist insists that I have three monthly hygiene visits to reduce any risk from gum infection getting into my heart. I have known EPs want any dodgy dentistry sorted before they will treat for similar reasons.

    You do need to put the fear of Bielzibub into this stupid woman to protect the innocents who follow you who may not be so lucky.

    Rant over

    Bob

  • everyone has been so kind Bob, I just feel so drained today. can't seem to get anything done, even simplest tasks.. its 3pm and I haven't even got myself in the shower yet. for me thats a prime indicator all is not well, even in coronary care I was arguing with them to let me shower.. that poor man, mine sounds mild in comparison. I just wish she had listened, when I realised she hadn't it was too late. I've checked different routes to complain this morning but I'm a little confused as to which is best today. I will not let it rest as somebody else as you rightly say might not be so lucky.

  • I have just had the pricipal manager of the dental practice on the phone apologising for yesterday and hoping I won't put in a bad review and he will sort this out as extra training is required... told him the review is already written and I will be following this up with a complaint to the relevent body.

  • Make sure you do. Don't let them off them hook.

  • I am paying to see a an EP regarding my AF on Monday as the NHS one only seemed to have 5 mins to spare and was unhelpful. One of the questions I will be asking him is as all the doctors I have seen up to now have said AF in itself is not a problem I want to know what everyone is worrying so much about on here other than the stroke risk, which is there for good once you have had one episode anyway. If it gets better after a few hours what is the concern about adrenalin?

  • It may not get better and can accelerate and promote AF.

  • Adenaline often triggers AF in some people and should be avoided for most . If it does set off an event it can result in very high heart rates which many people can't tolerate resulting in hospitalisation.

  • I am having oral surgery soon. My periodontist told me there is a tiny amount of epinephrine in the shots that should not be a problem but he would give me the ones without if I wanted even though they are not as effective. I called my EP who is very well respected and reknown , about this and he said emphatically that it is fine to have them because the amount is so tiny. Puzzling!!! I certainly don't want pain during the procedure.......maybe I should go to an oral surgeon and just get sedated intravenous!!!

  • I think there are mixed opinions on it as everybody is different and we all have our own triggers. I clearly wasn't ok but when the I went to hospital they said there shouldn't have been a problem. I was warned by the cardiologist years ago to be careful so I have been and always mention no adrenalin. good luck with your surgery.

  • Dave.

    AF is a mongrel afflicction. Importantly it affects different people quite differently. VERY importantly it can affect the same person quite differently from one day to the next. Many have a reaction to adrenalin whether in things (such as an injection) or self generated adrenalin.

    I am in persistent AF and adrenalin is a problem to me. I can personally vouch that it affects me and importantly differently from day to day. This an cause my HB to jump from circa 80 to say 140 / 150 in a minute or two. When in January someone phoned me at 9.30pm to say they had been in a minor accident but were 100% OK and no one else was injured but could I please help and take them to their home. Even though I deliberately did not rush nor panic I felt my HB rise and the AF itself become more active and buzzing. Even though I was back home in less than an hour even three hours later my HB was high and AF very active.

  • I haven't even sent my letter off to the relevent people yet to complain but apparently my review on nhs choices is being challened.

    Dear Patient,

    On 21/05/2016 you posted the comment below regarding Newcastle Dental Care, 11 Ridley Place, Newcastle Upon Tyne, NE1 8JQ:

    “I ended up in A & E

    I went last week to see the dentist regarding my broken tooth. After going through my medical history and medication they asked me what the Dabigatran was for. I felt a little uneasy, but went on to discuss my atrial fibrillation (AF) and how I needed to be careful regarding injections and medication given to me. I thought they understood what AF was and what they should be doing regarding my treatment.

    When I returned yesterday, 19th May at 10.55 they decided to try to fill my tooth and said I needed two injections. The dentist had not even finished giving me the second injection when my heart started to race along with sickness and I knew they had given me an injection with adrenaline in it. I asked them why they had given it to me and they said “its ok to give as its not in an IV and into the gum which is a muscle”.

    They asked why did I keep looking at my FitBit, I told the dentist I was checking my heart rate as it was going up, it went off after a couple more minutes as it was too high to read. The dentist said that they needed to talk to the boss next door. On returning the dentist said its ok to give you the adrenaline as its given it to angina patients all the time. I pointed out AF and angina are not the same. AF is an arrhythmia. The dentist went back to the boss where they were told it was okay. Not once did they ask if I was alright. It took the assistant to do that upon entering the room. After repeatedly being told by the assistant ‘I was ok’, I said I would have to ring my GP for advice. The response was that they would ring at 5pm to see what had been said.

    My GP asked me to go straight to the RVI to be checked. When I came out after 5pm I picked up a voicemail from the dentist. No sooner had I listened to it my phone rang with the dentist asking what had happened. When I said I had spent the afternoon in the RVI the response was “Good, Good”, which shocked me. When I said I didn’t think it was good I had ended up in A&E I was asked what had happened. I said I couldn’t talk and needed to go, the dentist went on “I will call you in an hour then”, when I said no they said “ok two”. I said I have had enough for one day and need to go. The manager called in the next day, asking how I was, stated some concern and went on to say they hoped I wouldn’t leave a bad review….”

    The practice has since challenged NHS Choices' decision to publish your comment as it does not recognise the events you describe and believes the feedback to not be accurate.

    To help us respond to the practice's concerns, could you please confirm within seven days that the factual account you have given as the basis for your comment is true and something you have first-hand knowledge of.

  • You need to find the recommendations on the NICE website. Talk to the AFA as well. I believe you might be entitled to a half an hour appointment with a solicitor free. I also believe that treatment without your consent is assault. It's not about suing, It's stopping them treating others in the same way.

  • Thank you, I just want to educate and try to prevent this happening to somebody else. I was lucky to get off so lightly , but somebody else might not be, which for me is scary

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