Re Dental Treatment.

[jennydog]

We have recently discussed dental treatments for AF sufferers. We established that we ought to ensure that anaethetics are adrenaline-free. Some dentists are not familiar with the new anticoagulant alternatives to warfarin. I commented that my dentist and her hygienist are totally unfazed by me taking Pradaxa. I also said that for some reason she asks if I have taken steroids or been injected in the past 2 years. To-day I have asked her about this.

She explained that steroids can make you vulnerable to fungal infections and this is important from a dental perspective. She explained about the medical perspective,and that was very complex, but my simplistic understanding was that steroid treatments reduce your body's ability to produce its own steroids so that your ability to cope with trauma can be compromised. In small doses there is no problem.

[BobD Volunteer]

Interesting Jenny. Thank you.

[Finvola]

I've been thinking about your post jennydog and it shows yet again how we need to be our own medical watchdogs - even with something as seemingly basic as dental treatment. Thank you for posting.

[traveler65]

@JENNYDOG i HAD INTERESTING DISUSSION WITH STUPID ORAL SURGEON WHO INSISTED THAT i WOULD BE OKAY WITH HIS ADRENALIN CONTAINING NOVACAIN BECAUSE THE WAY HE INJECTS IT SO SO SKILLFULL IT DOES NOT ENTER A VEIN. iTOLD HIM i HAD AFIB, TAKE SOTALOL , WARFARIN, BP MEDS, AND THRYOID HORMONE--HE SAID WELL LEAVE OUT ALL THOSE THIHNGS AND JUST TAKE BP MEDS. i TOLD HIM IF i DID THAT AND HE GAVE ME ADRENALINE i WOULD HAVE A HEART ATTACK AND WOULDN'T IT BE BAD FOR HIS REPUTATION IF HE HAD A CORPSE IN HIS CHAIR? oBVIOUSLY i USED ANOTHER SURGEON.

[jennydog in reply to traveler65]

That is awful. As @ Finvola indicated above we need to be our own watchdogs. My dentist is a Dr and Works for a large organisation doing NHS treatment. She is hugely knowledgeable. Her detailed description about the effects of steroids was amazing. I'm lucky to be on her list.

[sapphy]

I have learnt lots from people on here and after my ex dentist landed me in A&E I look for information before i go ,if I have to have something new done. Interesting about the steroids, thanks Jennydog.

[scotcitz]

Would be sort of tempting to take the shot, go into the crazy AF rhythm and then watch them freak out. Sometimes I am so immature ... hats off to traveler65 for dealing with that crazy (arrogant) dentist -- just something we constantly deal with about people who can't 'see' AF so don't think it's a 'big deal'. Love the corpse in chair comment. Must remember that one for future use.

[TerriN]

Believe me it's all too real....7 months after a second ablation , off all meds (except for xarelto) and no AFib at all, tooth pulled by dentist who shot my mouth full of epinephrine type novicane ....back in a fib that night and back on meds ...still fighting the beast 3 months later....talk about being pissed

[traveler65 in reply to TerriN]

TerriN there is something called carbocaine which has no epinephrine, but with extractions you can bleed a great deal if the dentist (see an expert oral surgeon) is not skilled enough to avoid nicking an arteriole. I had something like this happen with a not so expert at extractions dentist. After applying packing cause and ice packs to my head (as the big artery in your brain is why you can bleed so profusely from an upper tooth extraction if the dentist nicks a tiny arteriole.--this dentist drove me across the street, in his Cadillac Escalade while askinig me not to bleed on his car, to the office of an expert oral/maxifacial surgeon, who is the guy they call at the emergency room if he's needed there. This doctor injected epoinephrine so skillfully it was okay, and then inserted plugs of collagen into the bleeding tear. I had to remain lying down at home for 3 days with gauze on my extraction area. I think if I had gone to the expert oral surgeon first this would not have happened --so if you need anything medical done--figure out what level of expertise you need and find that person. Even though the original dentist was brilliant at other things he'd done and was a professor in the medical/dental college, this was not his area of expertise.

[traveler65]

@TerriN Did you tell the dentist before he worked on you that youhave afib and cannot take epinephrine? If so, sue him. I am not a litigenous person, like I do not sue people for a hobby--but this Dr. was really engaging in wreckless endangerment and probably afew other things that I cannot think of because I am not a lawyer.

[TerriN in reply to traveler65]

Yes the dentist knew I had AFib and they also wouldn't do the surgery until they had a letter from the cardiologist that they could stop the xarelto for two days prior....so at the moment it's a back and forth thing... Dentist says cardio should have also said no epinephrine , cardio says dentist should have know... Dentist says he wasn't injecting into blood stream....

So we are going back and forth...

And I had no idea. My EP However says that it will calm back down and should stop

[7Helena]

I'm on an extended course of dental treatment to put right damage done owing to my own stupid dental phobia. I've had only one extraction with INR results being satisfactory to him on blood taken less than 24 hours before surgery. He is much more worried because I also take Alendronic Acid which he tells me stays in the blood once having taken it. It prevents the gums from healing and so he is managing to correct damage by filling any decayed part of the tooth which ordinarily he'd have to extract. Although it involves very careful drilling, I'd imagine that any dentist could do the same (filling rather than extraction) where INR s are a problem?