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Adrenaline free or not at dentist

checkmypulse profile image
31 Replies

Hi, does anyone have a insight into the use of Adrenaline and AF? Fortunately since ablations in 2016 I have been symptom free although AF is probably still going on inside. Since then dental treatment has been with Adrenaline free anesthetic. Now an infected tooth needs extracting and despite 2 such injections the pain was so intense the dentist and me called a halt. I have a course of strong anti-antibiotics to try to calm down the infection before round 2 next week. Dentist explained that an standard adrenaline base injection will act faster, last longer and will seep down into nerves more effectively. So I was wondering whether to have one of these next time. If the ablation is controlling my symptoms ok at the moment do I need to be concerned if my heart rate goes up following injection?

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31 Replies
BobD profile image
BobDVolunteer

Hopefully the antibiotics should deal with the infection which will be what is blocking the local anaesthetic. My dentist would never try to remove an infected tooth because of this and always clear up the infection first. Apart from anything else it is well known that tooth infections can adversly affect the heart if not carefully controlled correctly.

Regarding the adrenaline whilst not recommended if round two fails then you may have to try it.

checkmypulse profile image
checkmypulse in reply toBobD

Also read some of your previous posts BobD re the tooth infection and heart, wasn’t aware of that. Thanks

Since adrenaline and cardiac arrhythmias are not a good mix, is a referral to your local dental hospital a possibility? That might allow an anaesthetist to give intravenous sedation alongside adrenaline free local anaesthesia.

checkmypulse profile image
checkmypulse in reply to

Thanks. That will be the plan if round 2 also fails, long wait though.

Gowers profile image
Gowers

I have had sedation along with adrenaline free injection & it's not affected my af. Maybe worth asking your dentist about this?

checkmypulse profile image
checkmypulse in reply toGowers

Thanks for this. I will ask him next week, but from our conversation today probably the dental hospital is the way he will do it. Would rather not wait that long.

Jalia profile image
Jalia

This is interesting. I was given an adrenaline containing injection prior to a filling some years ago and went into a very fast rate. Treatment had to be aborted. Since then I always ensured that injections were adrenaline free and any infections were always cleared by antibiotics before procedures.

However very recently I was treated by a new dentist who had bought into the practice ....had swollen face with infection from an old root . Given antibiotics which did not clear the infection but he decided to go ahead with root extraction anyhow . I asked for adrenaline free but was told it wouldn't be so effective. It wasn't!!

After reading Bob's reply I can see why....the infection was blocking the anaesthetic. He did say that the normal injection would cause a raised heart rate in anyone. ...I don't think he appreciated that mine would be liable to go over 200bpm though !

Moral of story here being....make sure infection has cleared first !!

checkmypulse profile image
checkmypulse in reply toJalia

All that noted. Thank you. I have been given a strong anti-b, never had them before, lots of instructions from pharmacist!

Jalia profile image
Jalia in reply tocheckmypulse

Good. What have you been given ?

checkmypulse profile image
checkmypulse in reply toJalia

Metronidazole, 400mg, 3 times a day after/with food and with a glass of water. No alcohol, not a problem as none since 2016 as this triggered my AF!

Jalia profile image
Jalia in reply tocheckmypulse

I was given this about 2 years ago and it cleared up my infection quickly. As I'm on warfarin I kept a close watch on my INR..not a problem as I self test. Hiwever my new dentist would not prescribe because of the warfarn interaction !

checkmypulse profile image
checkmypulse in reply toJalia

Jalia that's very helpful, thanks. I am on Edoxaban one a day, so stopped the dose on day before dentist attempting extraction. The advantage of a DOAC is it dosn't need monitoring like warfarin.

checkmypulse profile image
checkmypulse in reply tocheckmypulse

Further to this the enclosed leaflet does refer to Warfarin interaction. Don't know about Edoxaban. Guess I will find out!!!!

opal11uk profile image
opal11uk

I alway ask for Adrenaline free and, a friend of mine had an infected tooth removed, it was abscessed, and ended up in hospital in London with an abscess on the brain which her specialist diagnosed as being as a direct result of that tooth being removed, the infection had travelled to her brain. Thankfully she recovered so please be warned, dentists should never ever remove in the presence of an infected/abscessed tooth.

Jalia profile image
Jalia in reply toopal11uk

Very interested to read your reply opal11uk....my extraction was with infection still present and it has taken 3 weeks for me to feel better and swelling to completely disappear .I shall insist on further antibiotics to clear infection in future if necessary.

opal11uk profile image
opal11uk in reply toJalia

yes please do and be aware of any other symptoms, fever etc.etc., because my friends case was very real and scary. Good luck

Lucymoo profile image
Lucymoo

I’ve had dental treatment using standard adrenaline local injection with no problems at all. Go for it

checkmypulse profile image
checkmypulse in reply toLucymoo

Have you got AF , ablation?

pottypete1 profile image
pottypete1

Local anaesthetic Adrenaline and me do not mix and my dentist always uses adrenaline free Local anaesthetic.

However because my stress levels go through the roof in the dentist chair after my very bad childhood experiences I always have intravenous sedation as well.

It works well for me. Mind you because I have such a good dentist I haven’t had any dental work for about 6-7 years.

Pete

checkmypulse profile image
checkmypulse in reply topottypete1

I don't normally get stressed or bothered too much about dental treatment and can stand the pain from drilling without an injection etc but this was something else. I am not looking forward to the 2nd round and will need to ask him some questions, ie sedation, some good thoughts coming from this amazing forum. After this course of a-biopics I need to be reassured the infection has been treated before I allow those pliers anywhere near the tooth!

mrgwair567 profile image
mrgwair567

I’m surprised that your dentist tried to remove an infected tooth, you should have been treated with an antibiotic prior to extraction. I had a broken molar removed last week with a non adrenaline injection. My dentist made sure that enough was administered and although the procedure was not straightforward it was pain free.

Hope the second attempt will be successful!

Paulbounce profile image
Paulbounce

Following the post with great interest !

I need a root canal (or tooth taken out). I would like to keep my natural teeth and think going the root canal 'jobbie' is the option I would prefer.

However I don't the want the thing kicking in afib again. I would certainly ask for a non adrenaline injection - no way at all would I (personally) have the other one.

And yes - tooth infection will / can affect the heart. At the moment I'm doing a salt rinse everyday - great for infection but be sure not swallow any.

Paul

CCW66 profile image
CCW66

Ask your dentist for Carbocaine...not sure of spelling but this works for afib people with no added effects that you don’t want to spark. It does wear off after 40 mins and then you are just reinfected into already numb area.

checkmypulse profile image
checkmypulse in reply toCCW66

I will look it up, thanks

Paulbounce profile image
Paulbounce in reply toCCW66

Sounds good to me CC. I'll check it out for sure ;-)

Paul

Windlepoons profile image
Windlepoons

My heart raced every time I had an adrenaline injection at the dentist. This was happening for 15 years before I went into AF. Before knowing about AF i had wondered why it happened. My GP advised me to make sure i now have the injections without adrenaline. I personally wouldn't risk it.

checkmypulse profile image
checkmypulse in reply toWindlepoons

Yes it's the risk. Like you, before AF I had normal adrenaline injections and don't recall having any heart racing issues at all. That's why I am considering the risk.

I only learnt about the ad-free option through this forum and the AF association

Maggimunro profile image
Maggimunro

Hi thereLong before I had my official diagnosis of Afib I was advised to only have adrenaline free local anaesthesia after having had “ a bit of a turn” at the dentist. In those days Afib was rarely picked up.

The same was true for my 3 ablations. The first general anaesthetic sent me into shock but the second , adrenaline free, was absolutely fine.

Snowgirl65 profile image
Snowgirl65

Hi -- I recently had a tooth extracted that had broke and exposed the root, causing extreme pain. I first had to stay off Xarelto (a blood thinner) for 3 days before the extraction. Though I asked for an epinephrine-free anesthetic shot for the procedure (similar to your adrenaline-free one), my oral surgeon said the one with epinephrine would work better, so I agreed. I had 4 shots of it around the tooth and gums. Though I've lately been having lots of a-fib episodes, and feared the surgery would trigger one, it didn't. I hope this helps, and good luck to you.

checkmypulse profile image
checkmypulse in reply toSnowgirl65

Thanks, it's so interesting to hear all these experiences and yes helpful. I wonder if it will make decisions easier? I suppose it depends on the effects of this antibiotic. it's a waiting game.

Snowgirl65 profile image
Snowgirl65

I certainly hope everything works out well for you!

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