Another Adrenaline concern….

[Tellingfibs]

I have the beginnings of implant work tomorrow, with the initial drilling. I have just read a stream of posts on adrenaline injections and I am now even more anxious ! I have had a discussion with my dentist and he said he will use ‘reduced’ adrenaline dosage, but is it worth the compromise ? If adrenaline is present at all, will that trigger heart chaos ? I must say that before I knew about adrenaline in dental injections ( but since I had Afib ), I have had one for a tooth extraction and it caused no problems. Do you think this means I am likely to be ok, or was I just lucky that time ! And can anyone tell me - how scary is implant work anyway !?!?

[Teresa156]

Hi TellingFibs,

A dentist can use non adrenaline injections, but I don’t think they like using them as they wear off quicker ( but they can top them up) and they don’t tend to stem the blood as much, which is what I was told. However, I do always insist and remind my dentist to use non adrenaline and they do. I have also had a previous dentist say they’d put less adrenanaline in and they always seem to say that they don’t use a lot anyway and they have a ‘set amount’ but I still said I didn’t want it. You can insist.

However, I had some ‘invasive’ root canal re-work done earlier this year by a specialist edondontist on a back top crown and she used an adrenaline injection, on two ocassions and told me that there are less blood vessels at the top, ( or that they are further away or something ) that would carry the adrenaline to your heart, but that on the bottom teeth there were vessels that would carry it. I had no issues on both occasions, but I’m not sure if that is always the case, and I wouldn’t want to give you false hope if it’s a top implant. I trusted her ( she was very good) and as I said, no problems at all. I do prefer the Non adrenaline though, they do wear off so much quicker and this might not be what he likes, if doing an implant on you.

I’d insist on the non adrenaline to be on the safe side, if you can and see what he says and hopefully you can top up. I haven’t had an implant, but perhaps others may come along and share their injection stories…

Teresa

[Tellingfibs in reply to Teresa156]

Thanks very much for the detailed response. My dentist said the ‘half’ adrenaline was a good compromise, but I am thinking that any at all is as bad as a full dose !😱

[Teresa156 in reply to Tellingfibs]

I don’t like to say it and I’m sure they’re a very good dentist, but I think they may be thinking of themselves, more than you unfortunately…I had a dentist too who was talking about “less adrenaline’ and like you say, it’s either there or it isn’t! It’s not worth the risk, you might be lucky again but you might not.

[ibuputih]

Hi Tellingfibs - well I have learnt something this morning about adrenaline injections!

As for implants - not at all scary… I had all the prep and fitting work done but family illness and then Covid came along and I have not as yet had my ‘teeth’ attached. Thankfully they are at the back, so the gaps don’t show - I’m getting them finished off soon!

So, I had an extraction with an immediate implant inserted in the socket and 2 further implants all done at the same time. I recall that I had to take a dose of prophylactic antibiotic prior to the surgery. The dentist had first to drill into the jawbone and then the fitting was screwed into the socket that had been drilled. In my case he harvested the ‘sawdust’ from the jaw bone and packed it in and around the fitting. Then a few dissolving stitches finished things off. I was in the chair for quite a time.

I had very little discomfort from the drilling. The screwing in of the fitting was a weird sensation ( especially the sound and sensation of it being cranked into my jaw). I had a wee bit of pain while one implant was screwed in, but nothing major and it was thought to be due to previous jaw bone shaving during wisdom tooth extraction. I looked a bit hamster like afterwards for a short while as the work was all one side. I was instructed to take painkillers for 2/3 days, alternating paracetamol with ibuprofen. It worked brilliantly and I’m thankful that this was before I was on anticoagulants so I could take this combo.

The only analgesic that really works for me is aspirin but that was not allowed. It seemed that the pairing of (as I consider them) useless paracetamol and not very helpful Ibuprofen did the trick.

Hope it all goes well - I am sure it will x

[Tellingfibs in reply to ibuputih]

Thanks so much for your message. I feel a little braver now !

[Desanthony in reply to Tellingfibs]

I have had no problems with the normal injections given by dentist for implants - having some stuff re done now actually. Only just remembered to tell her about the adrenaline. Like many I didn't know this before and had gone through implant work with just the normal injections and had no problems - I think it probably depends on how much you have to have and maybe the work I had done previously which didn't take long meant I didn't have such a high dose. This refurbishment work is going to take a long time - at least 3 hours in the chair each time and 3 or 4 appointments - one down but I have to wait until December for the next appointment as dentist's are so busy.

[ijregner]

I just had a full mouth extraction. When I told the surgeon that I had afib he automatically switched to the no adrenaline injections. He had to add a bit before he was finished but it was fine.

[Tellingfibs in reply to ijregner]

thanks for that. It seems I should insist on the no-adrenaline injection and expect shorter period of pain relief.

[Bagrat]

I ask for non adrenaline injections and had rootcanal with no top up., but needed one for an extraction.

I'm pretty sure last time I didn't mention it and I had one with adrenaline with no ill effects apart from face being numb much longer.

Also the fact that your natural anxiety will boost natural adrenaline (fight or flee hormone) needs to be taken into account.

If you're concerned re bleeding or pain because of no adrenaline in jab you may produce more yourself!! I had no excessive bleeding after extraction and implant prep shouldn't cause bleeding anyway.

[Tellingfibs in reply to Bagrat]

Thanks Bagrat, all reports of dental experiences helpful and appreciated 👍

[Avatel]

Hi, If you have a lot of work done then you can choose non adrenaline. I recently had stiches for a cut and the doctor said gave me adrenaline jab, and she said a small amount of adrenaline is insignificant and gives it to a fibers regularly. It's a personal choice

[Tellingfibs in reply to Avatel]

that’s reassuring Avatel, thank you.

[Ducky2003]

I usually have adrenaline free but have a stubborn tooth that will not numb, even after 6 injections so dentist has suggested Articaine which is a very low dose adrenaline so Im going to check that out with my cardiac nurse.

[Tellingfibs in reply to Ducky2003]

thanks for the response Ducky.

[Ducky2003 in reply to Tellingfibs]

Good luck with the implant.

[Tellingfibs in reply to Ducky2003]

Thank you !

[pusillanimous]

Implant work is nor scary at all , the skill is in the correct placement of the implants by the dentist and not all have that skill unless they are experienced or specialists in the procedure. I had seven implants inserted at the same time ten years ago and they are still fine - the important thing is never to smoke if you have implants and take care of them. Mine are in the upper jaw, I had to have temporaries while the permanent bridges were made in the laboratory. Have you not been offered twilight sedation as well as local injections, either in the form of a tablet or nitrous oxide?

[Tellingfibs in reply to pusillanimous]

I’ve never heard of twilight sedation ! My dentist just suggested the injectable anaesthetic had reduced adrenaline as I was worried about my Afib kicking off. He said no adrenaline would be a less effective painkiller.

[pusillanimous in reply to Tellingfibs]

'Twilight anesthesia is an anesthetic technique where a mild dose of sedation is applied to induce anxiolysis, hypnosis, and anterograde amnesia. The patient is not unconscious, but sedated. During surgery or other medical procedures, the patient is under what is known as a "twilight state", where the patient is relaxed and "sleepy", able to follow simple directions by the doctor, and is responsive. Generally, twilight anesthesia causes the patient to forget the surgery and the time right after.' That's just a copy and paste version, and can be used in conjunction with adrenaline fee local (the problem with adrenaline free locals is they are not so long lasting). I was PA to a professor of Oral Rehabilitation (highly regarded professional who as well as his Chair had private practices in Durban, where I live and the West end of London - he commuted between them) as well as holding courses all over the world some on yachts and some in Swiss chalets - (who said dentistry was boring !!!) He always sedated his patient in this way, because he would be working on them for 3 or 4 hours. Possibly your work is quicker and less complex, so your dentist does not feel it necessary to suggest anything more that a local anaesthetic.

[JudyMarieC]

I've had 2 root canals with the non adrenaline injections. It's a lengthy process but I didn't need to have it topped off - it worked fine. Good luck!

[Tellingfibs in reply to JudyMarieC]

That’s interesting…. I think I am becoming less nervous now. Just my luck if my INR is too high tomorrow and I have to cancel 🙄

[Snowgirl65]

I only had a reaction many years ago, not knowing about epinephrine in Novacain for dental procedures. At that time, I didn't have a-fib. I've since had a dental extraction and dental implants with no problems with my a-fib.

[Tellingfibs in reply to Snowgirl65]

That’s very reassuring Snowgirl - thank you !