Dental fillings

[Jafib53]

Hello. I have just had a dental filling fall out and so will need to go and get it replaced. I haven't been to the dentist since my diagnosis of AF and nobody mentioned anything about precautions to me. I am currently on 1.25 bisoprolol, edoxaban and an anti-arrhythmic medicine (bepricol) which I think might only be used in Japan. Not sure if I will need an anaesthetic or not but am I right in thinking bisoprolol and local anaesthetics are not a good mix? (think I read that on here somewhere). Anything else I should be aware of or, more importantly, make sure the dentist is aware of?

[Finvola]

Local dental anaesthetics containing adrenaline are to be avoided for many of us with AF. I always ask my dentist for adrenaline-free injections which don't trigger any arrythmias with me. I've had fillings and two extractions with adrenaline-free anaesthetic without problems. The anaesthetic doesn't last as long as the adrenaline one but was fine for me. Best wishes with it.

PS - I don't think Bisoprolol is the culprit - just the fact that you have rhythm problems which adrenaline magnifies.

[Jafib53 in reply to Finvola]

Thank you. Hopefully the dentists are aware of any interactions between the drugs and the anaesthetic but will certainly need to update them on my current medical status.

[BobD Volunteer]

Make sure you ask for non adrenaline local anaesthetic is all.

[Jafib53 in reply to BobD]

Thank you - I will do that.

[Tellingfibs]

I have had half-adrenaline dental anaesthetic AND also some with full dose adrenaline. I am on 10 mgs Bisoprolol daily. Dentist said there wasn’t a problem with Bisoprolol. He also said that although he has heard some people have problems with Afib and the anaesthetic, he has never encountered any of those people during years of dentistry and always gives the full adrenaline injection unless asked otherwise.

[SilverliningsForNow]

Hi Jafib I am in touch with both my EP/Cardiologists and have asked them this question and they both said injections with adrenaline won’t have any impact. My dentist said the same and also they’re more efficient at dealing with any pain. Its hard to know who’s right.

[Silvasava]

I've had two extractions over the last few years. The only thing I've been asked to do is stop my anti co ag for 48 hours beforehand. Make sure your dentist has a list of your current medications.

[Mowgli44]

I had two teeth out yesterday and the teeth were tough to move. I was told to stop Edoxaban just for that day. I’ve also had several fillings over the last few months with no problems with the anaesthetic. Hope this helps

[Qualipop in reply to Mowgli44]

Lucky you. I broke a tooth a few weeks ago; can't have it pulled until JUne. Yesterday I woke with my cheek like a balloon; got an emergency appt; it's an abscess on the root of a different tooth ; one they tried to pull last year but it snapped off and they left the root in. Dentist did nothing but told me to ring 111 if it got worse. TOday the whole side of my face is swollen especially over my chin but guess what; the emergency dental service is booked up. Can't even get antibiotics. RIng back tomorrow. Very concerned about the effect it could have on my heart. I have bad ectopics today.

[Mowgli44 in reply to Qualipop]

I do feel for you. This happened to me a couple of months ago and I had to wait until the Sunday to get the antibiotics.

[Qualipop in reply to Mowgli44]

HOw to even do that? I'm housebound and they don't do electronic prescriptions. No one to take me on a weekend.

[pusillanimous in reply to Qualipop]

That is disgraceful, verging on criminal !

[Qualipop in reply to pusillanimous]

It's how dental services are. |So many people don't have a dentist they can only use the emergency clinic. The phone line opened today at 10am. I started ringing at 30 seconds to 10 and was number 29 in the queue. It took 50 minutes to get through and get an appointment by which time they were already booked up until 4.30pm. At least I do now have an appointment. The clinic closes at 5 so heaven help anyone who rang after I did. AT least I'm lucky t o have an NHS dentist ( except on a weekend).

[pusillanimous in reply to Mowgli44]

Forgive me for asking, but if they 'were tough to move' why were they extracted. Obviously they were well seated in good healthy bone and therefore able to be restored by one means or another?

[Mowgli44 in reply to pusillanimous]

There was too much decay at the root unfortunately and two (I’ve had 4 removed altogether) were broken off at the gum. The bone is ok but I have severe gum disease.

[Qualipop in reply to pusillanimous]

There's a limit to what can be done on the NHS. They can do crowns and dentures and posts but there has to be enough tooth left to fix something to. I asked about having an implant privately. ------ £3000. I had two teeth that broke off up by the g um too ; not enough left to get hold of to pull the root out and in any case my roots were twisted and crossed over each other. The infected one now will need surgery at the hospital to c ut it out of the gum.

[pusillanimous in reply to Qualipop]

It's a shame - did the dentist not mention the possibility of building a 'core' on the teeth that have broken off,? This used to be done quite often , once the core has been built the tooth can be crowned- maybe there is a reason not to do this. It's just after working for more than10 years with a man to whom extraction was a dirty word, I now get upset when I hear of teeth being removed. I have seen him restore teeth that were so mobile you could wiggle them from side to side because of the extent of the gum and bone loss through periodontal disease, It was a long meticulous process with surgery and splinting, but they were saved. I wish you all the best and I hope your pain is soon sorted out. No wonder Americans make jokes about British teeth. Oh dear. I'm waffling again, but to me dental treatment is so important for so many health and aesthetic reasons, and of course they are vital to enable you to nourish yourself !

[Qualipop in reply to pusillanimous]

Never heard of that and certainly not on NHS

[Tamgirl]

I'm on bisoprolol and have had 2 extractions with normal anaesthetic and no problems.

[healingharpist]

I am one of those w/ paroxysmal AF who gets a scary racing heart on the typical adrenaline-containing dental anesthetic shots. So it's now in my chart--no adrenaline shots. I'm well-controlled on metoprolol, but still don't want to risk that anxiety & awful feeling of the heart taking off... and going who-knows-where .... Diane S.

[Jafib53]

Thank you all for the replies. I went to the dentist today and he replaced the filling and I didn't need any anaesthetic at all. I did ask about non-adrenalin anaesthetics and he said he can give them when necessary. I'll ask my EP if there is any problem with normal aesthetics when I next see hime.

[Qualipop]

My dentist always uses the anaesthetic without adrenaline.

[doodle68]

Hi Jafib53, I spent 2 hours in the dentist chair recently having a root filling.

My dentist is aware of my AF and used an adrenaline free anaesthetic.

Modern local anaesthetics are very efficient at eliminating pain, the most painful part for me was keeping my mouth open for so long while the calcified roots were drilled and filled.

[Jafib53]

I had the filling replaced without anaesthetic but luckily it wasn't really painful. A few twinges here or there but quite bearable!

[BRHow]

Ive noticed that many across the pond do not visit the dentist every 6 months like Americans do. I find that odd.

[pusillanimous in reply to BRHow]

I think in a lot of cases BRHow , there just are not enough appointments available. I'm English born, but now live in South Africa, but before I left (when I married an SA resident) I was able to go every six months. When in SA I worked as PA to dental specialist (periodontist and prosthodontist) who was also a part time honorary professor at a University and had practices both here and in London (he commuted between the two). He had attended a lot of courses in the US before he specialised. But that said, I'm horrified at the number of extractions I read of here, there are very few teeth that cannot be saved with time and dedication both by the dentist and patient, I just hope that the gaps left by these extractions are filled either with bridges or implants. I do not know what the NHS offers. The last associate my boss had here in SA, before he moved permanently to London where his privates services were in great demand, was an English dentist who wanted to learn from him. There is no doubt that the USA is very much the tops in the dental game, in every respect.