Anyone know of a dentist willing to do tooth extraction on someone with permanent long-standing AF and occasional tachycardia?

[Jem237]

Hi everyone,

I'm looking for some advice on dentistry...

I have permanent long-standing AF (so I am constantly in AF and have been for 8 years), with occasional bouts of tachycardia (if I get stressed or have to walk too far - I can only walk a few steps without having to stop and rest). I am lucky enough to be scheduled for a minimally invasive Cox mini-maze procedure with Mr Modi at LHCH - following advice from MummyLuv and others on here. This is due to take place soon. I've been going through the many tests, scans, and an angiogram in the lead up to this, and having got through all of this, I now have a ridiculous problem - teeth!

I have three infected teeth which need to come out before the surgery - last time I went to have one of them removed (2017) I passed out, and the dentist was then not keen to proceed. However, since then my medication has been increased, and having got through the angiogram, I was confident I'd be able to get through 3 extractions.

Having waited months to be able to register with a private dentist (obviously no NHS availability at all), I went on Monday and was told that the dentist wasn't happy to do the extractions because she felt my heart was too unstable, wasn't happy about me being on Apixaban, etc. She thinks that if she refers me into the NHS I will have to wait at least a year, which obviously wrecks my surgery schedule with Mr Modi. She's trying to think of a private dentist/dental hospital that would be willing to do it, but she didn't seem very hopeful.

So my question is, has anyone else had similar problems with finding a dentist that will work on them? Can anyone recommend a dentist NHS/private that is willing to work on someone who is apparently "medically compromised"?

Obviously, having come this far on the road to getting my surgery, I'm feeling quite devastated that it could potentially be scuppered by my teeth, so if anyone can offer any advice, I'd be very grateful.

Thanks 😀

[jeanjeannie50]

My dentist took out a back tooth that had a root infection. His wife has arrhythmia problems, so he's very understanding. Thinking about it though I wasn't in constant AF at the time. I live in South Devon, which may be too far away from where you live. I would be happy to ask him if he could help you. He's German and his wife who is often his dental assistant is a qualified dentist too.

Jean

[Jem237 in reply to jeanjeannie50]

Thanks @jeanjeannie50 for your reply - you sound lucky to have such a great dentist. I live on the border between Shropshire and Herefordshire, so travelling to South Devon wouldn't be the easiest ... having said that, I've been going up and down to Liverpool for all my pre-mini maze procedures. Do you know if your dentist is accepting new patients?

[jeanjeannie50 in reply to Jem237]

Only private ones now.

[Jem237 in reply to jeanjeannie50]

Thanks jeanjeannie50 - same round here, no NHS provision, and when I registered with a private dentist I stil had to wait months before they could see me. I'll bear your guy in mind though - just working through all the options I've discovered from posting on here. Thanks again.

[CDreamer]

You don’t say in which part of the world?

In your shoes I would ring the nearest dental teaching hospital and ask for information rather than go to an unknown dentist. I suspect that you were considered high risk.

Hope you get somewhere as difficult scenario to deal with.

[Jem237 in reply to CDreamer]

Thanks @CDreamer for your reply - I forgot to add that I'm on the border between Shropshire and Herefordshire. The dentist I saw thought of teaching hospitals, but apparently the nearest one is Birmingham and she thought they'd be away for the summer now. I will certainly explore dental teaching hospitals as you suggest, even just as a source of information. Thanks for the advice.

[wilsond in reply to Jem237]

Nhs have many dental hospital departments! Your dentist seems a bit of a drip tbh!

[Jem237 in reply to wilsond]

Thanks @wilsond - I've been looking online at dental hospital departments, and as you say, there are a lot. I think she had a bit of a panic when she read my medical history, but I was already pretty anxious about the whole thing, and I must admit, she made me feel a lot worse. But yes, I will investigate dental hospital departments.

[DawnTX in reply to Jem237]

They seem to be very concerned here in the states, if you have dental issues such as infection or even a broken tooth. Infection can spread through and hit your heart so normally they will put you on an antibiotic first. I have been stuck between a rock and a hard place since my first a fib event because I fell when I blacked out and hit my face on concrete and you can only imagine what my teeth ended up like. Been a little bit. I am finally getting to the stage where I will soon be able to have some corrective surgery’s, both of my back and my teeth. It is health that I have had too much going on and the risk of infection is too much at this time. If I continue to do well since my pacemaker, I will be allowed to get my back surgery after the beginning of the year. Needless to say for now, the heart is number one actually, it always is.

[Jem237 in reply to DawnTX]

Thanks for your reply @DawnTX - sorry to hear you've been having such a bad time. Interested to hear you suffer from black outs with AF, as this has also happened to me, but doesn't seem to be a common occurrence with AF. I know only too well how terrifying it is to wake up on the floor and realise you've been out cold. Like you I fell and hit my face, but thankfully, apart from bruising, no permanent damage. How awful that you fell onto concrete - I really hope you can get your heart sorted out, then your teeth when things are more stable. You have my sympathies - it can all feel overwhelming when hearts start going wrong and then cause other things. Best wishes to you for things getting sorted out soon.

[2learn in reply to Jem237]

Hi, I had to have 2 teeth out before they would do open heart surgery. I wasn't in Afib at the time. One extraction took over 2hrs but was successful. I have to have doses of antibiotics before any extractions cos dental bacteria dangerous for heart. My dentist is private of course and based in Hereford, its Tupsley Dental Practice, 01432 267388. I have found them v helpful and understanding so it might be worth giving them a ring to see what they can do.

[Jem237 in reply to 2learn]

Thanks @2learn, that's really encouraging to hear. I'll give them a call and see if they might be able to help - and they're not too far away which is a bonus! Thanks again.

[SMwils]

Hello

I am in permanent AF and a flutter amongst other heart conditions

I have had 4 taken out at once

It was under general at the Denist

Can’t see any reason why Denist won’t

Just check on meds and chat with denist

[Jem237 in reply to SMwils]

Thanks for your reply SMwils . Encouraging to hear that you had a good experience. Unfortunately my dentist is adamant that she won't do it, so I need to find an alternative. I guess it depends on how experienced and/or risk averse your dentist is. Thanks for the information anyway.

[Vanna-C]

Since having AF, I have used a dentist in Dronfield, near Sheffield. The practice is Stephen Godfrey dental care.

Mike Ainsworth has carried out an extraction for me. The practice has always been very helpful. If it is near enough for you, you could give them a call and discuss your situation.

[Jem237 in reply to Vanna-C]

Thanks Vanna-C for the information - pleased to hear that you've received good treatment. I will add your dentist to my list to be investigated - I've had a lot of helpful replies to my question and am building up a list of possible dentists. Thanks again.

[Omniscient1]

After having a dentist wrestle with me trying to do an extraction we were both getting cheesed off. I told her to stop and said I'd go to the hospital. My GP immediately referred me and I went in for a fast (<5 mins) and painless extraction. She (hospital dentist) said that dentists outside don't do many extractions whereas she specialised in them. Conclusion - get yourself referred to the dental dept if your local hospital. Referral would be quick I imagine and they're equipped for special cases.

[Omniscient1 in reply to Omniscient1]

In fact of course your dentist can refer you straight away.

[Jem237 in reply to Omniscient1]

Thanks Omniscient1 - that sounds like good advice. Not sure if my local hospital has a dental department - I know there's a dental access clinic - but I will investigate further. Thanks for the advice -the quicker the better as far as the extraction goes!

[Mowgli44]

if you’re going up and down to Liverpool you could try the Liverpool Dental Hospital (teaching). I personally went to The Old Surgery in Crewe (private). Their dental surgeon is there on a Friday. I have had 4 teeth removed no problems.

[Jem237 in reply to Mowgli44]

Thanks Mowgli44 , I had wondered about Liverpool Dental Hospital for that very reason. Thanks for sharing your dentist's name and the fact that you had good treatment with them - I'm compiling a list from the many helpful replies I've received. Thanks again.

[Mowgli44 in reply to Jem237]

My journey started with my being referred to the private dentist because they take referrals from NHS dentists for anxious patients. In the end this particular surgeon was so good I didn’t need sedation. He took two out one week then two weeks later the other two. I felt breathing exercises helped me a lot.

[Jem237 in reply to Mowgli44]

Glad you had such a good experience - sounds like that's a dentist worth holding onto! I had hypnotherapy for my recent angiogram - don't think I'd have got through it without it. It worked amazingly well, and I was incredibly sceptical. Will be going back for more sessions before the dentist I think!

[wilsond]

I have had a wisdom tooth and other tooth out here in Warwickshire, referred from nhs dentist to our local dentist hospital NHS within a few months. I believe they accept private patients too. Whereabouts in the UK are you?I had AF and Flutter at the time xx

[Jem237 in reply to wilsond]

Thanks wilsond , that's useful to know. I'll investigate the local dental hospitals further. I'm on the border between Shropshire and Herefordshire, so Warwickshire isn't too far away. Thanks again.

[wilsond in reply to Jem237]

Good luck! Nuneaton is the place. George Eliot Hospital Trust. Xxx

[Jem237 in reply to wilsond]

Thanks wilsond - my parents live in Lichfield, so not too far from them. Thanks again.

[Sunnyann]

I've just had 3 teeth extracted privately at the wellesley hospital in Essex as I requited sedation and no NHS doctor would help me cause of my af . The NHS waiting waiting list was a year long and as I was getting repeated infections and tooth ache I became unable to bear it anymore Oral surgeon Dr ganeson was brilliant .

Paid 200 pound to see him for consultation and then 3 weeks later I was put under Ga And had them removed.

It was expensive at 2000 but worth it fir me as I have a dentist phobia .

I was looked after brilliantly and my heart behaved itself the whole time

You'll get no where with NHS dentists

Hope this helps

[Jem237 in reply to Sunnyann]

Thanks for the information Sunnyann - I'm so pleased to hear that this worked well for you, and that your heart behaved! Like you, I was told by my dentist that the NHS waiting list would be at least a year, and like you, I'm getting repeated infections. I find the idea of GA for this very appealing as I am really nervous about it - more about my heart doing something weird than the actual dentistry - but pretty scared of that too! I'll investigate the Wellesley and see if it might work for me. Thanks again.

[Sunnyann in reply to Jem237]

Mr ganesan was my oral consultant dental surgeon .....lovely man .....and having GA was just great as they monitored my heart frommstaer to finish whereas with a dentist as you know they won't.....and for us afibbers its its huge fear ...especially with any numbing agents that may contain caffeine which is a trigger for many af sufferers .

[Jem237 in reply to Sunnyann]

Thanks Sunnyann , I'll have a look at their website. You're so right about the heart monitoring, Whenever I've had to have any other medical procedures (endoscopies, angiogram, etc.) I've known that they're monitoring my heart, whereas with dentistry it's worrying to undergo a stressful and potentially painful procedure and not know what effect it's having on my heart. Glad it worked for you.

[Sunnyann in reply to Jem237]

If your anything like me the anxiety of dentists would be enough to set my heart off so this was the perfect solution fir me and worth the money I spent .I think I had about 5 courses of antibiotics fir infections in the space of 2 months leasing upto it and rhe nhs would of left me like that for a ywarnor more ...it just wasn't an option for me .

Again as you know us afibbers also can't tolerate pain relief meds very well and it was either paracetamol or codeine...paracetamol didn't touch the pain and codeine turned me into a constipated zombie .....

I feel for you as toothache is the worst pain in the world .....I hope you find a solution

[Jem237 in reply to Sunnyann]

Thanks @Sunnyann - sounds like you had a traumatic time - glad it worked out for you, albeit leaving you with a big bill! My main concern at the moment is that getting my teeth sorted doesn't get in the way of my surgery with Mr Modi - it's been such a long journey to get to the point where I've been able to get the surgery, don't want anything to jeopardise that now! Thanks again for the advice and encouragement.

[Sunnyann in reply to Jem237]

I totally understand that and aging sane as ne ...I'm due a 2nd ablation in September and knew the clock was ticking which is another I went privately to get it done and to heal before my 2nd ablation

[Jem237 in reply to Sunnyann]

Sounds like you've done the right thing - good luck with your 2nd ablation.

[Uniform96]

Hello, I’ve just had a very difficult tooth extraction. I attend a private dentist but due to my co morbidities was referred to an NHS dental surgeon located at a local dentist in Wirksworth Derbyshire. ( this was under NHS) No waiting times( he visits three times a week. It cost me £70. I wonder if your dentist knows of the same sort of set up local to you? Lots of people get referred to this chap for removal of wisdom teeth .

[Jem237 in reply to Uniform96]

Thanks Uniform96 for the information - that sounds like a really good set up. My dentist didn't seem to be aware of anything like that round here, but I've had a lot of useful replies on here, so hoping I might be able to get something done now. Thanks again.

[10gingercats]

I seem to remember from a few years ago my husband self refered to our local dental dept. in hospital and put himself on a cancellation list immediately. He was seen within a few days .Worth a try. Best to do this in person if you can rather than telephone.

[Jem237 in reply to 10gingercats]

Thanks @10gingercats for the information - I will investigate if this is a possibility.

[Qualipop]

Could you get a letter from your cardiologist saying it's safe to extract your teeth? Maybe he could intervene with the hospital dental department. I'm waiting for a retained root to be removed by the hospital because i's too difficult for the dentist to do and have been told there's at least a 12 month wait. I recently had a tooth pulled with no problems (NHS dentist). I don't have AF but do have bad arrhythmia; have had a heart attack and stents

[Jem237 in reply to Qualipop]

Thanks Qualipop for your reply - glad your recent extraction worked out well. I'm not sure that I want to go ahead with my own dentist now - her doubts and panic about my medical history have knocked my confidence in her. However, I've had lots of really useful replies on here, so hoping to find some way forward now. Thanks again.

[Tapanac]

have you tried the dental dept in your nearest big hospital?? I had 2 wisdom teeth out and painless. Then a few years later at different times 2 more teeth.

Your GP might have to refer you as urgent

Good luck snd hope all goes well

Pat

I did have to stop my apixaban that morning but started again next morning

[Jem237 in reply to Tapanac]

Thanks Tapanac for the information - glad to hear you had good experiences. I think the nearest large hospital with a dental department would be the QE (Birmingham), so that might be worth a try. Thinking about it my Mum had 3 teeth removed recently at Queens in Burton-on-Trent, so maybe that might be worth a try too. I hadn't thought of contacting my GP - thanks for the idea.

[Tapanac in reply to Jem237]

all the best and hope you will be fine soon

[Hidden]

my dad had extractions, privately, in permanent af and on apixiban with no problem. Your GP may wish to give you antibiotic cover prior to dental procedure due to surgery on horizon but the dentist shouldn’t have a problem. Poor old dad is bedbound now and we actually found a dentist that does home visits with her nurse and had further extraction from the comfort of his bed. Witham in Essex if you’re anywhere near. The only way is Essex as they say. Take care 🦊x

[Jem237 in reply to Hidden]

Thanks Hidden for the information. I'm glad to hear your Dad had successful extractions with permanent AF and whilst on Apixaban. Sorry to hear he's now bedbound, but sounds like he's getting great care. Essex is a long way from me, but thanks for the reassurance.

[Jacquisp]

It costs extra l, sadly, but a maxillafacial surgeon is the best person for the job when you have a complicated extraction of any sort. I also have Trigeminal Nuerapathy and had an a tooth removed earlier this year. They won't do anything heart related if you have an active oral infection of any sort. My ablation was delayed.

My surgeon was very good but he is in London. Good luck.

[Jacquisp]

Dr Vijay BhargavaOral/Implant Surgeon

[Jem237 in reply to Jacquisp]

Thanks Jacquisp for this information - I'm glad you found someone that helped you.

I've been going through a very complicated referral process - going from one private dentist to another - ended up with an oral surgeon, who is willing to do the extractions, but only in a hospital setting (he normally works in a dental clinic with just an anaesthetist on hand). However, in the meantime I've heard from the dental hospital associated with the heart hospital I'm due to go to - it seems they may be able to help, so fingers crossed.