Tooth extraction and ectopics

[Profound15]

Unfortunately had to get a tooth extraction today. One of my molars suffered from gum recession and was painful. Anyway after the removal I’ve been getting loads of ectopics and normally they are well controlled. Sometimes get two or three in a day but not always. However, I had local anaesthetic (two or three jabs as I could still feel it). My socket is still weeping but when the tooth was first removed my dentist called me a bleeder and she was concerned it wouldn’t stop although it did. She used a wet teabag on it and it eventually covered the wound with a blood clot. The blood weeping is still continuing but it has improved.

I’m on flecainide (50mg twice a day and one 1.25mg bisoprolol )

Would the local anaesthetic cause the significant ectopics or could it be the blood which I’m clearly swallowing. Hopefully things go back to normal in the next few days in terms of ectopics. Any views would be gratefully received. Thank you

[CDreamer]

Yes the local anaesthesia if it contained Adrenaline would be most likely trigger for ectopics however the stress alone would also provoke a reaction. Many of us ask for locals without Adrenaline however they are then not as effective at blocking the pain.

[Profound15 in reply to CDreamer]

Thanks CD. That all makes sense. How long does the lidocaine anaesthetic last in the blood stream please. I suspect everyone is different but I’m guessing a day or two

[CDreamer in reply to Profound15]

It should clear within a few hours but that doesn’t mean that your heart will suddenly calm down because my experience is that it may take a few days for your heart to settle. Have you tried doing the mindful breathing exercises to calm ectopics? They always help me - it’s remembering to do them!

[Profound15 in reply to CDreamer]

Thanks CD. I’ve tried the breathing exercises before but never really had much success but thanks for the advice.

The tooth socket seems to have improved a bit overnight so now it’s the salt mouth baths that the dentist recommended for the next few days to seal the wound.

I’m hoping the ectopics gradually reduce but will keep well hydrated in the hope that facilitates it as well

[davephx]

OOCH. It is painful just to read

[BobD Volunteer]

If you didn't tell the dentist you wanted non adrenaline local then yes,

[Profound15 in reply to BobD]

Thanks Bob

Fair point but didn’t know about the option at the time. Think I got three or four jabs as well so no wonder I’ve had the ectopics.

[Tigger_2]

Hello

Just curious, but how do you feel your ectopics?

I've just been told by the cardiology people that I get on average 100 per hour and I'm seeing one of the consultants in October.

I've no idea what brings them on, but they manifest as unusually slow (less than 40-BPM) pulse, erratic and low blood pressure.

Adrenalin in local anaesthetics is a new one on me, but if that's the case, then I would hope that someone might give some warning.

Hope you feel better after all that.

[Profound15 in reply to Tigger_2]

Thanks Tigger. Feeling better today ta. The dentist spooked me a bit by telling me I’m a bleeder but she was excellent knowing about the teabag trick. Ectopics for me is usually a missed or extra beat in the heart which I’m very sensitive to. My cardiologist has advised that they are nothing to worry about but nonetheless I hate the feeling. Always get the mind thinking I’m going to go into afib. Hope that helps

I didn’t know about the adrenaline either but I’m wiser now for the future. Read that it’s used to prolong the freeze and that without it the numbness isn’t as good

[Teresa156 in reply to Tigger_2]

Hi Tigger_2,

Unfortunately, you will need to ask for adrenaline free every time if you have Afib. Dentists may note it, but they don’t always remember or look too ( in my experience) so you will also unfortunately need to remind them every time…none of them ever think about it not agreeing with people, unless you point it out unfortunately.

[Denise-]

I had a reaction to anaesthetic when I was 30, so now always have one without adrenaline, makes me think how long I've been sensitive to adrenaline. I was told not to take flecinade for 24 hours before treatment. Does the dentist have your full medical and medicine details?

[Profound15 in reply to Denise-]

Thanks Denise. Yes she has full medical history and medication. I’m on flec but still had the ectopics. Feeling better today so far fingers crossed. I’ll know better if there’s a next time.

[Bagrat in reply to Denise-]

For extractions I have non epinephrine local. Of course you miss out on the bloodvessel constriction that reduces bleeding, but they use haemostat type dressings instead. I have never stopped flecainide ( that would defo push my natural adrenalin up!) though usually omit apixaban for 24 hours 12 before 12 after

[Profound15 in reply to Bagrat]

Thanks Bagrat. It’s clear to me now that the local was the cause of the ectopics as things have now gone back to normal. I guess if I need to have future dental work then adrenaline free anaesthetic is the way to go. Is the adrenaline added to prolong the freeze or to increase the numbing effect do you know.

[Bagrat in reply to Profound15]

It constricts blood vessels locally so anaesthetic stays in the area longer. Also for the same reason reduces blood loss.Non adrenaline (epinephrine) anaesthetics wear off more quickly but dentist will always top up if needed.

[Profound15 in reply to Bagrat]

Must admit the dentist told me I was a bleeder and she seemed concerned at the time. Guess that puts paid to the reduces blood loss for me 😀

[Bagrat in reply to Profound15]

They can use other means like alginate dressings or a stitch if needed. They are experts.

[Profound15 in reply to Bagrat]

Thanks Bagrat

[Denise-]

I'm on apixiban and I have to stop that for 24 hours too. But all dentist's have different views