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Tooth Infection interfering with effect of numbing agent.

LadyLost profile image
17 Replies

My first post. Have read many accounts. Very impressed by so many that are struggling and the kindness and suggestions of others.

I have been newly diagnosed afib and moderate heart failure. (3months ago) Dr put me on Eliquis and Metoprolol. Dealing with side effects and learning all I can to help myself. Many life changes.

Adding to these realities, I been dealing with an infected broken bottom molar for several months while waiting for appointment with dentist. Though going through 3 separate rounds of amoxicillin antibiotic the infection never totally clears up.

Finally was in the dentist chair for extraction but the numbing agent didn’t work. Dentist explained the infection was compromising the medication and she would not continue with extraction. Sent me home saying I needed to see an oral surgeon.

Just finished last round of amoxicillin 2 days ago. Having difficulty finding an oral surgeon that has a current opening. I have read that removing a lower broken molar can be both difficult and painful. Afib, heart failure and my medications put restrictions on what can be used for pain and their effectiveness.

I fear I will build an immunity from taking the amoxicillin and the infection could become systemic and continue to negatively affect the afib and heart failure. What has helped others in similar situations? I am at a loss.

Trying to understand and work with my new health diagnosis and medication effects, now the added stress of an infection and finding an oral surgeon that will consider the ongoing damage being done by the infection. How to get them to acknowledge the danger of waiting too long?

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LadyLost
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17 Replies
Mrsvemb profile image
Mrsvemb

I have been in this situation. Before I had AF I will add. As I am allergic to penicillin, my dentist gave me metronidazole and erithromyacin for 7 days. I had the tooth removed on day 5 and the local anaesthetic worked fine.

I always make sure that my dentist is a dental surgeon, not just a dentist because I have had a lot of root canal treatment, which makes the tooth brittle. They always break when being removed. Much better if dentist is able to deal with it there and then.

BobD profile image
BobDVolunteer

Metronidazole should, sort it but big warning. NO ALCOHOL or you will be violently ill if not worse.

Mrsvemb profile image
Mrsvemb in reply to BobD

Yes the only antibiotic to have a warning about no alcohol. I did stop alcohol each time I had metronidazole. For the last 12 years I don’t drink alcohol anyway because of AF.

CDreamer profile image
CDreamer

I’m at a bit of a loss as to why you had to wait so long to see a dentist as I agree with Mrsvemb, best dealt with there and then. Dentists these days tend to have larger practices with visiting consultants or can and should refer on.

I recently had infection which had been lurking for a few years which I realise now had been making me feel rotten, I have autoimmune diseases so need to be very careful. 2 dentists wanted to wait, watch and see and oral antibiotics - 3rd dentist had me in for root canal within 2 weeks - infection totally gone and I feel so much better.

If you cannot afford to see a good, private dentist then find a Dental School/hospital as they will often see patients the same day or within a few days if you don’t mind being seen by 5th year students - under expert guidance of course. The other advantage is that they will often have access to latest knowledge and research.

Hope that you get the treatment you urgently need very soon. Best wishes and good luck.

CDreamer profile image
CDreamer

You might find information from this site useful

patients-association.org.uk...

Referrals

Your dentist may decide you need a treatment they are unable to offer. This might be because it requires specialist training, experience, equipment or you will need an anaesthetic which may only be available in a hospital.

If that is the case you will be given a referral to a specialist. They will decide on the best next steps for you.

Your dentist should explain what treatment is proposed, what is involved and how long you might have to wait.

You may be given a unique reference number. You can use this to track the progress of your referral at dental-referrals.org.

10gingercats profile image
10gingercats

My husband got an appoint. at the dental dept. of our local hospital for a tricky extraction...no heart problems. He even put himself on the cancellation list and was seen within a week so worth trying. I actually went along to the dept and spoke to them rather than speaking to them on the phone.Try it if your hospital is close enough for you to make the trip.

Omniscient1 profile image
Omniscient1

I was going to add that seeing a dental surgeon for this kind of thing is much more likely to succeed than a dentist. In my (and my wife's) experience going to the dental hospital (ie the dental dept of our local hosp) for molar work and troublesome extractions has been easy and successful. But I can see that you are in the US so how you navigate that I don't know. In the UK we ask our Dr to refer us and it's done. So I'll affirm this - seeing a dental(oral) surgeon not a dentist sounds to be the right path, but then I'll add I have never been prescribed penicillin for a dental problem, always (more than once) metronidazole, so maybe go down that route.

Best wishes Gary

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi

I had an infection with a tooth.

I had to change from Amoxil to Amoxil Clav. Then it healed.

I have some more for another tooth being pulled out.

Then with a urine infection Amoxil didnt work and the culture said use Amoxil Clav.

Hope this helps.

Have the tooth completely out with root. Don't have a root canal. I am having crowns on either side and the hole is bridged. In gold $6250 NZ.

Cheri JOY. 74. (NZ)

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi again

I was on Metoprolol 1 year 3 mths. I was changed as it showed pauses during the night on 47 avge H/R Night. But 186 H/R Avge day - breathless on exertion and fatigue.

Changed to Bisoprolol which is also a BB Beta Blocker. Better for Afers.

But H/R Day still not controlled. I changed to a private H/Specialist. Now controlled.

Meds now Diltiazem 120mg AM and Bisoprolol 2.5mg PM.

110-130 / 69. 60s H/R Day.

Back Molars are usually extracted by hospital as they are too close to the sinuses.

cheri JOY. 74. (NZ)

Mrsvemb profile image
Mrsvemb

You say that you have read that removing a lower broken molar can be painful and difficult.

I had this done last year, by a dental surgeon. He cut the root into 4 pieces then removed one by one. I can honestly say that I didn’t feel a thing.

I am in the UK and go to a private dentist not NHS, so I don’t know how this works in the US. Surely you must have dental surgeons in some dental practices. That is your key to getting this sorted.

2learn profile image
2learn

HI, sorry about what I'm going to say, but personal experience. I was due open heart surgery Dec 21 but got toothache. Surgeon would not operate until tooth extracted because bacteria from infected tooth is apparently very bad forthe heart, so it is important you get your problem sorted asap. I was given large dose of amoxicillin by dentist and extraction took 2hrs for bottom molar that had rooted into jaw bone. Don't know what numbing agent they used but it was one for people with AF and they just put more in every 30 mins and it worked. My gum needed stitching and my heart op was delayed 10 days.

So you my have to bite the bullet and go for it regardless of pain/discomfort which can be bad, but they do go and better than infecting your heart. Good luck

Ducky2003 profile image
Ducky2003 in reply to 2learn

That's interesting about the heart op delay of 10 days. I've been told 6-8 weeks gap between any type of surgery, no matter how mild. I even had a 3 min laser eye procedure and they included that.

2learn profile image
2learn in reply to Ducky2003

heart surgeon at Brompton would have done it next day if I was up to it. I've heard that if tooth extraction done at hospital where heart surgery is then they will do both on same day.

Ducky2003 profile image
Ducky2003 in reply to 2learn

Ahhhh. My eye laser was done at the same hospital as the ohs is due at. I hadn't got a date for the ohs at that point but surgeon was very insistent on the 6-8 week gap and was actually trying to put me off having the eye surgery. I told him I was having it as he was not in a position to say when the ohs was going to be done.They all have their own little foibles I suppose 😊.

2learn profile image
2learn in reply to Ducky2003

Hi , I had 2 valves repaired, and an ablation, open heart, mitral valve pretty bad, by surgeon Ms Yadav, who I chose because for a woman to be a consultant surgeon at top hospital probably means she is better than most. Within 5 days had a pacemaker inserted under local anthesthetic at Brompton. I had it all done privately so whether the time frame you've been told is due to NHS rationing I don't know. Nobody mentioned any gap they just seemed to want to get things done while I was there, It was Dec 21 in the middle of covid and every delay meant more risk of someone catching it and not being avaiable.

Ducky2003 profile image
Ducky2003

I had a back tooth out a month ago. It would not numb with adrenaline free anaesthetic, which my dentist usually uses for a filling, as it was a "hot tooth".I'm on a list for a valve repair and had taken 4 lots of antibiotics on the trot. An abscess still formed.

He mentioned a while ago it may be a hospital under GA job if he couldn't use an adrenaline based local.

I spoke with my EP about it and he said he'd be more worried about a GA than adrenaline.

We plumped for a lower adrenaline one called Articaine. 5 jabs of that and it was just about bearable, though I wish I'd just gone with the full on adrenaline.

My dentist is private, so I don't know if that makes a difference as he does implants and allsorts so he's used to the heavy duty dental work.

He removed the tooth, even with the abscess there as he said it was better than leaving it.

Oral health is very important when you have heart issues so I'm surprised your dentist didn't even bother referring you or recommending someone else.

If you are an NHS patient, look into a private dentist. It will be more expensive but with toothache, I would have paid anything.

pusillanimous profile image
pusillanimous

Have they not tried a different anti-biotic? because until the infection is under control a local anaesthetic will not work. Maybe a general is the answer - a lot of dental work is done under GA.

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