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Dentist

Rhoded profile image
56 Replies

Hi just some advice please. I have AF. I have a tooth that’s infected went to the dentist today had the non Adrenalin injection quite a lot but did not take the pain away, they tried to drill to get to the root but the pain was unbearable. Had to stop.The dentist did say that it does not always work as well as the adrenaline one !! Fed up and in pain. Possibly going to have to extract so obviously dreading that and then the whole not taking of my edexoban !! And the pain. Long winded sorry but has anyone just had the injection with adrenaline and been fine ? She did say to speak to my cardiologist but I did say I am on a yr long waiting list !!

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Rhoded
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56 Replies
BobD profile image
BobDVolunteer

I had this problem years and years ago. MY dentist explained that the infection was "insulating " the nerve from the local anaesthetic and he needed to put me on a weeks antibiotics before he could do the work.

Rhoded profile image
Rhoded in reply toBobD

Thanks Bob.

Jalia profile image
Jalia

Many years ago, (25?) I went into a fast rhythm with an adrenaline injection and made sure I had non adrenaline from then on. However more recently a new dentist to the practice told me he used adrenaline type as much more effective for pain relief . I wasn't in a state to argue and I thought things may have changed over the years so i went for it..l had no problems and no pain , most importantly!

Rhoded profile image
Rhoded in reply toJalia

Thank you. First time at the dentist since been on the meds ! But the non adrenaline certainly did not touch the pain !! That’s exactly what I want no pain.

Popepaul profile image
Popepaul

I have had extraction and inplants with the adrenaline anaesthetic without issue. No pain and no bleeding. I skipped one dose of edoxsban

Rhoded profile image
Rhoded in reply toPopepaul

Good to know Popepaul

Pinkgolf profile image
Pinkgolf in reply toPopepaul

Popepaul could I ask how painful was your implant. I’m having one on Tuesday and I’m just concerned the pain might set off the old sleeping AF 🙏

Popepaul profile image
Popepaul in reply toPinkgolf

It was painless. I have experienced more pain via a simple filling. I did have bruising around my face post treatment. The dental nurse kept my mouth open with a dental device. She held it firmly hence the bruising. The experience was painless.Good luck.

Pinkgolf profile image
Pinkgolf in reply toPopepaul

Thank you , and thank you for your quick reply , I will hopefully have a similar experience 🙏

It’s always worse in your head lol

Popepaul profile image
Popepaul in reply toPinkgolf

I agree. The worry is often worse than the actual experience.

Pinkgolf profile image
Pinkgolf in reply toPopepaul

Absolutely 🤦‍♀️

Bagrat profile image
Bagrat

I usually ask for non adrenaline anaesthetic. Never had a prob with pain .Just a top up once.HOWEVER last but one extraction was with a Spanish lady who was excellent but difficult to understand and I forgot to mention no adrenaline. It's easy to tell and it was defo the adrenaline one. No problem with AF just took ages to wear off.

Additionally my last extraction was a wisdom tooth. Asked re apixaban, told not to stop it by my dentist but omitted morning dose. Dentist who did extraction said I was given wrong info and he would prefer if I'd omitted 2 doses, but all fine, not even a stitch!

Rhoded profile image
Rhoded in reply toBagrat

Hi Bagrat. Thank you, I did have the non adrenaline injection but unfortunately did not numb it as she was drilling into the tooth to get to the nerves to do whatever she needed to do to stop the pain. Got antibiotics and to go back ! Nightmare,bloody AF !

Bagrat profile image
Bagrat in reply toRhoded

As Bob said probably the infection preventing either local working. Once antibiotics have kicked in I'm sure it'll be fine. My dentist said AF isn't in their "book of words" as a reason for non adrenaline jabs and modern syringes prevent injection into a blood vessel. I have also been told by a doctor that if you don't believe anaesthetic will work and are worried about pain you'll be pushing out your natural adrenalin anyway. Damned if you do damned if you don't!!

Rhoded profile image
Rhoded in reply toBagrat

Ha ha yes absolutely Bagrat.

Mrsvemb profile image
Mrsvemb

The dentist should never have even tried drilling while you still have the infection. It would have been no different if you had the injection with adrenaline.

Once you have finished the antibiotics, it should be fine.

The non adrenaline injections will numb it, but don’t last as long so if a long treatment you may need a top up. I have had extractions with these and felt no pain at all.

I always have the non adrenaline injections and actually prefer them, because you don’t get that horrible tingling when it is wearing off.

Rhoded profile image
Rhoded in reply toMrsvemb

Thank you so much

opal11uk profile image
opal11uk

Firstly, I am very surprised that any dental surgery was attempted whilst you had an infection, first antibiotics/painkillers too then extraction or whatever is necessary. I hope you are on antibiotics now if not please go to your doctor and gets some. My friend had such treatment and ended up with an abscess on the brain which was very serious and necessitated a lengthy stay in hospital.

Morges profile image
Morges

This is all quite a worry to me at the moment.I have 2 teeth that have infections in the gum and have to come out. I saw the orthodentist last week. I asked if I should have anti biotics and he said no because the anti biotics would mask any infection and it's better to know if there is an infection.

I also had a very prickly conversation with him because I'd put on the form that I would prefer no adrenaline local. The form was filled in online by his secretary in her office - so I have no idea what she actually wrote.

Somehow it came up as me saying I am allergic to adrenaline rather than sensitive to it ( I get alarming palpations with it - this before AF set in so I'm more anxious now!) he - the dentist - had a right go at me for a. Not wanting adrenaline and b. Saying I was allergic.

He then said he wanted confirmation from my cardiologist that I could come off the anti coagulants for 72 hours.

A very unhappy consultation for which he was paid £230. I still feel upset and don't really want to see him again - he is this big shot specialist for orthodontal work which the regular dentist referred me to.

I can't afford any fancy work anyway. £6 k for one implant - I don't think so! I will have to be toothless wonder.

Omniscient1 profile image
Omniscient1

Your other option is to get a referral to your local hospitals dental dept (this would prob be very quick, people aren't left waiting with tooth pain). After I stopped a dentist after 45 minutes making no headway with an extraction I told him to stop and refer me. Hospital dentist did it painlessly in less time than it's taken me to type this. She said most dentists don't do a lot of extractions so they're not particularly good at it.

Desanthony profile image
Desanthony in reply toOmniscient1

Yes I was referred to Hospital Dentist quite a few times for extractions and specialist work some time ago. Much better experience.

Rhoded profile image
Rhoded in reply toDesanthony

Thank you

Tellingfibs profile image
Tellingfibs

I have had the normal Adrenalin for a tooth extraction and was fine. It was before I knew about the ones without. My dentist says there is one with half Adrenalin which is better for the pain than the one without ( I have this nowadays ) but it doesn’t last as long as the normal injection. It works fine for me. You have to balance having the full Adrenalin with the anxiety you might feel about the whole process. If you are worried about the pain beforehand, that could produce more natural adrenalin than the injection !

Annie.

Rhoded profile image
Rhoded in reply toTellingfibs

Thank you so much am back today so will ask and you are absolutely right about producing adrenaline. Never thought about that !

Desanthony profile image
Desanthony

My dentist gives more than one injection of small amounts around the tooth/teeth with the non adrenaline and that works for me. She often give s further top up during the work as well. This wears off quicker than the injection containing adrenaline but I have not had any problems and have recently had a lot of dental work. I have also not stopped my apixaban prior to this work and not had any bleeding problems either. I was interested to read Bob's reply. I have often had to have antibiotics to clear up gum and infections during this work and other dental work I have had.

Rhoded profile image
Rhoded in reply toDesanthony

Thank you for your reply I am on antibiotics and might have to have extraction ! Good to know your experience.

Ducky2003 profile image
Ducky2003

I was in a similar boat last year but my dentist gave me a local called Articaine. It has less adrenaline than standard and although there was some pain, it wasn't as bad as adrenaline free.I had emailed my EP first about whether this would be ok and he gave the thumbs up.

Maybe ask your dentist if this is a possibility?

hausjac profile image
hausjac

Sorry to hear about the non-adrenaline injections not working. I had an extraction a couple of months ago which was extremely difficult as I have long roots and it took over an hour. I then had the implant put in which was very easy. At no time did I feel any pain at all. He had put in two non-adrenaline injections at the same time one on either side of the tooth so maybe that's the answer. I stopped the Apixaban the night before and the morning one and had absolutely no problems.

Sixtychick profile image
Sixtychick

All the dentists I worked for, would have given you a course of antibiotics, before taking out the tooth, if it was infected.

I stopped having Adrenaline injections in my 20’s, long before I developed AFib, as they made me feel very shaky and light headed, so have had non- adrenaline local anaesthetics since then and they’ve always worked for me. I’ve had a lot of teeth out and fillings with no problems.

Several of the patients had that sort of reaction to Adrenaline. The None - Adrenaline injection is not quite as long lasting, but they’ll keep topping it up, if needed. Some medications react with Adrenaline as well. My Sotalol does, so another reason not to have Adrenaline.

I am on Edoxaban and I did not have to stop it when I had my last extraction and I didn’t get excessive bleeding from it, as they packed the socket afterwards. I didn’t have to stop it when I had my ablation either. I’m sure you’ll be fine.

Fullofheart profile image
Fullofheart

I always have the non adrenaline injection. I've had 4 extractions and root canals done with it. Never had a problem. Guess it effects people differently.

Sputnik56 profile image
Sputnik56

I had a tooth extraction about 12 weeks ago. Admittedly, mine wasn't infected, but it was cracked vertically and dentist was concerned that infection could set in so wanted it whipped out without delay. I sought advice from arythmia nurses about adrenaline or non adrenaline injection and also around the need to stop anticoagulant prior to extraction. As I was half way through blanking period post ablation, the message was that I had to remain on anticoagulants for the full 3 months post ablation, so we had a dilemma. As regards the injection, she put the onus squarely with the dentist! I trust my dentist implicitly and he reassured me that he had the resources he needed should I experience a bleed following extraction, but it was important that the tooth was removed. We went ahead with the adrenaline injection and, thankfully, it couldn't have gone any smoother. The only downside was that it took a little longer than usual for the extraction site to heal but a small price to pay. As an aside, I take my anticoagulant at night, so extraction was afternoon appointment which may have helped.

RoyMacDonald profile image
RoyMacDonald

Not a tooth extraction, but a minor op to remove a mole at the Doctors. She said that the adrenalin causes the arteries to constrict so the wound would bleed less while she cut it off. The Nurse and the Dr were laughing because it looked like a tiny brain in the jar. There was very little bleeding. They sent it off for analysis.

All the best.

Roy

Vonnegut profile image
Vonnegut

Poor you! I had a tooth extracted a while back and the dentist used appropriate stuff and I was fine and I decided not to have a replacement as the gap doesn’t show and my tongue likes playing in the gap! I do not take an anticoagulant as the Flecainide dose I am on has put an end to episodes. But we are all different and I hope it all goes well for you.

Rhoded profile image
Rhoded in reply toVonnegut

Thank you

Tomred profile image
Tomred

I requested, non adrenalin , dentist told me it wasnt as good , so had 2 extractions with adrenalin, no problems with af.

Rhoded profile image
Rhoded in reply toTomred

Thank you

Qualipop profile image
Qualipop in reply toTomred

It's not that it's not as good. It does work but it doesn't last quite as long and you usually need more than the adrenaline sort.

Tomred profile image
Tomred in reply toQualipop

Lol,sounds to me like it's not as good.

Qualipop profile image
Qualipop in reply toTomred

It's more difficult for the dentist having to top it up but it does work.

Qualipop profile image
Qualipop

I always have the non adrenaline injection with no problems at all. It works just as well as the usual one but it doesn't last quite as long so they have to top it up part way through. I've had fillings, crowns , extractions and an apicectomy with it. Your dentist should refer you urgently to oral surgery at the hospital. Mine did when he tried to pull a tooth and it broke off. He couldn't get he root out because there was a piece of jawbone in the way. Mind you it took ages to get the appointment. Thankfully the huge infection cleared up pretty quickly. Even if you have a private dentist he can still refer you to he hospital on the NHS.

Rhoded profile image
Rhoded in reply toQualipop

Thank you. I had about 4 top ups of the non adrenaline and still no good. Did not know private could refer cos they want the money !

Qualipop profile image
Qualipop in reply toRhoded

But if they can't treat you they should refer you.

Moonriver profile image
Moonriver in reply toQualipop

To Qualipop. I have a root left in my gum. Dentist couldn’t get it out! Did you have your roottaken out? I have appt for removal of mine at hospital after long wait next week or I can just have it monitored. Dreading more surgery.

Qualipop profile image
Qualipop in reply toMoonriver

NO, we didn't bother with mine; it's still there. It doesn't ache or cause any infection but I have an open appointment if it ever does. He said I could just phone and he'd remove it immediately. Gosh it must have been there at least 6 years now. I never think about it. I had another one left in years ago if memory serves me right. I wouldn't have bothered though. Years ago I had an apicectomy where they cut the gum open to fill a root from the very top. I think it was more bother for the dentist than for me. Didn't feel a thing. My roots are completely crossed over each other so there's always a risk of one snapping off. Taking my root out would only have been a normal dental injection. The one without adrenaline.

Budken profile image
Budken

That is strange. I have had several crowns, where most of the tooth was drilled away, as well as a quite complicated root canal, when I developed an abscess in a tooth that had a ceramic crown. All was done with non adrenaline anesthetic, and I experienced no pain whatsoever.

Dodie117 profile image
Dodie117

I had pain with non adrenaline so now just have the adrenaline one. So far no af episodes. I am a bit of a wuss when it come to dentistry!!

Rhoded profile image
Rhoded in reply toDodie117

That’s definitely me too !

MoyB profile image
MoyB

I always have to have the non-adrenaline injection and found it works very well. Is the pain definitely coming from the infection?

After my ablation, whilst still in recovery, I had horrendous pain, just like a tooth abscess but in every tooth. Consultant reckoned it was most likely referred pain from the heart. It took a lot of morphine to calm it down.

Perhaps a call to your cardio team would be worthwhile., even though the waiting list is long you may get some advice.

Xx Moy

Rhoded profile image
Rhoded in reply toMoyB

Thank you. No it’s definitely infected.

MoyB profile image
MoyB

Fair enough. Just thought I'd mention the other possibility in case. I hope they can do something soon. Xx Moy

Rhoded profile image
Rhoded in reply toMoyB

Appreciated 😁

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi

I had an infected tooth. I thought that I had a urine infection.

When the young Dentist asked me if I wanted a route canal I said NO please remove it.

Yes I had adenaline injections with one in the roof of my mouth. Yuck.

I took antibiotics AMOZIL-CLAV as Amozil did not work.

I had no pain. It is up to the Dentist to have you in no pain. We have a team at the hospital. They say that they have actions if necessary.

I delayed the 1/2 total dose of PRADAXA as I take it twice a day. 110mg x twice day.

cheri JOY 75. (NZ)

pusillanimous profile image
pusillanimous

None of the local anaesthetics work when the tooth is infected. That is why you are usually given a course of antibiotics before any work such as root canal therapy is undertaken, to calm the tooth down.

Qualipop profile image
Qualipop in reply topusillanimous

Sorry but they do work even with an infection. My top tooth was so badly infected my whole face down to my chin was terribly swollen. I had non adrenaline injections to try to clean it out and fill it before they discovered with an x ray that they couldn't get it out but the pain went immediately and they just made a hole to drain the abscess and then gave me antibiotics. They were going to give me antibiotics first but the swelling was so bad, they wanted it out ASAP.

pusillanimous profile image
pusillanimous in reply toQualipop

Of course there are always exceptions that prove the rule, but in general, endodontists (can I assume that you did not see an endodontist, but a general dentist?)always prefer to give antibiotic cover before commencing RT therapy, not only to kill the bacteria but to reduce the swelling and make the tooth receptive to even non- adrenaline local anaesthetics. So are you saying they did not Xray the tooth before commencing treatment, but only after an attempt was made to fill it? I presume that they finished the root canal therapy, or are you referring to the abscess or the tooth when you say 'They wanted it out ASAP?'

Rhoded profile image
Rhoded in reply topusillanimous

Thank you

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