Back in AF after 18 months and having root canal treatment next week

[Trent]

I had a successful cardioversion in January 2023 after being in constant AF for three months and have not had any episodes until yesterday. I take 2.5mg of Bisoprolol and Edoxoban daily.

I had the first part of a root canal treatment about three weeks ago and am due to finish the treatment on Tuesday next week. I have developed dreadful tooth ache and yesterday phoned 111 for advice, as my dentist is not open at weekends. They found me an emergency appointment and I saw a dentist who said the tooth is infected and prescribed antibiotics. The pain was so bad I took a 30mg cocodamol, that my husband had been given for a recent kidney stone, and about half an hour later the AF started.

I don't know if this is a coincidence or does anyone know if the cocodamol is likely to have caused it? My other question is whether or not it's OK to have root canal treatment while you are in AF? Given previous experience, I think it's very likely that I'll still be in AF next week and it takes so long to get an appointment at my dentist that I don't want to cancel my appointment as I'll have to wait another few weeks before I get to see him.

When I went into AF in 2022 I went to A & E and was kept in hospital overnight. I was told I would be sent a cardiology appointment. This eventually arrived but was for 7 months later so I paid to see a private cardiologist as I was feeling worn out with the constant AF and was desperate to get it sorted. He prescribed Flecainide and booked me in to have a cardioversion on the NHS. I wasn't able to take the Flecainide as it made me feel dreadul and I was lucky that I only had to wait about 6 weeks for the procedure. I believe the cardiologist I saw has now retired so I'm not really "under" a consultant's care anymore.

I would be very grateful to hear from anyone who knows the answers to my questions.

Many thanks

[BobD Volunteer]

Sadly any inflamation can bring on AF once you have it and tooth problems are a prime source but the good news is you are anticoagulated for stroke prevention. I think the not so good news is your peak rate of 220 bpm and I suggest that you attend A and E if that continues for more than a few minutes. Regarding treatment for your tooth this will depend on sorting out the infection first so probably not critical right now.

[Trent in reply to BobD]

Thank you for your reply. Interesting to know about the link between inflamation and AF. Luckily my peak rate isn't 220 bpm (I think maybe that was in a message from someone else).

[pusillanimous]

Didn't you have a course of anti-biotics before the root canal treatment was started.? The usual reason for root canal therapy is an abscess on the tip of one of the roots of the tooth. Apart from wanting to reduce the infection, the local anaesthetic won't take on an infected tooth. I'm surprised that you were not given an emergency prescription given the length of time you have to wait between appointments,

[Trent in reply to pusillanimous]

Yes, this will be the third lot of antibiotics I have been given. My dentist did give me an emergency prescription before he did the first lot of treatment but not after he had put in the temporary filling. I have a feeling I'll have the root canal treatment and then end up having to have the tooth out anyway! Thank you for replying.

[pusillanimous in reply to Trent]

No don't have the tooth out - it will get better - you might have to have it crowned though😀

[Trent in reply to pusillanimous]

Thank you for your reply. Fingers crossed the treatment will work.

[pusillanimous in reply to Trent]

Of course it will work - when you start having teeth removed you are asking for trouble. You will need the gap bridged or your remaining teeth will 'drift' into the space and you need your teeth to nourish yourself, and if they don't occlude properly you cannot chew well . The RC treatment removes the nerve and the tooth will become brittle - spend the money and have it crowned. you will never regret it!!!!

[Mrsvemb in reply to Trent]

I have had a lot of root canal treatment over the years, all due to abscess which I am prone to. If I had my time again I would not have had the root canal. All it does is delay the inevitable. The tooth becomes brittle and is essentially dead. It will in time shear off.

Root canal is an expensive procedure, I am not sure that it is worth it. Just my opinion.

[Trent in reply to Mrsvemb]

Thank you for your reply. You're probably right but I'll finish the treatment and hope for the best!