Dentist

[3rdNettydoon]

I am to have a tooth extracted. What anethsthetic can I have. I'm in pain so if they only have the one to avoid, how much and in what way will it affect me regarding PA B12d please.?

[Star13]

can they not save the tooth? They can do wonders these days. I just had some work done and I didn’t have an injection to numb, they used something called a wand. Much better.

[3rdNettydoon in reply to Star13]

Thanks for reply. Dentist recommends extraction. Big cavity.

A wand sounds interesting.

[Star13 in reply to 3rdNettydoon]

I’d get a second opinion. My dentis will not take out a tooth because of a large cavity.

[Star13 in reply to Star13]

found this article on the wand, you should ask your dentist or find one that uses it.

mcleandentistry.com/article...

[EiCa in reply to Star13]

The wand may spare some injection pain but it still uses anesthesia.

[Star13 in reply to EiCa]

of course it does that’s the whole point of making the dentistry painless! What would you rather have a huge great needle or that!!

[EiCa in reply to Star13]

I guess I am more afraid of having a reaction to whatever the anesthesia is than the needle. I have had two fillings done without numbing. It did hurt some but I had no side effects. I can’t use nitrous oxide, obviously, and lidocaine gives me tachycardia. I guess I was hoping it was a “magic wand!”

[Star13 in reply to EiCa]

don’t we all!😂

[charks]

Poor you. I have had to have extensive dentist work. I had such a fear of dentists I didn't go until forced to. My front tooth cracked down the middle!!!! By then my teeth were in a terrible state. It cost me a fortune. I now think that my fear of dentists was yet another symptom of my B12D. Since taking B12 I'm not so frightened. Don't worry about the anethsthetic. Dentists only use a relatively small amount. You should be fine. Love the wand invention. Best of luck.

[Technoid]

I dont think they use nitrous oxide in the UK , (EDIT- my mistake, unfortunately they do) (which would be a concern) but you can ask them if you want to make sure. I don't know of any specific dangers of other anaesthetics to B12 status other than the normal risk of numbness causing an accidental bite of cheek, tongue or lip (been there and its painful).

[helvella in reply to Technoid]

They do!

And they promote that they do with irresponsible and misleading claims like this:

Nitrous oxide sedation in dentistry When it comes to choosing between excruciating pain and anxiety, there is no option but to visit a dentist to get rid of dental ailments at the earliest. Fortunately, you have the nitrous oxide sedative to control anxiety and pain. Administration of laughing gas will make your treatment process joyful.

[Technoid in reply to helvella]

oh dear, sorry I didnt realize that, thanks for the correction Helvella. Best be quite sure they don't use that in any procedures... I know others experienced this even when they warned the surgery

[humanbean]

Some info on B12 and anaesthesia that might be of interest, although they are about surgery rather than dentistry :

b12-vitamin.com/anesthesia/

pubs.asahq.org/anesthesiolo...

[Scott-rock in reply to humanbean]

nitrous gas is not advised at all for people with b12 deficiency. Even at a dentist’s.

I have recently suffered from it after surgery for a hernia. Symptoms returned with a vengeance. If ten was the symptoms before b12 treatment these were a twelve plus!

gov.uk/drug-safety-update/n...

Look up the BOC guide too.

[3rdNettydoon]

Thank you all for your helpful replies.

[nmayow]

hi I had my wisdom removed at the dentist last year with just the numbing jab I was awake as I have severe anxieties with dentist and hospitals . I just got up and walked out of the dentist my daughter thought I never had it removed because I was all smiles. It never effected me in any way

[Parlay]

I have Sjögren’s as well so I have lost a lot of my teeth and they used lidocaine and it was fine. And I’m a big baby at the dentist. Because of the stress involved I did another injection a day later as stress depletes b12. Good luck you will be fine.

[Gambit62 Administrator]

Your dentist should ask you about existing medical conditions and be aware that nitrous oxide is counter indicated in patients with PA.

If you are in the UK it would be very rare for them to use nitrous oxide anyway - tend to use novocaine. Personally I find that can affect me and make me a bit drowsy afterwards though it is supposed to be less likely cause drowsiness.

Suggest that you are upfront about things. Ask what anaesthetic they are using and if they say nitrous oxide/laughing gas then tell them you have PA and it is counter-indicated for you,

[3rdNettydoon in reply to Gambit62]

Thank you. Very helpful.

[Cherylclaire Forum Support]

There are other options than nitrous oxide.

I always make sure dentists and hospital anaesthetists are aware that I can't have it.

Don't forget that, should the need arise, you also need to be careful about antibiotics: I have found that, since being B12 deficient, I cannot have Metronidazole or Doxycycline without getting severe vertigo and constant headache. These are drugs that can deplete B12 too.

Good luck !

[Sneedle in reply to Cherylclaire]

Hi Cherylclaire,

Aware that this is an old post but wanted to ask you about Metronidazole.

I had it in heavy dose for five days in mid June. I didn't have a reaction of any kind other than loose stools til about a week after I finished.

Since then I've been having vertigo off and on., but mostly daily episodes.

I also took Clindamycin for ten days at that time.

I'm wondering if your experience was similar ie a delayed onset of vertigo?

How long did it take for the vertigo to stop?

I have a low B12 reading not a PA diagnosis, but am very curious about the vertigo. I've never had it with any antibiotics. It's rubbish!

Thanks for any insights.👍🙂

[Cherylclaire Forum Support in reply to Sneedle]

No,no, this was immediate (within a day or two) - so obviously connected that I went to the GP the first time, and he agreed that I'd had an adverse reaction, but by then thought better to complete course as although still there, not as severe.

The second time, recognised the exact symptoms and did not bother to see GP as expected it and knew it could be tolerated short-term.

Never an acknowledgement that it could have been related to B12 depletion, not in a position to argue at the time. You know how this goes, you have to pick your fights. Just glad to get through it. Don't forget, I was on very frequent injections, EOD probably then, so bounceback presumably faster - no longer-term problems.

I also do not have a PA diagnosis, although a mild B12 deficiency on treatment gave rise to a fairly early functional B12 deficiency when not responsive to loading, and deteriorating on maintenance dose.

Prior to B12 problems/symptoms I was okay on antibiotics and rarely had need of them in any case.

[Ghound]

Hi Netty, As a former tutor of dental nursing, I can reassure you that any routine anaesthetic given in your general dental practice will be a local anaesthetic, ie. an injection directly into your gum.As others have correctly said, this will be of the Lignocaine / novocaine/ prilocaine variety.

The ONLY times nitrous oxide may be used would be on very rare occasions for an extremely nervous patient who had opted for inhalational " conscious sedation " or even more rarely, in general anaesthetic for more complicated oral surgery.

Dentists will take your medical history into account when planning treatment.

Try not to worry, your dentist will make things as easy and pain free as possible. Dentistry has come a long way even in the last ten years or so.

Sometimes if the tooth is very badly decayed with infection in the surrounding tissues the local anaesthetic doesn't 'take' quite so well, but this is less common and those teeth come out very quickly.

Believe me, an extraction is much better than the pain of a decayed tooth and abscess !

Very best wishes x

[Motheroflittle]

My husband had an extraction 2 days ago and his was a breeze. He just had a local injection for pain. Never felt a thing and still has no pain. It was a large back tooth so he was dreading it. He is on an antibiotic to prevent infection but no pain meds have been needed.

Interesting about the B12 anesthesia connection. Must be why my daughter had such a terrible experience as a child with the laughing gas. She thought she was a balloon floating toward the ceiling. Terrifying for a wee one! Hope all goes well for you 3rdnettydoon.

[3rdNettydoon]

Thanks to everyone for your help. Dentists asked me to go in this morning. I asked about the anaesthetic and it was the one Gambit62 mentioned. All went well and the offending tooth is out. Very surprised it was clean, painless and fast.

[Technoid in reply to 3rdNettydoon]

phew!

[Ghound in reply to 3rdNettydoon]

That's great news, we'll done! 👍 xx

[Motheroflittle]

Thats wonderful to hear!

Hylands Arnica Montana 6X - Homeopathic would help with bruising,swelling,pain and bleeding. We use it for any type of injury.

[Technoid in reply to Motheroflittle]

I thought this a good article on Homeopathic Arnica preparations:

painscience.com/articles/ar...

[Motheroflittle in reply to Technoid]

Thanks but I was referring to the oral tablets not topical creams. Our family has had success for over 20 years with it for many soft tissue injuries, bumps and boo boos. It especially reduces bruising/bleeding.

I wasn't trying to push it on anyone, just a suggestion based on personal experience.

[wholesome_todd]

I read that the most common anesthetic used by dentists, nowadays, is Lidocaine. It had replaced Novocain, which used to be the most common anesthetic, a couple of decades back. Anyway, it's wonderful to hear that you'd your offending tooth out in a painless and fast way. Speaking of this, well, there's this little kid, of my neighbour's, who had one tooth of hers extracted last week. She had hers extracted at a nearby pediatric dental office ( smiletown.ca/ ). She's a little girl and it was really cool for her. Went real well for her.