Thyroid, inflammation and dental anaesthesia

[hjh88]

Hi all,

I’ve been MIA from the forum recently. Finding myself not only fatigued by being hypo but in managing my longterm conditions generally. It can be quite the emotional grind so I’ve been engaging less. Apologies for the lack of contribution lately.

I find myself in need of your collective wisdom though for a slightly baffling situation I’ve found myself in which I suspect may be linked to thyroid health. Would very much like to hear if members have any similar experience or have heard of something along these lines! Trigger warning for dental stuff if anyone would rather avoid.

Basically, I need a tooth out but when trying to extract it the anaesthesia failed. Believe it was lidocaine as I’d asked for adrenaline free following slightly raised heart rate while adjusting T3. The dentist thought this to be a “hot tooth” - too inflamed for the pain relief to work properly. So no tooth out and riddled with anxiety I was referred for sedation to try again and given antibiotics (penicillin) to combat the tooth in the interim. Needless to say they’ve messed me up a bit but if they’ve staved off a toothache then needs must!

While waiting for the referral, I’ve had a further filling where the adrenaline free anaesthesia failed in the area where the tooth is. It was numb for the drilling but sensation came back later in the procedure. Dentist concluded this time that I was metabolising the anaesthesia rapidly. I’ve also had another filling on other side of mouth when heart rate settled with adrenaline which went well.

With 2 failed anaesthetics under my belt I’m more anxious than ever. I’ve since asked the team I’ve been referred to what pain relief is used during sedation. Yet to receive complete answers but have a sense it’s just IV sedation and local anaesthetic, not IV pain relief.

I’m now wondering how to proceed as I don’t want to be in a situation where I’m under sedation and can’t advocate for myself but with failing pain relief. Need to get this tooth out but I’m incredibly fearful now!

Does anyone have any experience of anything remotely similar or any advise on how to navigate this? And more thyroid related, if it is an inflammation issue (I’m always inflamed in some way because of my autoimmunity/PCOS etc), is there something I can do about that quickly? Is there a link I’m missing between thyroid conditions and how anaesthesia works in the body?

Thanks in advance!

[Bean101]

I had a mercury filling removed and the adrenaline free injection didn’t work, I didn’t bother with another injection as I found it more painful than the removal of the filling

[hjh88 in reply to Bean101]

If it was just a filling I’d be tempted to just go ahead but I don’t fancy having a tooth pulled out without any pain relief 😂

[Bean101 in reply to hjh88]

oh No definitely not

[GlowCoach Administrator]

Resistance to local anaesthetics can happen with some connective tissue disorders. This paper mentions a few local anaesthetics that might work better.

ncbi.nlm.nih.gov/pmc/articl...

The good thing about sedation is you won't even remember what happened while you were under its influence but it would help if you were confident the anaesthetic would work!

[hjh88 in reply to GlowCoach]

That’s a very interesting little tidbit. We’ve definitely got some kind of connective tissue disorder in the family and I know some of my joints hyper extend so definitely going to look into that. Annoyingly we all have the ginger gene too which I understand can make some anaesthetics less effective so maybe it’s a double whammy!

Thanks you for the link, this will be very useful for sense checking the suggestions they have for pain relief. Very much appreciated.

[Feelgoodbooks in reply to GlowCoach]

Oh my god! That makes so much sense. I had an urgent surgery and when I woke up, the doctor came to tell me that everything went okay, but I might feel a bit groggy cause they had to use more anaesthetic than usual since I kept grimacing during surgery.I thought it was thyroid related, even though I'm under investigation for connective tissue disorder, and they are quite sure I have it, just not which one.

hjh88 When I went to the dentist I told her straight away that I metabolise anaesthetic quicker than usual, so she told me to raise my hand everytime I started to feel uncomfortable, cause those were the first signs it was wearing off. So I did that, and she did have to inject me multiple times with it, but I barely felt it. I found telling her straight away about it, made it so much easier cause she was super cautious about it, and she would stop immediately when I raised my hand.

But she did give me with adrenaline, and for like 3 hours I was shaking quite a fair bit. She had to give me a sugary drink to help with that.

I would just explain to your dentist, and make him give it to you as much as you need.

[hjh88 in reply to Feelgoodbooks]

Mine did something similar first time round and I raised my hand on feeling discomfort. They tried to fill the tooth first so I was numbed for the drilling but needed 2 injections. When they started to prep to pull the tooth, I began to feel it again so raised a hand. I think I ended up having 4-5 injections but it just wasn’t touching it so they temporarily filled it and referred for sedation. That was adrenaline free which might be the difference, although I’m not sure. Good to know about the sugary drink for shakes should I need in future though since this doesn’t seem to be going away!

[Feelgoodbooks in reply to hjh88]

hjh88

I also wanted without adrenaline since I do tend to have spikes in my heart rate. But she said that it works better with adrenaline, and it decreases the systemic absorption of lidocaine, so I ended up accepting with adrenaline. The effects of it did last around 6 to 12 hours, but at least I was able to do like 3 fillings. I hope you find a solution

[hjh88 in reply to Feelgoodbooks]

That’s reassuring to hear. I’ve had a filling since with adrenaline since my heart rate settled and it worked just fine. It might be that that alone is enough to solve it and it’s just the anxiety I need to wrangle. Thanks for sharing your experience, it’s been encouraging!

[Blissful]

Can I give you a hug, you have my utmost sympathy. After nearly 70 years of dental this that or the other, I am now a very happy virtually toothless old crone!

In around 1969 I needed 2 wisdom teeth removed - I was given Valium delivered through a vein in my hand - it works as an amnesiac but you can still cooperate if the dentist asks you to move right or left. You do feel very out of it and when I came to I'd clearly been having a wonderful dream where I was cocooned in a hospitable jungle with large felines everywhere! (Tiger Tiger Burning Bright etc.).

I feel sure this type of anaesthesia must still be available? The adrenaline free injections need quite a time to work plus either empty or full tummy (I don't remember which) - no one has "time" to wait - the system is rigged against so many things.

Actually I am surprised that a professional would even try to extract a tooth with an ongoing infection.

Can you try salt water mouth swishes, very carefully* dab some clove oil around the gum line, dab a mix of inert carrier oil e.g. almond with a few drops of tee tree oil, clove, peppermint?

Periodontal disease is a bit scurvy like so a good look at your diet and lifestyle would be helpful. We are living through extraordinary times and stress levels are getting "silly" - constant stress (at the least) depletes vitamin C and magnesium.

* - it's not dangerous but if your tongue touches it, corner of the mouth etc. then it will go a bit tingly/numb for a short while

[hjh88 in reply to Blissful]

Thank you, I appreciate the virtual hug.

I’m yet to find out what sedation is used but very reassuring to hear of your experience with Valium. I’m sure I’ve read they still use it and if I can get out of the situation having had a nice dream, that’s be ideal! I didn’t realise the adrenaline anaesthesia worked better depending on when you ate as well, so I’ll definitely look into that. Will be useful to give it the best chance of being effective.

I’ll definitely give the clove oil a go, thanks for the recipe. Strangely, I know it can help but hadn’t made the connect between it and inflammation. Has to be worth a shot. Diet and supplements are always on the table for managing hypo and PCOS - strangely enough I’ve just begun loading up on vit C and magnesium again for other reasons but this’ll be another reason to keep it up.

You mention your surprise that the dentist tried to pull an infected tooth. I think part of the problem is it’s not really shown signs of infection. Luckily so far it’s just been occasional sensitivity, no sign of tooth ache, and it was the non-responsiveness to the anaesthesia that led him to think it was inflammation caused by it being on the verge of infection. Another layer of complexity 😂

[thyreoidea]

Hi hjh88, so sorry to hear about your experiences. If you are in the UK is it possible to be referred for this troublesome tooth to the hospital where they are better equipped to deal with more difficult situations. My wife had a persistent tooth infection in one of her front teeth and after 2 surgical procedures at her dentist was then seen at Guys hospital in London, eventually they had to extract it at her dentist. Have you been treated at the hospital already or are your own dentists trying to deal with this as it could be a good earner for them.

[hjh88 in reply to thyreoidea]

That’s a very interesting take, I’d not thought of it like that. I’ve not been treated at hospital to date. They’ve referred me to another of their surgeries where they offer sedation so it might be that they’re trying to keep me in system. I’m wondering, if I can’t get some solid answers around pain relief when I speak with them again, maybe asking for a referral out might be the way forward.

[thyreoidea in reply to hjh88]

As all dental practices are private in essence whether an NHS patient or not.

I would ask for a referral as hospital dentistry will be able to offer more options for your situation.

I hope you get treated soon as having dental issues especially infections are very wearing and stressful at the best of times.

[hjh88 in reply to thyreoidea]

Really appreciate the insight, thank you. I’m hoping I can get it solved soon too!

[Starmen in reply to hjh88]

I asked my dentist to refer me to my local dental hospital about 5 years ago for a problem impacted wisdom tooth wrapped around the nerve . They were reluctant to do this however I questioned why not ? The dentist then referred me saying it won't make any difference! Since I was referred the dental hospital they have monitored me yearly still got the tooth but I have yearly X rays. My problem is also the fact I am on immunosuppressive medication for Rheumatoid arthritis which has a high risk of infection. The point I am making is to ask for the referral the dental hospital were more than happy to see me as it is complicated situation.Also they took another tooth out rather than at my dentist as they are could monitor me closely .

I think in complicated conditions like ours and many of us have more than one the dentists don't fully understand the impact of having a procedure. As well as the different medications we take .

On another point I usually need more anaesthetic and I am ginger too .

[hjh88 in reply to Starmen]

This is the conclusion I’m slowly drawing - there’s more going on here than meets the eye and I’m feeling distrustful in the ability of the dentists I’ve seen to be able to explain and deal with whatever it is that’s going on. Much as I might hope that there are ways around it with particular anaesthesias or things I could do to give them a better chance of working, I’m just not feeling confident that they’re across all the variables as much as I am - and I’ve got no idea what’s going on!

Sounds like your experience with the dental hospital has been very good and reassuring to know they have an eye on all of the factors. I have a relative with RA on immunosuppressants so appreciate the complexity they’ll be navigating in keeping you safe. Thanks for sharing your experience, it’s heartening to hear.

[Marymary7]

Once I had to abandon an nhs dental filling as the injection made my heart go like the clappers and it literally felt as if it was about to burst out of my chest if I didn’t keep pressing both hands on my chest I changed dentist after, I went back to my previous expensive private dentist.

When I broke my wrist very badly morphine or whatever they gave me did not seem to work at all for the intensity of the pain. My daughter found the same after childbirth problems. Something genetic in us?

Very interested in any information….. sorry I can’t help you.

[radd]

hijh88,

Ensure your dentist is giving you enough of the adrenaline free anaesthesia .

The advancements of the newer anaesthesias (that I can’t tolerate) are they act much quicker, less is required for the same pain control and it wears off faster. Your dentist might be confusing the old required dose will the new lesser one.

Usually I have to have two or three injections given over ten to fifteen minutes to administer enough anaesthesia before starting the procedure.

[hjh88 in reply to radd]

Very interesting and could well be a factor. I’ll be asking them again about the specifics of pain relief so will be useful to see if they mention this or I can ask them specifically about it. Thanks for sharing, all very good ammunition.

[McMurtagh]

It takes additional time for local anaesthesia to take effect with me and on the last two occasions (filling and removal of a skin lesion) my body started to tremble and I had to have glucose and sugar.

I need to go to the dentist again but these experiences have put me off. I don’t want to be sedated.

[hjh88 in reply to McMurtagh]

So sorry to hear of your bad experiences. It’s so anxiety provoking and really not helpful when you know you need some work done. I hope you find a work around for it 🤞

[Brightness14]

This July my Ear Tumour Operation was cancelled until September because the level of my FT3 was too low for the Anaesthetic it would have be dangerous. I am not sure about Dental work but it could be something similar.

[hjh88 in reply to Brightness14]

I’m almost wondering whether a hospital referral is the way to go at the moment with all of the different factors - thyroid, failed anaesthetic, ginger gene and the possibility hyper mobility complicating anaesthetic. In the process of ordering thyroid tests to see what’s going on so hoping to rule low T3 out at least!

Good luck with your op for September, hopefully much better T3 levels by then 🤞

[Brightness14 in reply to hjh88]

Thank you I think that your idea of a hospital maybe the way for you to go I hope so.

[Miffie]

I have had mixed reactions to dental anaesthesia over the years. When I broke a tooth whilst visiting friends I had to have the nerve removed with no numbing at all when the anaesthetic injections failed. The tooth pain was so bad I’d have done anything to get rid of it ( tooth broken Friday evening saw dentist on Monday). My current dentist sent me to hospital dental services when I need a tooth removed due to a problem with a tooth which had previously had root canal treatment. The hospital assured me I’d not need a tooth removal as they could sort it out with a minor procedure under GA. In recovery they told me all had gone to plan and three teeth had been removed. My dentist was as devastated as I was. I’ll never go there again, Hopefully you’ll find sedation works well.

[hjh88 in reply to Miffie]

Gosh that’s awful, how on Earth did they justify the jump from no tooth loss to 3 teeth out?! With all the replies I’d been wondering whether my circumstances are complicated enough that hospital referral might be a way of managing all the factors better but maybe I shouldn’t be so keen.

[Miffie in reply to hjh88]

Does your dentist offer sedation at the surgery? My practice is a mix of NHS and private. NHS patients can have the odd job done privately and keep NHS status. I know we are super lucky. Private side has a range of sedation techniques. My sensitive and nervous friend swears by sedation they offer. It does seem to be numbing as well. Hope you get a good result.

[hjh88 in reply to Miffie]

I was so focused on the anaesthesia side of things I forgot to include anything about NHS vs private! Yes the surgery do offer sedation at another of the dental group’s clinics just down the road - that’s where I’ve been referred to for sedation. I’m a private patient currently. Knew I needed some fillings and would be opting for white ones not covered by NHS, plus the waiting lists for NHS are wild here.

That’s very comforting to hear, that your friend finds sedation numbing. I’m hoping when they get back to me/ I chase on the particulars of the pain relief it might be sedation + analgesic which would be ideal. Thank you for sharing!