Fear of local anaesthetic and panic disorder

T

Toothhurty

Junior member
Joined
Nov 23, 2007
Messages
4
Hi

I am going round and round in circles. :( About six months ago part of my back tooth broke off when I was eating some cornflakes. However, although I went to the dentist to let them have a look at it and take some x-rays, I didn't go back to let them sort the tooth or the other one next to it which I was told also needed a re-fill. This is because I have been suffering panic attacks and claustrophobia for the last three years. I also suffered agoraphobia but in the last 8 months this has improved and I do manage to get out and about to a point. It took me a year to pluck up the courage to see an optician, but that situations wasn't as desperate as the the situation I am now in. You see, I had a bad allergic to a prescription drug and now I am terrified to let any drug into my body and that includes local anaesthetics. It doesn't help that I know that my body doesn't react well to adrenaline and non adrenaline anaesthesia anyway (usually about 15 to 20 minutes after the injection, my heart races, and I get uncontrollable shakes). I still took the anaesthesia even though the reactions were horrible, but now because of the panic disorder that I have, I know that these reactions would most definitely bring on a massive panic attack.

There is no way I could consider an IV sedative for the reason I have given above about being scared to put any drugs into my body. My tooth is starting to show signs that it is not going to hold out much longer, so what the heck am I going to do?

Would appreciate any advice.

Many thanks

toothhurty
 
Zzzdentist

Zzzdentist

Well-known member
Verified dentist
Joined
Oct 11, 2007
Messages
1,106
I wonder if a hypnotherapist might be able to help you out. Do you think nitrous oxide might be something you would like to try? I guess with the claustrophobia, the nasal mask would be out of the question? I don't know what other options might be available to you, but maybe someone else could suggest something.
 
T

Toothhurty

Junior member
Joined
Nov 23, 2007
Messages
4
Actually, I went to a hypnotherapist around about March this year to help with the agoraphobia and it did work as i am getting out and about more. After a few sessions I asked her if she could work on me getting over my dental fears, but unfortunately, although she tried, it did not work. Perhaps my fears are too deep rooted. Nitrous Oxide is that the gas and air that you use when you are in labour? Would I still have to have an injection in my mouth or would the gas and air be enough?
 
Zzzdentist

Zzzdentist

Well-known member
Verified dentist
Joined
Oct 11, 2007
Messages
1,106
Yup, it's what's commonly known as laughing gas or Entenox. It gets you pretty light headed and carefree at moderate to higher levels, or at least I found it did with me the one time I tried it. It's quite fun actually. ;) You get into a state where you sort of don't care too much about your surroundings and you feel quite like your floating. It's a neat feeling.

I'm not sure if everyone's experience is like that, but I thought it was the closest to getting on a drug trip that I've ever been on, well except for taking Cotridin (codeine cough syrup yum!) a few times. If it's good enough to use while pooping a baby out, it should be plenty good for dental use!

Although the nitrous does seem to contribute to some numbing, you would still need some local anesthetic.
 
Last edited:
T

Toothhurty

Junior member
Joined
Nov 23, 2007
Messages
4
Yup, it's what's commonly known as laughing gas or Entenox. It gets you pretty light headed and carefree at moderate to higer levels, or at least I found it did with me the one time I tried it. It's quite fun actually. ;) You get into a state where you sort of don't care too much about your surroundings and you feel quite like your floating. It's a neat feeling.

I'm not sure if everyone's experience is like that, but I thought it was the closest to getting on a drug trip that I've ever been on, well except for taking Cotridin (codeine cough syrup yum!) a few times. If it's good enough to use while pooping a baby out, it should be plenty good for dental use!

Although the nitrous does seem to contribute to some numbing, you would still need some local anesthetic.


Oh well, looks like I am back to square one then. Over the last few days I have been going over and over it in my head, but I just know that gas and air alone would not allow me to accept the injection. I just have this deep rooted fear that I will at best either panic and be out of control or at worst, have a heart attack and die. I know this probably appears an OTT reaction but I guess its this fear of an allergic reaction and/or dying on the dentists chair that is the major problem. :o :(
 
Zzzdentist

Zzzdentist

Well-known member
Verified dentist
Joined
Oct 11, 2007
Messages
1,106
You know, over the several years I have been practicing dentistry, no one's even come close to dying in my chair, and I've had some pretty sick people come in with a medication list that's pages long. Knock on wood. ;) Our procedures are pretty tame compared to what general and orthopedic surgeons do.

The amount of anesthetics we use are in the mL quantities. Did you know that a single dental cartridge only contains about 1.8 mL of anesthetic? Keep in mind that 5 mL = 1 teaspoon so it's less than a half a teaspoon of anesthetic!

I'm not sure how to reassure you that having dental work is quite safe. I don't think that it's the adrenaline that would be causing your heart to race and cause you to shake 20 minutes later. It usually can do something like that quite quickly if inadvertantly injected into a vein, but it's temporary so most everyone that has this happen handles it just fine. Usually the dentist is very cautious in their aspirations during injections to avoid this sort of problem.

The human body naturally produces adrenaline (epinephrine). Like in the fight or flight response, your body releases adrenaline to get your systems all pumped up for an emergency reaction. Your heart races, the blood rushes to the brain, and a person can certainly get shakey. Epinephrine is a naturally occuring chemical in the body.

There have been some people who had a sensitivity to the local anesthetic itself or the preservative used. Sometimes the dentist can try a different type or brand of anesthetic to see if that might help. I had one patient who experienced the same after effects from anesthetics, but we tried Carbocaine with no epinephrine, and she found that one worked great for her. You could see if the dentist could try a little of that instead.

One idea might be to visit the dentist and have some nitrous oxide. The dentist could give you a very small amount (eg. 0.4 mL or quarter carpule) of Carbocaine infiltration to see whether that causes you any problems. You wouldn't even have to have any work done. It could be just a visit to see if a different anesthetic might work better for you. You could then wait 20 minutes to see if you had any problems.

Another idea is to visit an allergist who is able to test you for specific allergies to different anesthetics.

Here's some info:

 
T

Toothhurty

Junior member
Joined
Nov 23, 2007
Messages
4
Thanks for the info. :) Will have a read and a think about what I am going to do.

Regards

Toothhurty

p.s. my previous dentist thought that it was the preservative that I was reacting to and not the adrenaline in the local anaesthetic.
 
Last edited:
Top