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New phobia unlocked šŸ˜° Local Anesthesia Toxicity

M

Mrsmurray23

Member
Joined
Dec 7, 2023
Messages
68
Location
Texas
Hello,

I have posted quite a few times as Iā€™m struggling with dental phobia and am going to have IV sedation for a lower molar extraction and having 5 cavities filled (3 upper 2 lower).

I have now developed panic regarding the local used. I will be sedated so I am worried if something happens and I experience toxicity symptoms (hypotension or brachycadja specifically) that Iā€™ll die because Iā€™m already sedated and itā€™ll make things worse.

My dentist will be using mepivicaine as I donā€™t handle epi well - do you think numbing the whole upper quad and lower quad on my right side and doing this amount of work is cause for concern?
 
you will be fine! better to complete to avoid need for a further sedation session as you have no history of toxicity or allergy to local. treatment is done with you lying flat ( retired dentist)
 
Hi did you see @Gordon's post in this thread:


Unless your dentist is planning on using more than 20 cartridges of local anaesthetic (which is highly doubtful), it's not an issue šŸ™‚
 
Sorry to hear of your distress. Sounds like your biggest problem is your own mind. I understand, because I can be the same way about anything medical. My thoughts start running amok with all kinds of fears. As more time goes by, my worries only increase as I start coming up with new things to worry about, even things that are highly unlikely to happen (as you seem to be doing). Eventually I can reach a breaking point where I can't think straight or hardly function. My heart starts beating so fast I think that it will leap out of my chest.

I don't have an easy answer for you but I do know that bringing our minds under control is key, and the key to that is finding the right thoughts to help redirect our minds. I'll share with you a few thoughts and ideas that I try to use to help me.

I remind myself that one way or another, we all have to face difficult, painful things in our lives. We can either face these things with fear or without fear. I choose to do it without fear, as fear makes everything worse. Or at least I try to make that choice, but I know, it's easier said than done, but it's good to at least visualize a goal here.

Sometimes I try to split my mind in two - between a mature, strong, tough, reasoning, logical adult
mind, and a panicked little child mind. I don't deny the existence of the panicked little child mind, I just try to put my adult mind in charge. I want my adult mind to be dominant, to be 80% of my thinking, and keep my child mind in control, with both correction and comfort.

Another approach is to try to just not care. Try to mentally detach yourself from yourself, or at least from your body, as if you were watching someone else, even a stranger, go through this. In other words, try to depersonalize the whole thing. Finding something else, even another problem, another type of problem, to get preoccupied with can help with this one.

Another thing I comfort myself with, is the thought that I live in 2023 with modern dentistry, and not 100, 200, or 300 years ago and before when dentistry was primitive or even non-existent. IOW, we live in the best possible time in all of human history to have dental work. Even today, there are many people who have little to no access to dentistry.

I hope these thoughts might help even a little bit. Anyhow, I hope you are able to settle down and do what you need to do. The IV sedation is wonderful BTW, and I would gladly opt for it when having major work done. I know that the lack of control can be a fearful thing, but in this case, it's better to let the pros be in control while you take a nap - just like we do when flying.

I am actually having some dental pain going on right now and I have an appointment in a couple of hours for an assessment. I'm very nervous that there's a major problem that will require major work. So when I come back on in a panic talking about how I need to have a root canal and extraction and whatever else, feel free to throw all of my words right back at me. :)
 
@oneby oh my goodness thank you so much for your reply! I really appreciate you taking the time to comment things that work for you.

I love the idea of trying to detach from it or ā€œsplit your mindā€. Iā€™m trying to do that now and also just remind myself how many thousands of people have iv sedation dental work a year safely and effectively. I know I am scared of it, but the actual statistical risk is very low (lower than things I do daily, like drive or ride in a vehicle), and people often choose this just for comfort in a procedure vs me who will have to have it due to anxiety. I know I am in the hands of a very skilled dentist who has about 20yrs of experience and has been doing iv sedations for almost 10yrs safely, his reviews are amazing, and I rationally know I can trust him to take care of me. My ā€œchild brainā€ (I liked that lol) however is screaming having a scary panic tantrum. Youā€™re absolutely right though, I continue to find new things to be concerned about. I was first concerned with the iv sedation and being over sedated, then learned of the reversal drugs and my dentist agreed to use only midazolam which has a very wide margin of safetyā€¦as soon as I started to calm a little bit then I started to panic about the local anesthetic and turn that into a catastrophic scenario in my mind. It is truly my mind, which I know we do have control over, even if in the moments it can feel impossible.

Youā€™ve had Iv sedation for dental work before? Can you tell me what you had done and how your experience was? Iā€™m trying my best to surround myself with stories and people who have had it done successfully and recommend it so my brain can see it happens safely all the time and can happen safely to me too.
 
I only had the IV sedation done when I had my wisdom teeth out, long ago. I was scared out of my mind. When I went in for a consultation, the oral surgeon actually showed me some guy they had just finished worked on and who was still sedated. That scared me even more. For the weeks leading up to the procedure I just kept thinking about them cutting into my gums and cutting my teeth out. And I thought about someone putting me to sleep. All of those thoughts overwhelmed me. The surgeon prescribed a sedative for me to take before coming in for the procedure and was surprised when he saw that my pulse rate was still so high.

As for the IV sedation itself, one second they were telling me that they were about to being, the next second they were waking me up. I had a faint memory of a voice or two during the procedure, but nothing else.

For me at the time, the whole procedure was such a big ordeal and I know I went on and on about it with others, but then I knew of some others who had the same procedure and they just sort of shrugged their shoulders at it like it was no big deal and hardly even spoke about it. More recently my son had the same procedure and it all seemed rather unremarkable to him as well. This all just reminds me about how important mindset it in facing these things. Fear just makes everything worse. Even makes your body more sensitive to pain. I'm till aiming for indifference now when I face things, but it can be hard to acheive that mindset.

If the dentist today tells me I need an extraction I will seriously consider IV sedation. The only problem is that takes an oral surgeon and would cost more. On the other hand, if my dentist told me he has time today to do the extraction right away, I might opt for that so that I can avoid the waiting and worrying.

So much to think about but remember - we only have so much control over things.
 
@oneby Are you in the US? Here our dentists can also become certified to do iv sedation, which is what my dentist did many years ago. I think he got his initial license for sedation in 2015 and has been using sedation regularly since. He assured me his entire team is up to date on all training and emergency procedures as well, so I hope my experience I quite unremarkable also and I just go in, take a nap, and wake up and itā€™s all done.

Itā€™s funny you say that about your son not caring really - my daughter is 17 and she needs a wisdom tooth and a molar extracted and I asked if she would want sedation and she said ā€œyes for sureā€ so itā€™s not even a concern for her lol. Crazy how our minds can all work so differently
 
Yes, in the US, but I didn't realize US dentists also do iv sedation. My dentist doesn't even have Nitrous oxide. I'll remember this in the future. As for now, thankfully, I don't need any dental work, I just needed a minor adjustment of a crown. But good to know, thanks.
 
Local anesthetic toxicity is very uncommon and very safe to use. Some patients can be sensitive from the adrenaline and may make your heart beat faster so adrenaline free options are out there.

As someone has already pointed it, the maximum dose is like 10 cartridges which I'm sure you won't need for fillings.
 
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