Expert: Jeff Dalin DDS - 7/1/2006

Question
I need to have dental work done that i have put off for 10 years because the shots with the epinephrine cause rapid, pounding heartbeat for about 20 minutes straight that made my heart hurt painfully. I have been told I could get  shots without the epinephrine but that that it would cause too much pain and too much bleeding. The dentist decided not to work on me. What could my options be now?  

Answer
Dawn
I do not understand why the dentist will not comply with your wishes. There are anesthetics without epinephrine...carbocaine 3% without vasoconstrictor to name one. It does not cause more pain. It does wear off a little quicker but you can work for a good hour. If you are doing surgery, no vasoconstrictor can cause a little more bleeding but you should be able to control things other ways. Here is the main issue. We use aspirating syringes when giving injections. What that means is that we are able to place the needle where we feel it is needed, pull back on this syringe, and see if we are in or next to a blood vessel. If we are using an anesthetic with epinephrine, you should not inject it in at that time. If you do, you can create the scenario you experienced. You merely place the needle in a different location. Now you mentioned that you have gotten this response many times. This means either the dentist is not ever doing this technique or you are super sensitive to the epi. Just sit down and discuss things with your dentist. You now have all sorts of good information including techniques. You are the boss here so to speak. Either the dentist does things the way you want them or you find one who will listen to your wishes. This is your right as a patient. Good luck,

Jeff Dalin, DDS