Dentistry; dental treatment

See also our Members Only thread on Dentistry -Dental treatment


I've never had a cavity but at my once o'half decade dental check-up the dentist found a tiny cavity on one of my back teeth. I'm completely housebound and mostly bedbound. Fairly sensory sensitive. Mostly just all around fragile.

So, is there anything I need to consider when getting this cavity filled? What besides, drilling, do they do? What sort of chemicals do they give you? I've been avoiding it since that appointment last November -- initially because of my annual post-Christmas crash, but now because I'm afraid of what it might do to me and dreading a bad crash. In the meantime, I've been making sure to brush, floss, rinse with flouride-based mouthwash, chew xylitol mints in-between brushing, etc. I know it's not going to get any better but so far it hasn't gotten too much worse. But that won't last forever. Sigh.

 

Epinephrin in the freezing is what most people with ME react to. Considering your current condition, i would recommend you ask the dentist to freeze you with plain lidocaine.

(Edit to add: the reaction I have had to epinephrin was 3 days of horrible migraines and a 3 weeks long horrendous crash. i needed the same procedure repeated a mo th later and we did the no epinephrin thing, and. I did nothave the reaction, so we knew it was the epinephrin)

The good news with dentistry is that all of it is done reclining and the procedures are usually no longer than an hour, usually less than that.

I would recommend you do not wait any longer. You do not want the cavity to reach your root, and then needing more invasive and more costly procedures.

 

I'm in the UK and with my dentist we discussed using a local anaesthetic without adrenaline.

Epinephrin is based on the adrenalin molecule and both will constrict blood vessels around the site ofnthe injection.

Depending on where you live you might need slightly different terminology.

When I have needed work done at the very back of my mouth I have sometimes found it useful to have a small towel rolled up to support the back of the neck when the jaws are wide open.

Good luck with it &, as already advised, I wouldn't leave it.

 

I don't know what country you're in Michelle, so this may not be a consideration for you - but check what filling material the dentist is going to use. If it's dental amalgam make it clear that you need an alternative, even if there's a cost involved. As you already have health problems you don't want them to put a source of mercury vapour in your mouth.

 

Thanks for the responses! Yes, epinephrine would kill me. Maybe literally. I respond badly to any sort of stimulant, caffeine, d-ribose, ALCAR. Tiny doses of Effexor, an SNRI, landed me in the hospital with a potential cardiac event many years ago and left me twitching so badly I couldn't sleep (and I'm much sicker now). So cheers for the epinephrine heads up!

@Hutan , Yes, muscle fatigueability is a huge problem for me. I'll ask about the frame. I also have problems with joint hyperextension (hEDS) so concerned about that too.

@Stewart Yes, I've wondered about the mercury issue. The dentist said he would use a silver filling. I haven't been able to tell how worried to be about the mercury (i.e. if it was an alternative medicine conspiracy or if there was good research about this issue). Unfortunately I'm on Medicaid so I'm limited in what my state's dental benefits will pay for.

 

A silver filling? Never heard of one if these before? I know the mercury amalgams look silver in colour when they are new.

My dentist uses some sort of composite and we completely avoid mercury. All my fillings are the same colour as my teeth. It is slightly more expensive than the mercury amalgams though.

 

In the United States, there are "visiting dentists", who will come to your home. I've never used such a service though.

A couple examples (not an endorsement):

• http://www.visitingdentistsli.com/
• http://housecalldentists.com/

 

It's an extremely contentious issue. Mercury is one of the most potent neurotoxins in nature and it's bioaccumulative, so if you're exposed to mercury it builds up in the tissues of your body where it can cause a wide range of health issues. It used to be believed that the elemental mercury in amalgam was rendered completely inert when it was combined with other metals, but we now know that this isn't the case. Small amounts of mercury vapour are continuously given off from amalgam fillings - but there's no agreement on exactly how small these amounts are (in fact some studies have claimed that the amounts are quite large) or how much of a health risk they pose. Other studies have shown that activities like chewing, tooth brushing and drinking hot or carbonated drinks - things that people with fillings inevitably do every day - dramatically increase the amounts of vapour released.

But even if it's true that only tiny amounts of vapour are given off, the fact remains that mercury is *never* good for you in any amount. Given that you already have health issues I'd encourage you to push your dentist as hard as you can to avoid a silver filling, just to be on the safe side.

The following article is a few years old now, but it does a good job of providing a fairly neutral summary of what we currently know:

www.doctoroz.com/article/toxic-teeth-are-our-amalgam-fillings-safe

 

just so it is clear, silver is a marketing term for mercury amalgam. i'd call it a lie; it seems reasonable to assume that many consumers would think it's actually pure silver.

carbocaine does not have epinephrine. i have had good results with it. in fact, i have hyperalgesia, so expected to require at least 3x the normal dose, as was the case before [dentists don't believe this until they see it for themselves], but did not have to.

i had heard about the dangers of epinephrine from the mcs community, where they seem to get panic attacks, but didn't know if it was a problem in pwme.

 

@Webdog -that is really cool. I have never heard of a dentist coming to you. That is wonderful. It also must be very expensive, but I think its an option that is great for those who can't leave the house. Thanks for sharing.

 

Glad to help. In my city, there is even a veterinarian service that make house calls, for those that can't bring in their pets. I know someone that uses this.

 

Poor you @Michelle.I am practically housebound myself, so usually have to cancel any appointment I schedule. However last year when I finally got to go it turned out that I had a cracked filling that was leaking Mercury into my mouth!

I would say get it done asap- even if someone has to carry you in andyou lie on the chairs in the waiting room. I have quite a bit of pain, but I have to say reclining in the dentist's chair is probably more comfortable than average.

I wear dark glasses and pre arrange to be seen downstairit is now on my file. I am also take Arnica 30 the day before, on the day and one a day after which helps the bruising. Leaving it is only going to lead to bigger problems further down the line. Good luck!

 

Merged thread
I have not been to the dentist since i got ME In 2006. I used to pass out at the dentist before I got ME and i now have severe ME but know I’ve got a couple of broken teeth and need couple of fillings.

I have severe ME and know I must go to the dentist but easily get sensory overload. I’ve just got no idea what to do. I’ve managed to get an NHS dentist appointment at the end of June and I am going to email the dentist. Just making it into the dentist terrifies me. When they even scrape my teeth for me it’s just pure agony. The last injection I had before a filling made me pass out.

I feel I’ll get really sick going to the dentist and am wondering if total sedation would mean I can get treatment but unsure what to do.

I’ve always felt a lot of pain and just am fearful of getting sicker. I use a powerchair for mobility and am in bed 2-3 days a week.

 

If you are in the U.K., check out what domiciliary dental care there is available in your region?

I am aware of a couple of friends who have used our County-wide Dental Specialist service locally but am not sure to what extent the home service would be able to provide absolutely everything that you need.

According to this link, it appears that your own dentist should be able to refer you.
In my own experience, I have found both dentists and opticians to have far better understanding of ME than medics. I think perhaps the ME Association has a leaflet on dental care/local anaesthetics?

I wish you much luck and gentle hugs

https://www.nhs.uk/nhs-services/dentists/dental-treatment-for-people-with-special-needs/

 

Thank you so very much for this as I had no idea that this exisits. I have an appointment with my local NHS dentist and have emailed them. But I’ll print this off and take it with me. Huge thanks x

 

I've come across several people (although not ME patients) who're very afraid of dental treatment, and the consensus seemed to be that dentists are pretty good at understanding this. Many are willing to offer a dose of Valium before they start the treatment.

I shared an office for years with someone like this, and her routine was that she had to get to the surgery about half an hour before her appointment. Her dentist would give her a tablet, and she'd return to the waiting room whilst he saw the next patient. It meant she needed someone to drive her home because she'd be really woozy by then, but she could cope with the treatment without becoming enormously stressed. Stress does tend to magnify pain levels.

There might be reasons why this wouldn't work for you, but I thought I'd add it as a possible option to consider? I really hope you manage to find a way to make it do-able, anyway.

As a final thing, if local anaesthetic tends to make you pass out, talk to the dentist about adrenaline-free injections. Adrenaline does the same to me even though I don't mind dental treatment at all, because it tanks my already low blood pressure. This type of anaesthetics isn't quite as profound (the adrenaline is there to stop the liquid migrating through the gum), but it just means that in a long procedure it may need topping up. Since the area's already numb, you don't actually feel the top-up.

 

I second requesting an oral sedative.

 

There is an existing thread on this, although I'm not sure where it's gone, because I remember the MEA having produced a leaflet about anaesthetics.

Edit: Ah, no wonder I remember it. I started it
Members only - Dental treatment | Science for ME (s4me.info)

 

Merged thread

Long Covid and White Dental Fillings on the NHS

Hi, I wonder if anyone can help me. My husband is still managing his Long Covid. He needs 3 dental fillings after finally getting into an NHS dentist. I thought the amalgam fillings had already been banned but apparently the white ones are only offered for free on the NHS for those with certain medical conditions. The dentist wouldn't say what those medical conditions are.

In order for the Dentist to offer him the white fillings, they need a letter from his GP stating what his medical condition is and why white fillings are requested.

We don't want to risk the mercury fillings in case it gives him a relapse. Is there anything we could give to the GP to support our request? We can't afford white fillings otherwise and he would go without.