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FAQ:  Sedation Dentistry

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Mitral valve prolapse and tooth implant: I am so worried about an upcoming tooth implant surgery.

I explained to the specialist that I was very concerned about NOT getting Epinephrine. That I had a bad experience years ago and almost passed out! I had palpatations to the point where I could barely get my breath. Very scarey.

They had to put an oxygen mask over my face. Well, this doctor that will be doing the implant surgery told me not to worry. He can inject novacaine with epinephrine into a certain vein without effecting the heart? Any insight on this procedure? ...Visitor from PA

Your question topic was mitral valve prolapse but you did not ask about this at all.

Since you have mitral valve prolapse you should ask your implant surgeon about what type of antibiotic coverage you need before your implant appointment.

As for your epinephrine concerns, many patients have slight heart palpitations or an increased heartbeat when they receive a local anesthetic containing epinephrine. When a patient is extremely nervous,the effects of epinephrine can be increased.

This feeling with epinephrine is not an allergic reaction. The epinephrine in local anesthetic prolongs the numbing effect of the anesthetic by constricting the small blood vessels, thus preventing the bloodstream from carrying the anesthetic away.

This in effect keeps the tooth or soft tissue number for longer dental procedures. The numbing needed for a dental implant is not that much, as only the gum and jawbone area that will receive the implant needs to anesthetized.

You can ask your implant surgeon if he/she could use a non epinephrine containing local anesthetic, followed by a little epinephrine containing anesthetic to do your procedure.

In addition, you should try to relax and maybe at least ask for nitrous oxide (laughing gas) for your implant visit. Also, remember that the implant surgeon is probably very experienced with placing implants and keeping patients relaxed and comfortable.

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