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FAQ:  Sedation Dentistry


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Question:
Sleep apea, Tachardia, Palpitations, irregular heart beats: Recently a piece of my tooth broke off.

I went to the dentist yesterday and they discovered that since there was no pain that the tooth was probably dead. I will now have to have a root canal and a crown.

I am 58 years old and have never had any kind of anesthesia or novacaine. I have never been put out and I am really terrified and feel panicked already.

I have sleep apea, tachardia, palpitations, irregular heart beats. I also take metoprolol and protonix. I don't know what to do.

The dentist told me if I don't have it done an abcess will form. Should I be concerned about anything? ...Visitor from MD

Answer:
I can understand your fear as you have never had this kind of dental problem before,and you have never had general or local anesthesia.

Since you have a history of sleep apnea,tachycardia, palpitations and an irregular heart beat you may not be a candidate for in office oral or IV sedation dental care. Your sleep apnea is a result of a restricted airway when you sleep,which is caused by loose tissue and your tongue falling backwards while you sleep. I would also guess that heavy snoring is a component of your sleep apnea as well.

I feel your limited airway while sleeping is a conta-indication to being sedated in a dental office setting. A second major concern is your irregular heart beat and palpatations.

Many local dental anesthetics contain epinepherine which can speed up the heart beat for several minutes after getting numb. If you are already tachycartic (elevated heart-rate), having an epi containing anesthetic could present problems.

Since you are so apprehensive about your upcoming dental appointment, I recommend talking to your dentist a bit more about your concerns and how you are feeling. Your dentist may even refer you to a root canal specialist to complete your needed root canal treatment. A non-epinepherine local anesthetic can be used to decrease the chance of a speeded up heart rate.

Sleep apnea and snoring can lead to increased systemic problems and heart issues. There are anti-snoring appliances available that help position the lower jaw forward during sleep that greatly reduce or eliminate snoring and can reduce sleep apnea. If a patient is able to keep their tongue from falling backwards with the use of one of these appliances, they will get much better sleep.

Editorial Staff

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