UPDATE: Root canal--scared and need answers to questions :)

[Harriet Vane]

Folks, I am scheduled for a root canal tomorrow.

 

I am wee bit scared. I have never had one done.

 

I had a crown put on over Christmas and did well with that. At that time, I asked that they numb the area without epinephrine. My reasoning is that I am prone to overreact to stimulants, so best to avoid it. The smallest bit of coffee will keep me awake forever. The few times I have used an asthma inhaler, I had real issues with not being able to sleep not just that day, but the next few days my sleep was light and disrupted. When my daughter had some dental work done, she had a racing heart and anxiety while in the chair due to the epinephrine.

 

The endo's office staff said that without the epinephrine, they have to give me more of the numbing agent and sometimes it wears off much quicker.

 

So now I am scared and don't know what to do. 

 

Tell me what to expect, and please give me feedback about the epinephrine.

 

UPDATE:

 

I was a nervous wreck! But I think it went as well as could be expected. 

 

I had never met the endodontist before, and he turned out to be kind, gentle, and proactive in giving thorough explanations. I was so reassured.

 

I did not do the epinephrine, and it was fine. Early in the procedure I had a few little sparks that felt almost like a tiny electric shock. The doctor immediately gave more of the numbing agent, and there were not further issues. This was really not traumatic.

 

The procedure itself went quite a bit longer than planned. Apparently I must have a high pain tolerance, because when he opened up the tooth he was astounded at the amount of inflammation and icky stuff. He later said he would have expected me to be in agony.

 

I listened to Les Mis during the procedure, which helped a great deal.

 

I am so glad it's done. My jaw is sore, but my tooth pain is gone.

 

Thanks for your kind replies.

Edited April 8, 2017 by Harriet Vane

[unsinkable]

Well, if it is an endo, I'd assume she's competent and quick, bc she does a ton of RCs. So that's good.

 

I'd ask how long the numbing agent will last, and how long the procedure will last and ask what the plan is if the numbing agent wears off before she's done.

 

:grouphug:

[Arcadia]

The endo's office staff said that without the epinephrine, they have to give me more of the numbing agent and sometimes it wears off much quicker.

My DS11 was given just the numbing agent and they keep reapplying but his RCT was for a baby molar. For my RCT when I was 14, they gave a local anesthesia. We just went on a liquid diet for two days for convenience as the spot was sore and numb. There are many choices though and googling gave me these from a dentist webpage.

 

"Local anesthetic - Mepivicaine without Epinephrine

This is used for patients with high blood pressure or glaucoma, pregnant women, patients taking medicines that interact with epinephrine, and patients with a known sensitivity to epinephrine. This anesthetic is not as long acting as that with epinephrine, but does not raise blood pressure or cause epinephrine side effects.

 

Local anesthetic - Marcaine

This is a very long lasting local anesthetic, used primarily to provide sustained pain relief after extractions or surgery. It may last about twelve hours after administration." http://drkayes.com/dental_topics/anesthesia/

[rjand6more]

Epi is what keeps the anesthetic working.  Yes, depending on the procedure, it may wear off before the procedure is done.  Honestly, I would not want that to happen during a root canal.

 

That said, since you are seeing an endo, I am sure the procedure will be pretty fast if it's a front tooth especially).  So, your choice.

 

As far as the actual root canal...nothing to worry about.

[JudoMom]

When I was pregnant, I had to get a filling.  The dentist called my obgyn, and the obgyn preferred something to be left out of the numbing agent.  I googled, and I'm guessing it was the epinephrine.
 

I wouldn't do that again, especially for a root canal.  The numbing agent didn't last and they had to keep giving me more during the procedure, only they only knew when to give me more after I felt pain.  

I've had root canals, and they weren't a big deal because I was totally numb.

Edited April 6, 2017 by JudoMom

[PeterPan]

Wow, I had no clue the one I had involved epinephrine. You might call around and see if that's the norm everywhere. Is this a referral from your regular dentist? You might call your regular dentist and just ask. 

 

Mine was really fast, like xray at the regular dentist, cross the street, boom. I had pain and they just did it. Yes about the endo. Like they've got the whole gig. If you have earplugs, take 'em and take a nap. My dh was traumatized, lol, while I just took a nap. 

 

I don't recall feeling springy afterward. I really don't know about the epinephrine. I'm sure they want you out, way out, of pain. It's a very precise gig. It didn't hurt, but it's really precise. I wouldn't have wanted to hear it or see it.

[katilac]

If she offers laughing gas, that will offset the epinephrine! 

 

I've had entirely too many root canals, and they aren't bad at all. The worst part is having your mouth held open if it's a lengthy one. However, there is no way I would alter the usual numbing procedure. Stimulants might disturb your sleep, but so will having your meds wear off during a root canal. 

 

 

Edited April 6, 2017 by katilac

[PeterPan]

Are the agents premixed or can they lower the epinephrine dose?

[J-rap]

Don't worry about it.  Talk to the endo when you get there.  You'll come up with the best solution together.

[Ailaena]

I also had epinephrine-free numbing and between accessory nerves and what was apparently an exceptionally long time to numb up, endo eventually ended up directly numbing nerve inside tooth. Like, literally shot lidocaine (or whatever they use now) into tooth. 2 seconds of pain with that and then everything was fine.

 

Except my extreme guilt at needing a root canal, but I guess an endodontist can't numb feelings?

 

 

 

Eta: for me, the lack of epinephrine was to avoid potential heart issues. Using it is pretty standard

Edited April 6, 2017 by Ailaena

[Tap]

If the one without epi starts to wear off....they can just give you another shot of it.   I metabolize pain meds at about 2x the speed of a normal person.  They Always have to give me additional shots during the procedure to get, and keep me numb.  I'm not bothered by shots, so it isn't a big deal to me.  Especially since I am half numb from the first shots, the subsequent ones are pretty much nothing. 

 

The epi makes me feel really uncomfortable for about 5 minutes  (heart races, legs bother me, etc) but I know what it is feels like, so I can mentally excuse the discomfort.  If you are worried about it, then just insist that you don't want it.  There are other options. 

[AimeeM]

Well, if it is an endo, I'd assume she's competent and quick, bc she does a ton of RCs. So that's good.

 

I'd ask how long the numbing agent will last, and how long the procedure will last and ask what the plan is if the numbing agent wears off before she's done.

 

:grouphug:

While generally I agree, there are times the Endo "gets in there" and there is more to be done than originally thought, or it needs to be done in a different way. I have a great Endo, and have had over a half dozen RCs over the years. My Endo is very competent, but not always quick. I'd prefer slow, steady, and thorough to quick, though :)

 

OP, please relay to the Endo -- prior to the procedure (as soon as you're in the chair) -- that you may need more numbing agent, and please tell him/her that you're nervous. I do -- frequently -- and my Endo simply stops the procedure, gives me more numbing agent, lets it set in for a few minutes, and starts back up again. No sweat.

Edited April 6, 2017 by AimeeM

[Catwoman]

I had a root canal without the epinephrine and I was worried about it beforehand, too. Google was not my friend. :glare:

 

It turned out fine. I'm pretty sure the dentist gave me an extra shot of the numbing agent part way through the procedure, but I was already numb so I didn't even feel that needle. I guess he gave it to me as a precaution. It was really no problem at all.

 

Try not to worry. Root canals sound a lot scarier than they really are. :grouphug:

[hellen]

The endo doesn't want you to feel pain. I've had several root canals. Regular dentists have a tough time getting me numb but the endos have special powers. Root canals are my least painful dental procedures.

[housemouse]

You can have it numbed with lidocaine with without epi. My root canal doc gives me 2 carpules of that stuff and I am good for 4 hours. The goal is to find something that will last at least 2 hours for the procedure.  And if it hurts, tell them. If it makes you feel better by knowing what is going on, ask your endo if he would tell you what he is doing as he is doing it. Sometimes knowing makes it better than now knowing and guessing. Also knowing when you are half way through the procedure helps too.  On a side note, if have a tendency to have jaw pain/issues ask your doc to put in extra support for your jaw (plastic support looking thingy)- it we be way less pain for you later. Good luck.

[rjand6more]

You can have it numbed with lidocaine with without epi. My root canal doc gives me 2 carpules of that stuff and I am good for 4 hours. The goal is to find something that will last at least 2 hours for the procedure.  And if it hurts, tell them. If it makes you feel better by knowing what is going on, ask your endo if he would tell you what he is doing as he is doing it. Sometimes knowing makes it better than now knowing and guessing. Also knowing when you are half way through the procedure helps too.  On a side note, if have a tendency to have jaw pain/issues ask your doc to put in extra support for your jaw (plastic support looking thingy)- it we be way less pain for you later. Good luck.

Unfortunately everybody metabolizes differently.  There is no way to accurately predict the amount of time it will take to start to lose numbness unless you know from personal history.  But, all you have to do is ask to stop if you feel anything.  They are more than happy to accommodate that.  And more than happy to give more anesthetic.

[Rachel]

My endo was going to do my root canal without epinephrine but I was having too much pain. It had sort of a delayed effect and then I felt extremely jittery for about 5 minutes, I can't even explain how jittery. Then I was fine. I don't know that I'm especially sensitive to pain meds though.

 

As far as the actual root canal, I wish I had gotten it about two months earlier. I felt so much better afterward.

[Anne in CA]

I have no advice, I just feel for you being scared before a medical procedure so I wanted to tell you I'm sorry. Wishing you the best!

[Tammi K]

I always use a numbing agent without epi due to an allergy.  I've had two root canals that way.  I didn't have a problem with pain caused by the meds wearing off. The root canal procedure was fairly quick.  I believe one time I needed a top-up but pain wasn't a problem.  However, there was more bleeding without the epi which caused the dentist some aggravation.  It made his job a bit harder but it was all the same from my side of the chair.

 

I think you should be fine.  Wishing you the best.

[Rachel]

I always have to have without epi also, and it's fine. Just raise your hand to let them know if you start feeling anything, and they'll top you off. The subsequent shots don't hurt at all, because you're still mostly numb. Fwiw, I have found the crown part of the procedure worse, so if you were fine with that part, you should be fine. I was far more freaked out by what I had heard about root canals than the reality warranted. I'm sorry you're experiencing the worry right now, though!

I have to agree with this, the crown was definitely worse than the root canal.

[gaillardia]

:grouphug: Yes, they sound a lot worse than they really are, I agree. I had one, or was it two? I don't have any problems with the epinephrine, as far as I know.

I hope you don't worry, can relax, and just get it done quickly. (I always have to remind myself to relax my grip or relax my shoulders). 

[Scarlett]

In my 20s I had a bad reaction to epi. Never again. It is in my charts. Now with my racing heart I feel there is a connection.

 

They just have to give you more numbing if they don't finish quickly. And I always get laughing gas now.

[unsinkable]

I'm Praying all goes smoothly, HV!

 

Let us know when you're done.

 

:grouphug:

[bethben]

Can you drive after a root canal? I may have to get one done next week. It's my first crown or anything involved like this.

 

 

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[alisoncooks]

Can you drive after a root canal? I may have to get one done next week. It's my first crown or anything involved like this.

 

 

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I drove myself home.  I had mine a year ago.

 

 

I found having an iPod with soothing music very helpful.  I had to keep it low enough to communicate with the dentist, but it helped having it running in the background...

[vonfirmath]

Whoa. Is the epinephrine used for root canals related to the epi given when in labor? Because I had a bad reaction to that during my last birth (my oxygen dropped such that I was continuously monitored until the baby was born and they recommended I not get one again).  Maybe I should mention that to my dentist just in case.

[kitten18]

Can you drive after a root canal? I may have to get one done next week. It's my first crown or anything involved like this.

 

 

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Yes, it's just a local numbing. My root canals were exactly like having a filling they just take a lot longer.

[AmandaVT]

I drove myself home.  I had mine a year ago.

 

 

I found having an iPod with soothing music very helpful.  I had to keep it low enough to communicate with the dentist, but it helped having it running in the background...

 

I drove myself there and back for both of my root canals. It was fine. 

 

For my first one, I listened to an audiobook and that helped a lot. My second one was just a few months ago and the endo and his assistant were listening to Jim Croce radio on Pandora and were singing along. Their banter back and forth was cracking me up as well - all in all, they went out of their way to make it a very relaxing process. 

 

I agree very much with whoever said that Endos have magic powers. My root canals were done by two different Dr's and each time, I had less discomfort than when getting a cavity filled. It's also a gentler process, IMO. 

 

Good luck today Harriet Vane!!

[alisoncooks]

I will add, I had a huge dental phobia for most of my childhood...which carried over into my young adulthood. After I had kids, I avoided the dentist for almost a decade :o and only went in because I broke a molar. My root canal was my baptism by fire, my first splash back into the dental world (I've since had MANY visits in the past two years to repair damage). Anyway, all that to say: I was terrified of the root canal but it wasn't as bad as I feared. Mindful breathing helped.