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Dental Anesthesia

Dizziness from novacaine injections

11/04/2008

Question:

I had and appointment to have my tooth extracted. I as a little anxious because I have been in pain, but nothing out of the ordinary. I had injections without epinephrine because I had a bad reaction to it last time. This time I had the same reaction. I got dizzy after just two injections. The room was spinning. I couldn`t focus on anything. Everything was blurry. My blood pressure rose to 154/90 and my heart was racing. I was not able to have my tooth pulled. My husband had to be called cause I couldn`t drive. I felt like fainting even after resting for quite some time. I got home and fell asleep for 2 hours and felt better once the novacaine wore off. Now I don`t know what to do. I still have to have the tooth pulled but I don`t know what kind of anesthesia to use. I`m scared.

Answer:

This is most likely an anxiety reaction, as I suspect your dentist told you. This is not an "allergy" to local anesthetic. Your vital signs suggest that you were pre-syncopal, that is, just about to faint. In fact, depending on when your vital signs were taken, they may have indicated a near fainting episode.

Fortunately, the solution is rather simple. You will need some form of sedation to reduce your anxiety prior to the dental procedure. This can take many forms. Probably the most common is nitrous oxide (laughing gas), which works very well for most people. It is breathed in via a special nose piece and has the added advantage of very rapid onset and rapid wake up. You should be able to drive yourself home after having it.

Another option is an oral sedative, usually a drug in the Valium family. This can also be very helpful but you will need someone to drive you to and from the appointment. IV sedation can also be provided but this requires specialized training and a special permit. Your dentist may not have this.

You may also work with your dentist to have a dentist anesthesiologist come to office. He or she can provide any level of sedation as well as general anesthesia if you need to be completely asleep to have the dental treatment provided in the most comfort. A dentist anesthesiologist can be found at www.asdahq.org. Discuss these options with your dentist to determine what is the best avenue for you to pursue.

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Response by:

Steven I Ganzberg, SB, DMD, MS Steven I Ganzberg, SB, DMD, MS
Formerly, Clinical Professor of Dentistry
College of Dentistry
The Ohio State University