CRPS patients and dentist appointments

Many patients ask for advice about what they should say to the dentist about their CRPS. Some dentists have come across patients with neuropathic pain, but may not be familiar with the extent of involvement of the central and autonomic nervous systems in CRPS. Or of the possibility of CRPS spread after dental treatment without sensible precautions.

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So here’s a list of helpful tips for you and your dentist to reduce the nervous system response to treatment…..

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– Relax the central nervous system beforehand if possible (e.g. laughing gas)

– DO NOT use anaesthetic with adrenaline/epinephrine in it (because our ‘fight or flight’ is wacky enough already, making it even worse is to be avoided)

– You may require more anaesthetic than our healthier counterparts out there. Particularly if you are also hypermobile, ‘double jointed’ or have been diagnosed with Ehlers Danlos Syndrome (EDS). (The absorption of local anaesthetics can vary from the ‘norm’)

– Limit treatment sessions to 15-20 minutes (to help the body calm down and recover afterwards in a more timely manner and to avoid any long-lasting issues)

– The dentist should also give you another dose of the local anaesthetic before you leave (to give your nervous system longer to calm down before any resulting discomfort kicks in)

– Ask the dentist to write this information on your medical notes so that you do not have to remember to tell him/her every time you visit them

– After any invasive treatment it is helpful to take vitamin C for 2-3 weeks, 500-1000mg per day (to help the nerves to recover) NB: the body can only absorb up to 500mg in one go

– Set aside time after the appointment to rest and recuperate. (It is important to allow the nervous system to calm down and to keep it calm, if possible give yourself a rest day the next day as well)

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These are tips and suggestions founded in the scientific understanding of CRPS. Some are more crucial than others, but all are worth doing if at all possible. For example, my dentist does not do the calming of the central nervous system first, but then again I’m pretty good at calming myself anyway. I always insist on non-adrenaline (non-epinephrine) anaesthetics as the effect on my heart rate and near-syncope (near-fainting) is pronounced. And a good dentist should always ask you if an area is sufficiently numb anyway. Once the dentist knows about these things then they should become the norm whenever you go in for treatment, including the post-treatment anaesthetic and just doing one thing per visit (unless you’ve both agreed otherwise for good reason and with counter-measures in place, of course). A good dentist is worth a lifetime’s tea! (Well, maybe a month or two, not sure I could give up tea for life!) 😉

If you’re just going for a check-up.. the extent to which you need to do the above will vary per patient. For some people these are still important, for others just keeping calm and resting afterwards is enough. Discuss your issues with your dentist and choose what works for you for check-ups.

So there you go, some tips for CRPS dentist appointments. I really hope that this helps.

Much love from me,

x

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An NHS link you can show your dentist re hypermobility and anaesthetics not working so well is here.
(This link courtesy of my fellow blogger the Hypermobile Hobbit, x)