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Original poster

DS9 almost passing out after local injection at dentist?!?!

24 replies

coffeeandcakeage · 20/10/2021 18:21

Any dentists around, or anyone who's had a similar experience...?

9yo DS needs a tooth extraction. We have an NHS dentist who, to be polite, is the reason people have dental phobias. I appreciate NHS dentists are like gold-dust, and he's the only one at the practice we are registered at.

So...

First appointment for the extraction, DS had the local anaesthetic injection and whilst we were in the waiting room he complained of feeling dizzy. Within seconds he went completely pale and his eyes were rolling back in his head - I shouted for help and the nurse brought some glucose water, which seemed to help stabilise him and he was steady enough on his feet to get him home (although a bit washed out for the rest of the day).

I spoke to the clinic the next morning and they said it was likely a reaction to the adrenaline in the anaesthetic. They updated his notes and in future an injection with adrenaline would be given.

We arranged another appointment for this afternoon (1 week later). Double checked with the dentist that his notes said he needed an injection without anaesthetic. All good. However, exactly the same thing happened again.

He wasn't anxious or worried about the extraction (in fact, he was happy about finally getting rid of the troublesome tooth). Dentist has said the only option is to refer him to the local hospital for removal under general anaesthetic, which I'm not super-keen on.

So, I guess my question is this.... is it possible the dentist has somehow given too much anaesthetic, perhaps a time-pressure thing? Rather than giving the dose gradually, he just injected as much as possible, causing system overload? I'm hovering whether to ask for an official investigation; my son is taking it in his stride, but I'm actually really shaken.

I also want to know whether it's worth seeing a private dentist who may not have the same time constraints and will be a bit more gentle??

OP posts:

ThirdElephant · 20/10/2021 18:23

TBH I think it's probably best to let the hospital handle it.

Morgantowers · 20/10/2021 18:26

Go to hospital or find another dentist.

Fluffyowl00 · 20/10/2021 18:28

I had this, it was due to low blood pressure. I now have the LA without adrenaline.

Does he often feel dizzy or tired/faint in the afternoon?

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Dental health

Hellocatshome · 20/10/2021 18:31

Let them do it under general they are coming round almost before they are under its that quick.

DamnUserName21 · 20/10/2021 18:31

Could be syncope (fainting), not caused by the drug but the pain and fear. Common in teenagers being vaccinated

www.cdc.gov/vaccinesafety/concerns/fainting.html

Peridotty · 20/10/2021 18:42

Dentist here. Highly unlikely they gave him too much anaesthetic. For an adult I can give 10-14 cartridges as a maximum for example. It is likely that the shock of the injection made him faint or perhaps it was the adrenaline in the anaesthetic that made him feel dizzy. The adrenaline can do that if it accidentally goes into an artery. In my 10 years of practicing I have had 2 patients faint after an injection (one went into an epileptic seizure).
If he isn’t phobic then he doesn’t need sedation.

Peridotty · 20/10/2021 18:43

Oh and they said they fainted because of the fear and shock of the injection.

Original poster

coffeeandcakeage · 20/10/2021 19:06

Thanks so much everyone.

@Peridotty that's reassuring to know re the max dose.

Reading more about syncope, it sounds very much like that. Even though he wasn't visibly nervous, perhaps he tensed up during the process and then started hyperventilating.

Looks like the hospital referral may be the best way forward.

OP posts:

CarrotSticks23 · 20/10/2021 19:20

Hi OP. It's quite normal for someone to feel faint after an injection. Especially children/teenagers. Often a sugar drink and a lie down and they are fine. Has no one ever asked you if your a fainter prior to blood tests or injections?

Often people tense up, and hold their breath while the injection is being given. As a result they feel faint. He probably is at least a bit nervous, he's 9 and he's having an extraction. Is he having a proper breakfast with a sugary drink before hand? The fact the glucose made him feel better suggests it was a simple faint.

Its unlikely he used too much anaesthetic, and whilst often the adrenaline can make people feel dizzy or like their heart is racing it doesn't mean it needs avoiding in the future. I don't think he needs sedation or a GA, just maybe a more reassuring hand?

MissCreeAnt · 20/10/2021 19:23

@Peridotty

Dentist here. Highly unlikely they gave him too much anaesthetic. For an adult I can give 10-14 cartridges as a maximum for example. It is likely that the shock of the injection made him faint or perhaps it was the adrenaline in the anaesthetic that made him feel dizzy. The adrenaline can do that if it accidentally goes into an artery. In my 10 years of practicing I have had 2 patients faint after an injection (one went into an epileptic seizure). If he isn’t phobic then he doesn’t need sedation.

Peridotty can I ask what that would feel like to the patient, apart from the fainting? I had a horrific experience at the dentist and as a result haven't been back for years. I assume it was just me being silly and panicking but I do remember feeling the anaesthetic flowing in a branching pattern as it went in.

OP your poor son, I can really relate.

Original poster

coffeeandcakeage · 20/10/2021 19:29

@MissCreeAnt sorry to hear you've been through similar.

I'm also afraid of giving him a lifelong phobia of dentists, having gone through this twice now and each time me reassuring him it's a simple 2 min procedure and he'll be done...

OP posts:

CarrotSticks23 · 20/10/2021 19:34

What is he eating before OP? I always tell my prone to fainting patients to have some lucozade prior their procedure

Original poster

coffeeandcakeage · 20/10/2021 19:38

@CarrotSticks23

What is he eating before OP? I always tell my prone to fainting patients to have some lucozade prior their procedure

@CarrotSticks23 he had a light lunch (sandwich) and I gave him a flapjack after school before we headed out. Maybe not substantial enough...

Good tip on the Lucozade!

OP posts:

Greybeardy · 20/10/2021 19:43

The adrenaline suggestion was completely reasonable after the first attempt. What you’ve described doesn’t sound like a typical local anaesthetic toxicity presentation, and a reaction bad enough to cause cardiovascular symptoms would usually require proper medical treatment. Also doesn’t sound typical for an allergic reaction. Simple fainting (vasovagal syncope) isn’t at all unreasonable as a suggestion.

Referral to the hospital setting seems reasonable doesn’t it?….either for another bash with local if they felt that was appropriate (with the reassurance of cardiovascular monitoring and access to anaesthetists and paediatricians should it all get stressful again), or for GA. Extractions under GA are common and generally not something particularly to worry about. I imagine that managing an unwell child in the community setting might be a risk the dentist quite reasonably wouldn’t be keen to keep taking. (DOI: anaesthetist)

Peridotty · 20/10/2021 19:47

To add to what @CarrotSticks23 said, it’s likely that he doesn’t have to avoid adrenaline in the anaesthetic in the future (unless he has certain heart conditions). The adrenaline actually helps the anaesthetic to be more effective and therefore require a lower dose overall. And agree with the sugary drink! Before an extraction I will always ask my patient if they are or drank before otherwise they are more likely to faint in my chair!

@MissCreeAnt
Sorry to hear it happened to you! For many patients they might feel like their heart is racing after the anesthetic. For my patient who fainted, they went all dizzy first and then they wanted to get up and they were panicking, they got up even though I told them to stay seated and they passed out on me. Called the ambulance who came and they gave him oxygen and then he felt better and went home.
The patient who fainted and had the seizure, it was a bit alarming but it can happen. I let him fit and then lay him down, I don’t think he remembered much when he came round.

Peridotty · 20/10/2021 19:53

I would advise to try another dentist? They sound like they are overbooked if they have to send your son out to the waiting room between patients. It would be much better for him to have it and then stay lying in the chair rather than getting up and going to the waiting room. Finding a good dentist is worth it because you would be preventing dental phobias in the future. For GA you could go down that route or how about nitrous oxide sedation if he is nervous? Fewer risks with sedation. If he isn’t nervous then I would suggest changing dentists to one who can take a bit more time.

20viona · 20/10/2021 19:59

Nothing to do with too much anaesthetic. I'm a dental nurse in a hospital and I'd say this happens at least twice a week to our patients. He will be ok, sometimes patients being seen at the hospital just reassures them a little and maybe he won't need a general.

LemonLymanDotCom · 20/10/2021 20:01

I once had to have a procedure where it was the dental nurse who was passing out, at the sight of ME getting the injection. I ended up having to prop up the nurse with one hand while I was being injected in the other (was sedation, not LA). It was a 2nd attempt too, she already felt woozy at the 1st attempt, the dentist gave it 5 minutes and hoped she'd be ok for a 2nd go... She wasn't.

Not sure it was the career for her TBH

popapoppadum · 20/10/2021 20:05

I had this exactly when I was probably a similar age to your son. Went all clammy and nearly passed out in the waiting room waiting for the anaesthetic to kick in for an extraction. It's never happened since with any jabs for fillings etc but I do often faint when having blood taken. Could be low blood pressure related maybe?

Artichokepiglet · 20/10/2021 20:12

I suffer from vasovagal syncope and that sounds very similar to what I experience. It's weird because I don't consider myself scared of injections or blood tests either and that's something I've struggled to explain to nurses when I've had to warn them I might faint.

NapoleonOzmolysis · 20/10/2021 20:13

I only have 20 adult teeth - the rest, along with lots of baby teeth, were pulled out. Fainted at every single extraction, the dentist would get someone in to pin me to the chair and look upon it as a general anaesthetic. Came to a few times to her knee on my chest as she pulled. Ahh the good old 1980s. I also pass out at blood tests and other stuff like that - proper flapping around passing out. It's thought to be low blood pressure related. Has he ever fainted at anything else?

savagebaggagemaster · 20/10/2021 20:28

I had a horrible experience with my heart racing uncontrollably the last time I had an anaesthetic at the dentist (both upper and lower right hand sides were injected) I panicked and really felt like I wanted to jump out of the chair and run out of the room, but the feeling passed. The dentist told me it was due to the adrenaline in the injection.
I'd never had that reaction to the anaesthetic before and now I'm a bit worried it could happen again in future!

MissCreeAnt · 21/10/2021 08:46

Thank you @Peridotty and OP. I would take the hospital option on the strength of what people have said here, too.

junebirthdaygirl · 21/10/2021 08:59

@savagebaggagemaster

I had a horrible experience with my heart racing uncontrollably the last time I had an anaesthetic at the dentist (both upper and lower right hand sides were injected) I panicked and really felt like I wanted to jump out of the chair and run out of the room, but the feeling passed. The dentist told me it was due to the adrenaline in the injection. I'd never had that reaction to the anaesthetic before and now I'm a bit worried it could happen again in future!

I had this too and the dentist calmly explained some of the injection had entered my bloodstream and the sensation would soon pass and it did. Hearing him be so blasé about it helped Mr. It never happened afterwards as l had a few treatments. So not necessarily going to happen again. My adult friend frequently faints at the dentist as she is prone to fainting . She continues to go and her dentist is very patient with her. Op l am sure it was just a reaction to the whole experience for your boy.

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