Dentist
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Dentist
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AnonymousApril 5, 2010 at 10:39 am
I have not had to have dental work done since I had “mild” GBS. I have heard that this can cause relapses or problems. I had to have some minor work done (a filling fixed) so I imagine the dentist will just use Novocaine or a local numbing agent. Should I be concerned about this? One member suggested telling the dentist to use the kind that they use on MS patients. Any advice?
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AnonymousApril 5, 2010 at 12:48 pm
Dear Jessicah,
Most dentist use Lidocaine. Immune-mediated inflammatory neurological disorders are characterized by demyelination, axonal damage and the occurrence of soluble anti-excitatory factors in serum or cerebrospinal fluid (CSF). A combination of these three pathological changes may be the cause of impaired axonal impulse conduction and neurological symptoms. Evidence of a sodium-channel-blocking factor [i.e. Lidocaine] is based on the investigation of CSF from many patients with multiple sclerosis (MS), Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP).
See [url]http://www.nature.com/nm/journal/v6/n7/full/nm0700_808.html[/url]
You can log in and read more at this link which I recommend you do.
You should print the article and give it to your [B][U]dentist[/U][/B] and neurologist.
Best regards.
Jethro
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Jessica,
We have no choice when Kev gets an ingrown toe nail episode, we get 3 shots in the toe. In addition, when we had the port we had twighlight but lidocaine as a local in the incision area. When you had your spinal they used lidocaine as well. If you search the archives you will find info on it, there were many threads on it. I too was freaked out because of reading the info but what else could we do. If there is another option obviously try it. I am not looking forward to wisdom tooth extraction for Kev. -
AnonymousApril 5, 2010 at 4:34 pm
Jessicah,
I had a root canal and a crown done a year after I had GBS the second time. I found out the type of anesthetic I needed -it is the kind that does not last as long as the other one. I could call the endodontist if you need to know before May 13 when I go back to my regular dentist for a cleaning. I prayed and crossed my fingers the whole time I had the root canal. After an hour and a half,the endodontist said I would have to come back for a second session!! I panicked…go through this again??? It was a molar…why didn’t he tell me this was a possibiity when I made the appt. I had to rent a car and drive over an hour to get there. But the worst part was worrying if it would exacerbate the GBS. Plus I do not have friends or relatives up here is PA. That makes a big difference in dealing with it. GBS has wounded us physically emotionally, and spiritually. Since you had a mild case of GBS, I bet you will be okay…
I had a root canal dentist in Tampa who looked just like a younger Tom Sellick, wore saddle shoes, dressed like a preppy, and was so gentle… -
Duh, I forgot to include that nothing happened. When you had your spinal, did you feel like things got worse? I don’t remember the exact drug, but I asked the podiatrist/orthopedic doc when he did the toes about the lidocaine and he said it was an older drug that had lidocaine in it, but that it was the part that was not lidocaine. We have had at least a dozen lidocaines with no problems. If money is not an issue maybe you could go to an oral surgeon and get the twighlight, or gas is another option. Good luck!
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AnonymousApril 6, 2010 at 10:26 am
Thank you all. I talked to my dentist yesterday and he said that he has 3 kinds of anesthetics, and he has used the strongest one on MS patients with no problems, but he has 2 others, less strong, one he uses on pregnant patients. I will let him know what Jethro said and we will see. My hubby said, maybe you could do it without any numbing agent, and I said, very funny!
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AnonymousApril 6, 2010 at 11:35 am
Jessicah,
In addition to the above, here is another web link with the information from the link:
[url]http://www.nature.com/cgi-taf/DynaPage.taf?file=//nm/journal/v6/n7/abs/nm0700_808.html&filetype=[/url]
Article
Nature Medicine 6, 808 – 811 (2000)
doi:10.1038/77543An endogenous pentapeptide acting as a sodium channel blocker in inflammatory autoimmune disorders of the central nervous system
Heinrich Brinkmeier, Peter Aulkemeyer, Kurt H. Wollinsky & Reinhardt RüdelDepartment of General Physiology, University of Ulm , D-89069 Ulm, Germany
Department of Anaesthesiology and Intensive Care, Rehabilitation Hospital Ulm, Oberer Eselsberg, D-89081 Ulm, Germany
Correspondence should be addressed to Reinhardt Rüdel [email]reinhardt.rudel@medizin.uni-ulm.de[/email]
Reversible blockade of sodium channels by endogenous substances has been claimed to account for the fast exacerbations and relapses commonly seen in demyelinating autoimmune diseases. Evidence has been provided that in the cerebrospinal fluid of patients with multiple sclerosis or Guillain-Barré syndrome, a sodium-channel-blocking factor exists that has properties of local anesthetic agents. This factor could contribute to the nerve conduction block and paresis seen in these disorders. We describe here a previously unknown endogenous substance in human cerebrospinal fluid with distinct channel-blocking properties even at very low (0.00001 M) concentrations. The pentapeptide with the sequence Gln-Tyr-Asn-Ala-Asp exerted its blocking action by shifting the steady-state inactivation curve of the sodium channels to more-negative potentials, as most local anesthetics do. In the cerebrospinal fluid of healthy individuals, its concentration was about 3uM, whereas in patients with multiple sclerosis and Guillain-Barré syndrome, it increased 300−1,400%. At these concentrations, the peptide’s blocking efficacy was higher than that of 50uM lidocaine. At a concentration of 10uM, lidocaine is able to ‘unmask’ subclinical lesions in multiple sclerosis; thus, the endogenous pentapeptide may well contribute to the fast changes of symptoms. Furthermore, it may become valuable as a marker of disease activity.
Best regards.
Jethro
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AnonymousApril 7, 2010 at 12:54 pm
I showed the information that Jethro posted to my dentist today and he did use a different numbing agent, a milder one, and put a note in my chart. He understood the abstract and what Jethro said about no vasopressors. I wasn’t taking any more chances with having more problems so this was very helpful! Thanks!
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