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We know how daunting dental treatment can be. Our Dental Phobia certified experts are here to help ease your mind before treatment by answering your questions.

Am I allergic to adrenaline based injections?

Local anaesthesia containing adrenalin sets off an instant (3 seconds after injection) tachycardia and rise in BP -which my dentist has said cannot be a systemic reaction to the adrenalin. It calms after a few minutes and I understand why all the dentists I have discussed it with say it is anxiety related not physiological. However injections NOT containing adrenaline -straight lignocaine- do not have this effect yet I know they are less effective and so should cause me more anxiety -but I get no cardiac response to them whatsoever. This is following a tachycardia caused by other health problems including a diagnosis of slight sympathetic system overreactivity in autonomic tests and I take anti arrhythmic medication. Prior to that I was fine with adrenaline based injections. Is there a logical physiological explanation for this?

This is a difficult one to answer .
Some people react adversely to adrenalin in local anaesthetics after a dental injection is given which nicks a blood vessel and the adrenaline stimulates the heart and causes palpitations; this is quite unpleasant but harmless .
Often this then creates a cycle of happening every time due to your body producing more ‘fight or flight ‘ adrenalin .
Im curious how you know that your blood pressure rise is instant without blood pressure monitoring equipment ?
Just avoid adrenaline in locals at the dentist , other types can be less effective for some procedures , but if you have a large enough dose , and wait long enough , the risk of it not being effective diminishes .
I have occasionally had to top up this with a very low dose of adrenaline containing local for a tooth with a very inflamed nerve , using a special intra ligamentary technique , without causing a problem for the patient . Feeling pain will produce a lot of internal adrenaline .
Hope this helps .

Answer provided by: Dr Jennifer Pinder Retired
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