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Dental Anesthesia

Adverse reaction to novocaine + carbocaine

04/30/2007

Question:

During a dental procedure (crown), I had an adverse reaction to the novocaine + carbocaine injections I received. Partway through drilling, I experienced severe vertigo and had to be transported to the emergency room. The vertigo wore off about 2 hours after administration of the anesthesia. I am now sitting here with a halfway drilled tooth. The dentist is afraid to continue, because he doesn`t understand what happened.

He`s been practicing for 27 years and never saw anything like this before. Do you have any thoughts?

Answer:

Thank you for your question. It is not clear from your narrative that you experienced a reaction to local anesthesia. For instance, when you say that "partway" through the procedure you experienced the reaction, does this mean maybe 10 or 15 minutes after injection?

You use the colloquial term "Novocain" which is not used in dentistry anymore. More commonly, lidocaine with epinephrine is used, so I am not sure what anesthetics were used. Carbocaine is a brand name of mepivicaine, so were two different anesthetics used?

Also, the symptoms you describe of "vertigo" is I assume, an uncomfortable sense of spinning of either you or the room. Was there any pain that might have precipitated this reaction? If epinephrine was used in local anesthetics, when exactly were the injections in relationship to symptoms?

Also, I do not know your age or medical history which may also impact on the diagnosis. Although a possible reaction to local anesthetics, it is not clear that this is the problem. I would certainly consider obtaining a neurology and ENT evaluation to rule out another cause of your symptoms. I would hope your dentist, a dentist anesthesiologist, or maybe an oral surgeon could also help in the diagnosis.

I hope this helps.

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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