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Going to the Dentist with CRPS

This The following was written by Dr. Pradeep Chopra Going To The Dentist With CRPS - A printable version can be found here. Dental health is very important for those of us with CRPS as many of the medications that we take cause dry mouth. With reduced saliva, we are more at risk for decay. Biotine is very helpful for dry mouth. It comes in toothpaste, mouth wash and mouth spray. Personally I prefer the mouth spray. It can be found in the isle with toothbrushes. Cleanings: I try to schedule my teeth cleaning for just before a ketamine infusions. I ask my dentist to numb my gums with topical gel Be sure that your dentist knows that you have CRPS If you have ketamine troches or nasal spray use them before and after the appointment. Dental Work: Dental emergencies can not be predicted. Here are some things that you can do to minimize a flare/spread. Start Vit C 500 mg and continue for 2 weeks Ask your dentist to prescribe Minocycline to prevent infection and it has a pain fighting component As your dentist to numb your gums topically first Marcaine without epinephrine is the preferred numbing medication. If your physician doesn’t have Marcaine be sure   that the lidocaine that they have does not have epinephrine in it. They should give you more marcaine than they would another patient. If you already have face/mouth CRPS; ask for nitrous oxide (laughing gas) If you have ketamine troches or nasal spray use it before the visit and after as needed. Dental Surgery (tooth extraction) Many dentists have ketamine. Meet with the oral surgeon first. Ask them if they have ketamine and if they can use that to sedate you. It may be preferable for you to have the extraction done in an outpatient surgery center with an anesthesiologist. The anesthesia technique will vary with the surgery. These are general guidelines and the patients doctor should make their own decisions. Here are some guidelines: Avoid surgery unless you have to. Pre – operative 1. Start gabapentin or Lyrica a 2 weeks before 2. Minocycline 1 day before and continue for 2 weeks after 3. Vitamin C 500 mg one daily. Start day befure surgery and continue for 45 days after surgery Intra-operative 1. MUST use iv ketamine as part of anesthesia 2. Apply Synera patch or some numbing medicine patch over IV site before insertion of 3. IV must be inserted with minimum trauma (first shot) Post operative 1. Continue low dose IV ketamine in the recovery room for a few hours – very important 2. Continue, minocycline, gabapentin/Lyrica Copyrighted material. DO NOT COPY WITHOUT GIVING RECOGNITION TO THE AUTHOR DR PRADEEP CHOPRA
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© CRPScare 2014

Going to the Dentist with CRPS

This The following was written by Dr. Pradeep Chopra Going To The Dentist With CRPS - A printable version can be found here. Dental health is very important for those of us with CRPS as many of the medications that we take cause dry mouth. With reduced saliva, we are more at risk for decay. Biotine is very helpful for dry mouth. It comes in toothpaste, mouth wash and mouth spray. Personally I prefer the mouth spray. It can be found in the isle with toothbrushes. Cleanings: I try to schedule my teeth cleaning for just before a ketamine infusions. I ask my dentist to numb my gums with topical gel Be sure that your dentist knows that you have CRPS If you have ketamine troches or nasal spray use them before and after the appointment. Dental Work: Dental emergencies can not be predicted. Here are some things that you can do to minimize a flare/spread. Start Vit C 500 mg and continue for 2 weeks Ask your dentist to prescribe Minocycline to prevent infection and it has a pain fighting component As your dentist to numb your gums topically first Marcaine without epinephrine is the preferred numbing medication. If your physician doesn’t have Marcaine be sure   that the lidocaine that they have does not have epinephrine in it. They should give you more marcaine than they would another patient. If you already have face/mouth CRPS; ask for nitrous oxide (laughing gas) If you have ketamine troches or nasal spray use it before the visit and after as needed. Dental Surgery (tooth extraction) Many dentists have ketamine. Meet with the oral surgeon first. Ask them if they have ketamine and if they can use that to sedate you. It may be preferable for you to have the extraction done in an outpatient surgery center with an anesthesiologist. The anesthesia technique will vary with the surgery. These are general guidelines and the patients doctor should make their own decisions. Here are some guidelines: Avoid surgery unless you have to. Pre – operative 1. Start gabapentin or Lyrica a 2 weeks before 2. Minocycline 1 day before and continue for 2 weeks after 3. Vitamin C 500 mg one daily. Start day befure surgery and continue for 45 days after surgery Intra-operative 1. MUST use iv ketamine as part of anesthesia 2. Apply Synera patch or some numbing medicine patch over IV site before insertion of 3. IV must be inserted with minimum trauma (first shot) Post operative 1. Continue low dose IV ketamine in the recovery room for a few hours – very important 2. Continue, minocycline, gabapentin/Lyrica Copyrighted material. DO NOT COPY WITHOUT GIVING RECOGNITION TO THE AUTHOR DR PRADEEP CHOPRA
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