MEDICAL MATTERS
- Medical Matters features questions asked by Members of the ME Association on health-related topics.
- Dr Charles Shepherd and the ME Association's other advisers answer these questions by sharing their expert knowledge.
- Medical Matters is based on the popular ‘Ask the Doctor’ series in ME Essential magazine.
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Questions in the Category: Dental Hygiene
Dental: Anaesthetics
My dentist has told me about a drug in regular use as a local anaesthetic in dentistry, which is stronger than Citanest, called Mepivacane. I need a lower molar removed and would feel more comfortable with it should the need arise. I occasionally suffer from palpitations so wish to avoid adrenaline if possible. What is your opinion of the relative merits of these anaesthetics for someone with ME/CFS?
Dental: Pain
I’m very prone to pain in my teeth. When I mentioned this to my OT she said that she hadn’t heard of that before as an ME/CFS symptom but could be connected to the central nervous system. My dentist tends to say that if there was a problem it would be obvious in a particular tooth or it could be tooth grinding especially at night. I don’t feel it is this as I tend to sleep with my mouth open and I don’t wake up with pain usually but it will come on during the day. Symptoms are varied ranging from a general tension and pressure, generalised aching pain in either the top or bottom teeth, or throbbing pain in certain teeth. The deep throbbing does tend to be in “ vulnerable “ teeth i.e. ones with deep fillings.
Sometimes I will get a very bad pain e.g. back molar on right lower side then the exact same tooth throbs on the other side. Of course I realise I need to discuss this again with my dentist at the next check up. However, I wondered if people with ME/CFS are more susceptible to tooth pain generally? Have even wondered if it’s stress? It’s been particularly bad these last few months and I can’t say I’ve been any more stressed than usual!
Symptom: Mouth Ulcers
Is there any connection between recurrent mouth ulcers and ME? I have always had them since childhood and have been told that they can be stress-related, and that there is no underlying infection present.
Last year I had quite a few nasty mouth ulcers and was prescribed antibiotics because I had a secondary infection in the ulcers. Since then the ulcers have become more regular and persistent.
Dr Charles Shepherd
Dr Shepherd has been Trustee and Hon. Medical Adviser to the ME Association for more than 40 years. He is integral to the charity's activities and provides information and support based on his professional knowledge, personal experience as a doctor with ME/CFS, and the understanding gained from helping many thousands of people with the condition. He was a member of the comittee responsible for the 2021 NICE Clinical Guideline and is a recognised expert on ME/CFS in the UK. His knowledge extends to Post-Viral Fatigue Syndromes (PVFS), Myalgic Encephalopathy/Encephalomyelitis (ME), Chronic Fatigue Syndrome (CFS), and Post-Acute Sequelae of SARS-CoV-2 infection (PASC) or Long Covid.
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Medical Matters is based on the popular ‘Ask the Doctor‘ series featured in the highly-regarded member’s magazine, ME Essential, and in the healthcare professional magazine, ME Medical. Both are produced by the ME Association and published as hard-copy magazines every 3 months and sent to members and healthcare professionals by post to home or business addresses.
If you are an HCP you can sign-up here to receive ME Medical magazine (people with ME/CFS can also nominate their HCP by completing the sign-up form).