Believe it or not, some people have confused Charcot-Marie-Tooth disease with a problem with the teeth. It is not. Dr. Howard Tooth was a British physician who worked on identifying CMT the same time as Drs. Charcot and Marie so his name was added to the name of the disease.

Some of us do have problems with dentistry though mainly because we may not feel pain the same as everyone else (we may feel it more or less) or we have adverse reactions to the ingredients of dental freezing.

I'll quote the word of Dr. Daniel Haas, DDS, PhD, Assoc. Prof. Faculty of Dentistry (Dept. Of Anaesthesia) and Faculty of Medicine (Dept. Of Pharmacology) at the University of Toronto, Ontario, Canada - "Local anesthetic: Novocain is the trade name for the original synthetic local anesthetic, which at one time was commonly used. Over the past few decades, related drugs have been introduced which are slightly more effective with a lower chance of allergy. Due to their superior qualities, it is now rare to actually get true Novocain for local anesthesia for dentistry. You are much more likely to get a drug such as Xylocaine, Citanest or Carbocaine, to name only a few."

When asked if people with CMT are more predisposed to problems regarding anesthetics than the general population, Dr. Haas said there is no scientific evidence of this because the hypothesis has never been tested.

Epinephrine - "When you receive an injection of local anesthetic for dentistry there is a very good chance that epinephrine is included. Epinephrine is the same as adrenaline, the natural
hormone that is released during "fight or flight" scenarios. It can induce a great number of actions to help prepare the body for stressful situations. One of its affects is to make the heart beat more quickly.

Epinephrine is included in many local anesthetics as it constricts the blood vessels which, in turn, keeps local anesthetic at the site, making it work more profoundly and for a longer time. It is for that reason that it is used. Usually, no side effects are noticed. Some patients, however, may feel its effects if some of the epinephrine is absorbed directly into the bloodstream or if they are particularly sensitive. The side effects may manifest as a racing heart, palpitations, or dizziness. These same symptoms may occur when anxiety about the injection ensues, because the anxious patient will release natural adrenaline.

If you are one of the people who appears to react strongly to epinephrine, there are local anesthetics without it. They go by the trade names of Polocaine, Carbocaine, Isocaine or Citanest. These same trade names can also have epinephrine or epinephrine-like compound so you have to specify Polocaine-plain, Carbocaine-plain etc. to be certain. One drawback of these plain anesthetics is that they re short-acting, particularly when used in the upper jaw. Therefore you may need more than one injection. In the lower jaw, they are only slightly shorter-acting than the local anesthetics with epinephrine.

Amitriptyline - Tell your dentist if you are on Amitriptyline and if you are worried about the side-effects of freezing with epinephrine in it. Amitriptyline works on some of the same nerve cells as does epinephrine. This results in some patients who take Amitriptyline being susceptible to epinephrine side effects. Although epinephrine can be used, it is usally recommended that high doses be avoided. Therefore the patient on Amitriptyline can still have the benefits of epinephrine in local anesthetic; they just should not have too many injections at the same appointment. Another alternative is to have one of the local anesthetics without epinephrine.