Hi Deborah,

I'm a general dentist and have a patient with Mast Cell Disorder, a "condition" that came from her health history and in discussion by way of her visit to Mayo Clinic.  What then is MCAD?  Is my Google search result suggesting "Medium Chain acyl CoA Dehydrogenase" another subject or are these forums about  her issues?  Am I mis-understanding her concern about a reaction to all things taken orally, or simply misunderstanding the acronym MCAD as used in these forums?  She seemed overly protective, or even unsure how to express what her condition actually is so I'm simply trying to understand her better.

I'm not a frequent user of these forums so please be gentle.

Thank you.

furstm

Hi Furstm,

How wonderful to have a concerned health provider coming here in search for more information as to how to deal with their patient!!  You are to be heartily commended!!  I wish MORE doctors and health providers would be so considerate!!!

Your patient has every reason to be very concerned and anxious as to his/her care.  MCAD or Mast Cell Activation Disorder is a recent diagnosis of another form of Mast Cell Disease which to this diagnosis also belongs Systemic Mastocytosis.  Although science has progressed as to gaining understanding to Mast Cell Disorders, they are still unsure as to whether MCAD is a problem of the proliferation of mast cells or that of an activation of mast cells. Regardless of which it is, the end result is still the same - we are hyper-reactive patients.   In other words, you are not going to get a patient who is MORE "ALLERGIC"  than a masto patient!  

Our doctors are required to treat us with kid gloves!  Some of us are HIGHLY reactive to medications, latex, foods and medical procedures.  Some of us are less reactive.  Each of us have very individualistic presentations of this disease.  There is not a single one of us alike.  So, although some masto patients can face dental procedures without a single issue, some others of us must do our dental procedures in the operating room with an anesthesiologist on standby.   I am one of these.   Although I have not had any recent dental work, when I needed to have a tooth removed 3 years ago, it was in the OR and I was given sedation to help deal with the anxiety as well as to keep the Mast cells quiet.  Yet I have a history of severe reactions and will react to any kind of invasive procedure and contrasts.   We masto patients are capable of what is called Stress Anaphylaxis - it's a form of anaphylaxis which has been striggered by the stress system and as you know, dental procedures create a lot of anxiety with many people.  This anxiety is probably more reactive than the anesthesia you use.

We have on here specially designed protocols for masto patients.  Here is the location:  http://mastcelldisorders.wallack.us/yabb/YaBB.pl?num=1293571751

I also have the email address of a Dentist in Portugual who not only has mastocytosis, however he also has written his thesis on dental procedures on masto patients and their oral issues.  If you send me  PM, I'll be more than happy to get you in touch with this dentist so that he can help you gain more understanding as to how to work with masto patients and what our particular needs are.

I hope this helps!

Lisa

You have actually gotten some wonderful responses here that seem to answer your question. Some of us MCAD people will go into anaphylactic shock. My dentist is very wary about doing anything and always asks and defers to my opinion if something is safe because he knows that I will have checked it out with my specialist if I don't know the answer. Anything can send a MCAD patient into anaphylaxis, which can be fatal. For example, I would love to whiten my teeth, but since I do go into anaphylaxis from things, am too nervous about trying it. Just because someone else on this forum may have no problem with teeth whitening, it could put me into shock. That is the hard part of this disease -- no one rule holds for everyone.