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If you start experiencing new dental sensitivities or pain, bleeding gums, or overt dry mouth despite staying hydrated, I would recommend making an appointment with your dentist as soon as possible, says Agrawal

Monitor blood pressure and pulse when administering local anesthetic with Epinephrine to a patient taking Topiramate as this combination may increase the risk of cardiac arrhythmias, QT prolongation, and hypokalemia

It is important to inform your doctor if you have conditions like arterial or thrombotic disorders, cardiovascular health issues, diabetes, epilepsy, peripheral neuropathy, or kidney and liver diseases