Teeth problems and jaw bone exposed, please help!

[sitting-pretty]

Hi everyone

Hoping someone can please advise, brief summary of what's happened so far:

-Diagnosed with lupus 2011 & started plaquenil.

-This year had upper left gum infection, treated with antibiotics and then had the broken tooth causing the infection extracted. Felt very unwell, bloods confirmed lupus had flared again.

-Had another infection following extraction, treated again with antibiotics, but then could see/feel bone sticking out from side of gum above where the tooth was extracted.

-Back to dentist, took x-ray, confirmed it was small fragment of jaw and she removed it.

-That was last week, I can feel hard lump in gum again which feels like it could be another fragment of jaw bone working its way out of my gum!!! Waiting to see if it becomes exposed and will go back!

My questions are, has anyone been through this or similar? I'm not having jaw/ear pain so dont think its TMJ. The pain is only from infection and the bone exposing. Could it be that the lupus is attacking the jaw bone causing it to crumble and fragment? As a previous flare left damage to the bones in my feet! Rheumy doesn't seem to have much experience of lupus and teeth and likewise dentist doesn't seem to experience about lupus! Thanks guys, hope its a good day for you all today Xx

[Barnclown]

Hello sitting-pretty

My feeling is that your dentist &/or gp should refer you to NHS oral surgery clinic immediately for examination & assessment...but I'm cautious 😏

My immune dysfunction & connective tissue disorder have been factors in my complex persistent oral issues....and now I'm on bisphosphonate treatments for osteoporosis this is another factor.

My rheumatology clinic tells us that lupus is attracted to any site of active inflammation in the body

For what it's worth: Probably my biggest oral problem was longstanding osteomyelitis infection in my upper jawbone...my gp ordered an X-ray & referred me to both max fac & ent (because the sinus above the infected jawbone was involved). My private oral sugeon stayed involved. Investigations & treatment took many months, but I'm "ok" now....and I'm much more ready to insist on referrals due to persistent signs & symptoms, whether or not I actually know that my lupus etc are involved

Hopefully your prob will turn out to be straight forward & easily resolved

Take care

🍀🍀🍀🍀 coco

[sitting-pretty in reply to Barnclown]

Thank you, I think I will be pushing for referral & more x-rays! Xx

[Barnclown in reply to sitting-pretty]

👍👍👍👍

If poss, please let us know how you get on....🍀🍀🍀🍀

[sitting-pretty in reply to Barnclown]

Yes I will, thanks for your help Xx

[PMRpro]

What drugs are you on?

[sitting-pretty in reply to PMRpro]

Hydroxychloroquine 400mg a day

[Barnclown in reply to sitting-pretty]

Not on a bisphosphonate for osteoporosis?

[sitting-pretty in reply to Barnclown]

No, I've not had any bone investigations since feet x-rays when I had my initial flare & diagnosis. Been lucky up till now & relatively healthy!

[Barnclown in reply to sitting-pretty]

👍 GOOD: not great to have teeth/jaw work going on while on bisphosphonates....

[Hidden]

Rheumatoid Arthritis and Sjögren's can cause similar erosive problems i believe. I'm also wondering if you've had a bone density scan at all? I agree with Barnclown that your dentist really should have referred you to an oral consultant by now as it sounds as if they are way out of their depth.

[sitting-pretty in reply to Hidden]

Thank you, not had bone density scan (I'm 31), will be pushing for referral when I go back Xx

[Annienjoe]

Not certain if relevant as I have only been diagnosed with lupus recently, BUT all these stories about mouth and teeth problems ring very familiar I have lost most of my teeth and have had oral surgery several times in last 30 years, most recently problem appeared to be bone in gum after extraction; oral surgery revealed oral airway fistula (oaf) full of 'rubbish'. May be worth discussing with dentist or oral surgeon. Good luck.