Should I go to Doctor?

I think I read somewhere that you should stop your MTX if you get an infection.

I think I have a tooth abscess, big lump on jawline about the size of an egg which came up very quickly this afternoon, very hot and really painful radiating to my ear. Tried ice which hasn't made much difference yet to the swelling or pain. Took the MTX yesterday anyway so can't stop it now.... Should I go to the dentist or the Doctor? Do you have to be careful about which antibiotics you take?

Sorry, more than one question...

19 Replies

  • Hi, dentist first I think, dtech if you message him might be able to advise? So sore, hope u feel better soon xx

  • Thank you Allanah, as if there wasn't enough to deal with....getting fed up now. X

  • Sounds horrible! Just as well the bank holiday's over as hopefully you'll get this sorted quickly. I've had 2 teeth removed since I've been on Mtx & Sulfasalazine, I didn't have an abscess or need antibiotics but one of the teeth was infected.

    I just went to the dentist but sounds as if you'd do well to give your GP a ring just in case he/she thinks they need to see you and to check about Mtx if you do need antibiotics. But an emergency dental appointment is probably on the cards & I hope you feel much better ASAP! xx

  • Thank you for answer woolly, I'll try and get emergency dental appt in the morning..x

  • Or maybe both? Sounds painful. Just make sure you say you're on MTX and they will check that they give the right antibiotics. And you can also double check with pharmacists when you pick them up as they'll know as well. You don't always have to stop MTX with infections, depends on circumstances. Hope gets better quickly. polly

  • Thank you helix, it is agonizing ! It's still swelling and spreading further along my jaw! Look like a hamster now. Good point about the pharmacist, they usually know better than GP's about drug interactions .. X

    Can I just say that I hate all this crap as I'm sure that you all do.

    I feel I sound really precious about myself, since I was diagnosed a few weeks ago and started MTX every ache pain, dizzy feeling, whatever, that I used to put down to just getting older is now either RA or MXT related....

    I am officially p*ssed off now ..

    Ok, rant over, thanks everyone for understanding xxx

  • Poor you I'm not surprised you are truly pissed off! I'm still pissed off 18 months after diagnosis and almost RA free currently so I can only imagine how you must be feeling with a possible abcess on the cards too. But if it is an abcess you may not want to wait until morning as the infection can eat into your jawbone. Phone the 111 or NHS 24 and ask them what to do now I would? Tilda x

  • Smart thinking darlin, that never even occurred to me, I'm off to do that now! Xxx

  • Definitely dentist, though I wouldn't just go through the ordinary appointments - I'd phone the emergency NHS dental services for something like that, and stress that you are on immune suppressant meds to make sure they take it seriously. Don't know what its like in other areas, but up here I would be able to get a next day appointment for that (would be same day, except local transport wouldn't get me there.)

  • Go to dentist as earth witch says. And don't worry, it won't eat into your jawbone overnight! If you go to a&e you'll sit for hours and they'll send you home to take painkillers as they don't touch teeth.

  • Erm, nope, told me to take brufen even after I mentioned I was on MTX and had taken co coda moll 30/500 already.

    Ah we'll, I will get through tonight and phone dentist first thing...thanks all for you input and support x

  • Exactly! Lol. Hope you get it sorted.if you can't get an appt with your dentist, if you are near a hospital with a dental dept they may have a drop in clinic, ESP if they are a teaching hospital.

  • ....and dtech, thank you so much, as weird as it seems that's actually what I was worried about, it eating into my jaw overnight ?? or spreading through my system at a helluva rate x

    Neurotic or what?

  • Try a warm salt mouth wash too it may bring the abcess to a head and help with the pain.

  • Thank you, I'll try that now. X

  • Sorry if I worried you - thanks to Dtech for putting us both right eh? I do know that you can take co-codimol (analgesic) with ibuprofen (anti-inflammatory/ NSAID) though. They are from different drug families and both shoukd be okay with methotrexate too - this is same with flare ups for future reference, although you should double check this with your GP in case its different in your case. Hoping its not so bad this morning? Tilda x

  • No worries a darlin, you didn't say anything that I wasn't thinking lol x

  • There are three or four antibiotics you mustn't take with mtx. Trimethoprim is one of them, and I can't remember the others, but the person prescribing the antibiotics should know which ones not to prescribe. For a tooth infection they tend to start with amoxicillin, which is fine, though if your mtx day comes round again while you are still on antibiotics, you should give mtx a miss.

    Hope that helps,

    Dotty x

  • Glad you told me that Dotty, I wasn't aware. The dentist I saw as an emergency this morning put me on Metronidazole and Amoxicillin, (he called the extensive swelling 'impressive', I aim to please.) The antibiotics are due to finish by Sunday and I take the MTX on Monday so hopefully that will be ok?

    Saw my GP also, I Have a high temperature and she wants to see me in 24 hours, if the swelling hasn't gone down she will arrange for me to have them Intravenously.....well they'd just better work then cos I don't do hospitals..!

    Thank you all again for your support xxx

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