Hi all,
I had periodontal disease before RA & Mtx & was told to stop smoking, which I've done (I've blogged about this before.) But I've had 2 teeth out in the last 3 months and now another one is aching & feels loose - & for me that tends to mean extraction looms. Previously my last tooth extraction was at the age of 14.
I think I have a good dentist (but how to judge? If you get what you pay for she must be a very good dentist!) and the hygienist is happy with my oral hygiene.
As I understand it my jaw, which is quite badly affected by periodontal disease, will not take crowns or whatever without extensive work e.g. bone grafts. And this latest loose tooth is at the front.
My dentist seems to have a working knowledge of the drugs I take but obviously she's not a rheumatologist & so far she hasn't mentioned Mtx affecting teeth & gums. I found a thread on this site from 2011 about Mtx causing gum & tooth problems. I've got a rheumy appointment in a couple of weeks & there may be decisions to make about my treatment. If Mtx is exacerbating my tooth/gum/jaw problems then that would represent quite a serious problem with a drug that's not helping much anyway. (I take 25mg.)
Does anyone else have similar problems or know anything about all this? Luce xx
Ever since I have been diagnosed with PsA, my gums have become worse and with a loss of three teeth, two of which are in the front, one has been replaced with a false one the other is unable to be done. I have been informed that I am unable to have the dental implants as gums are the reason I am loosing my teeth. Like you have spent a fortune in the Periodontal treatment with a specialist, have been treated at the hospital as I bleed profusely, each have said the same regarding dental implants. Bridges etc are also a no,no. When I mention the treatments that I have received and used what the disease I have and all don't know if this is the actual cause of it. But it's funny that I did not have gum disease before the onset of PsA. MTX will affect the gums in relation to the bleeding so you should have any extractions from the hospital, you still have local anethestic but it's a more concentrated type. I have been informed that any teeth extractions that I have to go to the hospital also that they are to be taken out in the morning due to the blood loss.
Any treatment that you have at the hospital you do not pay for, but are sent back to your dentist for teeth replacement.
Hope this helps, and am sorry to hear that you have landed in the same boat as me on this one.
It helps to know a bit more, thanks Georje. I did have periodontal disease before RA & have erosions in my jaw as a result - the consultant showed me the x-ray & scared me half to death! I know I may have brought it on myself by smoking and obviously a drug that carries on where cigarettes left off is the last thing I need.
It is distressing to hear that they can't use bridges etc. isn't it? The last extraction resulted from the one before it i.e. the tooth got loose without its neighbour so I'm worried that I could end up toothless at this rate! But I'm lucky in that I don't bleed much despite mtx.
I hope you don't lose any more teeth Georje. If I get to the bottom of whether or not mtx makes this worse I'll let you know.
Luce xx