Mtx & periodontal disease

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.

I can't help on this at all Luce but as I told you before my friend has this same condition and has recently had 3 front teeth removed and is having a hip graft to get bone to fill the gap left in her jaw. She does not have RA though. I do know that next year when the graft has healed/ settled she will get three molded teeth to replace the three removed and they won't be false teeth, they will be fixed.This is not going to come cheap though although her operations are being done on the NHS.

I would be happy to find out more if it helps as she's in the process of it all at the moment. I do hope MTX isn't exacerbating things in your jaw because it's an important drug for Biologics too - although Leflunomide might be an alternative as Georje takes this with Enbrel I believe and has similar problems to you it seems. Tilda xx

Ugh this RA journey feels hellish to me and I've not even got any joint pain just now - what must it be like for those who have side effects AND very active RA and other health problems? - this thought usually stops me in my tracks. I really feel for your about this peridiodontal disease. And stop beating yourself up about the smoking - you've stopped now and I can tell you that the friend who is undergoing this treatment has never smoked and has always been a really healthy eater who rarely has anything sugary - and I've known her for many years! Its just very bad luck, same with RA. Xxx

Is there a way you can hang onto it Luce? You say your oral hygiene is very good and I bet you don't suck sweeties - I don't know enough about gum or periodontal disease but I bet you are doing all you can. I'm not doing very well with this group of friends just now - I just emailed our other great friend to say happy birthday and he emailed back "12th JUNE!" - heck I'm useless! XXX

No known link between RA and perio/tooth disease. Or with MTX.

You dont need a different local anaesthetic if you are on mtx.

You shouldn't have to go to hospital for extractions unless you have other medical problems following extractions. If in doubt ask your dentist.

As far as I am aware there is no greater risk of post extraction hemorrhage if you take mtx.But the dentist will assess individual risk before treatment.

And implants are a no no if you smoke due to potential bone loss.

Um - weirdo artists??!

Not wanting to undermine you in any way Dtech, we are very fortunate to have you here (even if you are not fortunate to be here), but I was looking for info on strange tastes in relation to RA yet again and found a New York Times article about RA which listed related conditions including this; "Periodontal Disease. People with RA may be twice as likely as non-arthritic individuals to have periodontal disease. Chronic inflammation and immune dysfunction are central to both diseases.".?

It didn't sound very grey in this NY Times article Luce? Xx

I would like the link as well to see where the research was carried out and how many case studies they had. My reply was based on me asking, on behalf of this group, 12 consultants and deans of most of the teaching hospitals in the uk at a conference I went to. None of them had heard of any research being done, sadly.Or any links they had found, that's not to say their arnt any of course.

I knew Dtech wouldn't take it personally Luce - he's far too rational and intelligent! . I will look it up again but I wasn't actually searching for periodontal disease when I saw it. It was in the New York Times so if you google RA in that context it will probably come up?

I have no gum disease and my mouth has never been healthier since I've had RA actually so what would I know? In my case this is largely because I dropped all refined foods and sugars from my diet I think - and also since the foul taste I've been extra zealous about my oral hygiene! I've just received an email from the friend I was telling you about Luce. I will PM you with what she says as it may be reassuring I think. Tilda xx

Here you go - hope this works okay.

health.nytimes.com/health/g...

My two bobs worth. The maxillofacial surgeon told me that treatment ? not sure which one he was referring to tho- causes dental problems and to get myself a good dental regime. As I am not on treatment yet and dentists in Oz charge like wounded bulls I haven;t bothered as yet.