Dental treatment and MTX

Hi all....I was told by my Biologics Nurse that if I have any teeth removed in any dental work below the gum line to come off MTX for a week before and after treatment, wait another week. So all in all two weeks off MTX......I need Four new crowns and one tooth removed.........ever since I started MTX, I have lost 8 teeth.... :(. I was told it's the meds, accepted that, some people on same meds though doesn't have same trouble as myself......question I need to ask is have any if you that are on MTX ever come off your medication to have dental work that involves Blood?...........A good friend of mine is on MTX and she did NOT come off the meds and had a tooth removed, she said she was ok.....but I am scared to do that due to Infection etc.........anyone help.....thanks Jill

17 Replies

  • Hi Jill

    I haven't come off mtx to have teeth removed, only when I had to take antibiotics because I got an infection. :-( My dentist says the problem with teeth and RA is the inflammation going on which affects the gums. Mine have been crap. I go every four months or so for a check up so she can nip any problems in the bud.

    Dotty x

  • Thanks for your reply Dotty :) in that case, I might just stay on it, ya know, I must be so thick because it hasn't occurred to me to see the Dentist every four months, what a good idea. In Jan this year I had my second spine op, and couldn't go to the Dentist as I couldn't sit or lie down in the chair, so I saw her end of December, I knew I wouldn't see her for at least 8 months, however, it was longer, 10months, due to having Vertigo, so severe, I had it for near on 6 weeks! Nightmare!........oh well, gums are infected up top too, my Four crowns have disintegrated, gums coming away from the crowns( at least I'm getting shinny new crowns lol ). One tooth....guess it could be worse again soon, I'm sure ...Jill x

  • I go to a lovely Dental Access Centre dentist - she keeps me on her books because of my special medical needs. One of the splendid benefits of RA. ;-)

    Dotty x

  • i was told that if i have teeth out have op's or any live vaccines that i have to stop taking mtx and biological treatment at least 1 week before and after as having it done as without stopping can make you more prone to getting an infection

  • was also told if any sign of infection i have to straight to A&E as infection can spread faster and not allowed to take antibiotics

  • Hi yes that's what I heard too.....might ring up my Nurse and check take care :)

  • I'm the same as Dotty. I had a tooth extracted this year and was not told to come off MTX. only time I was advised to come off MTX was when I had an infection. My dentist had an issue with removing my tooth due to MTX and wouldn't do it until given permission from my consultant. The dentist was so nervous when removing it, he needed a fag afterwards!

  • Hi Charlotte! yea seems we are getting different info lol......oh well will ring my nurse and double check....take care Jill x

  • might be worth checking with the specialist just to be sure safest way to be honest

  • Hi Jill,

    You have not said Which biologic are you on? I know reading through my paperwork certainly had to stop mine for any kind of surgery including dental MTX is not a biologic rather a DMARD and I stay on that. So as has been said check with your team

    Do not envy you your visits to the dentist...good luck

  • Hi Poppylady, thanks for your reply, as I read your comment, due to Brain Fog, I've just realised that it was when I was on the Enbrel, at the mo I'm on just DMARD , MTX, so I think I'm safe LOL.....when I was taking Enbrel I was a nervous wreck, especially having teeth removed, but your right, it's when a person is on the Biologics.....oh I'm so daft....but thanks for your reply, and I'm so glad I brought this topic up.....mind you these meds are taking their toll on my brain x

  • Lol....with you totally on the brain fog....does not make going to the dentist any easier


  • Hi scouser thanks for your reply, after reading Poppylady's reply to me, I've realised it's only when your on the Biologics that we have to be concerned about infection, I was on Enbrel, but been taken off it! due to the brain fog I suffer badly with! I can't remember why my rhumy took me off it, but I'm due too see him soon, and want to go back on enbrel thanks for caring and taking the time to reply to me :). Take care Jill x

  • To everyone that replied to my question, thanks so much for all the replies, I feel a bit stupid, as after reading Poppylady's very nice reply, it's only if we are on the bio logics that we need to worry about infection.....I'm not on Enbrel at the moment, just MTX, my brain fog is getting worse and I can't remember a lot of things! but as soon as someone says a Key word, it triggers off my memory......Thanks all :). Jill x

  • Hi

    You are not stupid at all Jill. It's always best to check these things and your specialist nurse is probably the best informed.

    I have never been advised to stop mtx before dental treatment but have been advised to prior to operations. This is because mtx reduces the immune system activity which naturally fights infections. RA is an auto immune disease and it gets over stimulated so to speak and attacks our bodies. Mtx keeps it in check but the result can sometimes be a lowered resistance to infection (which is why we are qualify for flu jabs).

    I feel for you regarding the dental work. It is something that really gets to me - vanity I guess, but it seems so unfair on top of everything else. Good luck. xx

  • Awwww thanks for your kind reply Creaky( love your name lol).....talking about vanity my four front teeth needed crowns, had wonderful fitted crowns, they were so good they looked like real teeth, I've see some crowns that look obvious and dreadful, so I was lucky, I guess, anyway, without trying to digress, which is impossible for me lol, I was eating a tangerine, and my crown flew out my mouth, just eating a tangerine!! That was one of the Front Teeth Missing, so had to have a plate made, as the months before that, I had four abscesses, and four side teeth were now I needed a plate, otherwise the side of my face would cave in lol.....I between the treatment process to prepare for the crowns, I stupidly opened a packet of fish using my teeth lol, and u have guessed it, the tooth besides the front one I lost, dropped in my mouth!! Horrified, near to tears had to go back to the dentist( thank god she's a good friend) back to the beginining of the process to now Add on another tooth to the plate my lovely plate with wonderful gleaming teeth! looks so natural.......until! I went up to my daughters house, after saying Goodbye etc, got In the car, and took them out lol, and put them on top of the rubbish I had sin my lil bag........with the thought that as soon as I get home, I will wash and clean it, and put safely away in my False Teeth Box LOL.......Tired after few hours at my daughter house! got out the car! my bag fell to the floor( this was dark by now), I picked my bag up, and went In and FORGOT about my shiny plate of teeth lol.................very next morning, my hubby takin son to uni, they were in the car reversing out, when suddenly, my son said he heard a loud CracK..............he came back into house with, yup you have guessed New ' Teeth Denture'.............. I was devastated ( for ten mins ) to Dentist that week, and had to explain everything to her ( known my Dentist years, and we have slowly become friendly and laugh and joke when I visit her) , anyway.............Fast Forward to NOW..............( had ' Teeth Denture' for around 11 months) and as my post about Dental issues above, I mention that I need FOUR new crowns and one tooth removed.........and one of the new crowns I need is one at the to Summarise, I need another new Denture....along with the other crowns to be replaced.....LOL.Thankgod I have a SOH, or I would have gone Bonkers by now.............actually, maybe I am, well just a lil bit........xx

  • Oh my goodness, you poor thing. What a complete nightmare saga :-( I hate going to the dentist, even though she's so nice, so you have all my sympathy.

    Dotty xx

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