Tooth infection and methatrex

[sallygrain]

Hi. I am due for an extraction shortly Tuesday 5th as the tooth is infected. Constant gum infections around the site and off and on hideous pain. The dentist in fact both dentist have dismissed all questions re my RA drugs. What would be the experience of others re stopping methatrexate etc. Before dental surgery that involves infection. I did postpone the methatrex injection during a course of antibiotics earlier. The advice found online in re RA and dental issues and that given by the average dentist is very different. I hope you all are keeping well and safe

[Green230461]

I was told to stopRA drugs and was given a week of antibiotics before my extraction. Spoke to hospital and they agreed. 😃

[sallygrain in reply to Green230461]

Thankyou I am going to do that to be safe. It is so odd and disturbing how inconsistent knowledge of RA is among dentists despite the online info available

[Green230461 in reply to sallygrain]

Some think of it as osteo and therefore not a problem. Hope it works out for you. Happy new year minus the tooth 🥳

[Neonkittie17 in reply to Green230461]

More or less what I did two years ago when I had to have a crown done over two lengthy sessions but my abx were for after the dental work.

[Niao]

I hope you get a definite answer soon, unfortunately I'm no help being very new to methotrexate but I'd be very interested to know. I would have thought too that it would be as Green230461 has said. Hope you're getting some relief from the pain, dental issues are horrible!

[Hidden]

I had major root work done I didn’t stop methotrexate dentist said it was fine only if I developed an infection requiring antibiotics. Thankfully all ok

[Mmrr]

I was told by my rheumatologist to stop MTX for 7 days before extraction and until the wound had healed, which was around 10 days. I didn't take antibiotics as I did not want to upset my gut unnecessarily. Similarly, I stopped my biologics for a separate extraction 5 days prior to extraction and for 5 days afterwards. I restarted them early as I was becoming unwell RA wise. Wound healing was slow, but the wound remained clean and I did not take antibiotics.

For both extractions I was on 20mgs prednisolone per day too.

I used salt water mouth rinses and good / strict dental hygiene.

[sallygrain in reply to Mmrr]

Thanks mmrr. That sounds sensible. I am reasonably under controll these days so a week or twos hold off should not be too taxing