Rituximab and Dental Treatment

[3LittleBirds2]

Hello

Hope everyone is keeping well and enjoying being out and about a bit more after a year of shielding, I am due to have Rituximab soon so will be back to semi-shielding for a while., this brings me to my question.

I need some dental treatment done, a root filling. I am currently on antibiotics for the tooth infection and hopefully will be good to go for Rituximab on Thursday.

I have asked the dentist and my Rheumatology helpline, to see how long I should leave it after Rituximab to have the dental treatment..I'm thinking a month?? None of them can give me a definite answer and Rheumatology so difficult to get hold of. I will try and ask a Doctor when I go in on Thursday too.

It is completely Sod's law that this has happened now after over a year of no appointments but has anyone been in the same position? I have searched on the site before anyone suggests it but didn't find anything with Rituximab and dental treatment.

Many Thanks for reading. 🙂

[Neonkittie17]

I was told by the rheumy if you are planning any treatment such as cosmetic dental then leave 3 months after your last Rtx and you’ll be right in the middle of your treatment if you usually have Rtx every 6 months. I have had root canals in the past, 2 months after Rtx as they were emergency and I was put on abx for 2 weeks as soon as they’d done the root canal. As you’re already on prophylactic abx I’d think they will extend them beyond the treatment to be sure. If Rtx starts to rapidly deplete the B cells 2 weeks after your infusion then you’ll feel quite low around a month after infusion so always better to mention re abx as you obviously have. Your healing process would be slower without the abx. No one can plan for dental emergencies/necessities. 😑 Hope all goes well. I found this on the British Association of Dermatologists re Rtx or the Oral Health Foundation has a helpline. Not sure they’d know Rtx but they may give advice re general immunosuppressants and dental. Good luck. X

Text

[3LittleBirds2 in reply to Neonkittie17]

Hi NK

Thank you so much for your reply and hope you are doing well.

I have done so much research into this and neither the dentist or Rheumatology advice line were much help. The infection won't fully go I don't think until the tooth is treated, as it's under a very old crown and given me no pain etc it could have been there years without me knowing. 🤷🏻‍♀️ Until the small pimple appeared..yuk!!

Exactly, right we can't actually time some dental work but common sense was telling wait a month..ish after Ritux and get some more antibiotics when it's done ?!

I am back at the dentist Weds to see how it is and if the infection is "ok" to proceed with Rituximab but will go to the hospital Thursday as I may actually be able to see a doctor and ask them, rather than back and forth with emails with help line.

Thanks again and have a good weekend x

[Neonkittie17 in reply to 3LittleBirds2]

Yes the dentist won’t do the treatment till the infection is gone and you’re doing all you can re abx and leaving a month. It’s all you can do as you can’t let that tooth flare up. 😑. I’m finding things very challenging at the mo tbh and trying to work through it all practically and efficiently. I hope you are steady apart from the tooth. Enjoy your rest of weekend. x

[3LittleBirds2 in reply to Neonkittie17]

Yes, everything seems very overwhelming for a lot of people at the moment. Hope things improve for you soon too x

[Neonkittie17 in reply to 3LittleBirds2]

Just a waiting game and nothing I can do to hurry things up. 😑 x

[3LittleBirds2 in reply to Neonkittie17]

It is just rubbish and so hard, the thing is we are normally can do stoic people but sometimes..we have to put the breaks on and look after ourselves. Thank you for replying, it can get so lonely and isolating at times when no one else gets this blasted condition. X

[Neonkittie17 in reply to 3LittleBirds2]

It can indeed. I hope you feel relief after your tooth gets fixed. xx

[3LittleBirds2 in reply to Neonkittie17]

Thank you and my very best wishes to you too xx

[Neonkittie17 in reply to 3LittleBirds2]

Good luck for Thursday 💗xx

[3LittleBirds2 in reply to Neonkittie17]

Thank you...I have everything crossed..well as much as I can! Worrying as cases are starting to rise again and the 3rd Vaccine shambles xxx

[Neonkittie17 in reply to 3LittleBirds2]

We can all see things getting worse in England. Awful, as it was before to watch things going backwards. I’m not sure how Boris & Co. are going to react to the new variant they’re calling Delta Plus. 😑 xxx

[3LittleBirds2 in reply to Neonkittie17]

They will probably sit on the fence and react late, like they've done all the way through this! Xx

[Neonkittie17 in reply to 3LittleBirds2]

Wondering if they’ll ever learn? 😑xx

[3LittleBirds2 in reply to Neonkittie17]

Press Conference tonight so we shall see! A new Delta offshoot is being mentioned as well online called "Nu".

[Neonkittie17 in reply to 3LittleBirds2]

Delta Plus .. It’s been bubbling for a while now and first recorded here in July I read and I was aware but it’s not been front page etc until very recently. Now, as the case numbers have significantly increased and the pressures mount to from the medical authorities to act, B&Co have to say something even if not do anything as yet.

[Hidden]

I had several broken teeth (thanks RA!) which had to be extracted. The dentist appeared to know very little about the immunosuppressant qualities of the RA drugs like Rtx & Mtx. However, my Rheumy told me that the best time to have any dental treatment is 3 months after the Rtx infusions. I was also advised to stop taking the Mtx for 5/6 weeks to give my mouth a head start on the healing process. I’ve had 4 extractions now & my gums take around 4-5 months to heal back to normal after each one. Hope you get sorted soon x

[3LittleBirds2]

Hi, thank you for your reply! Yes, I agree the Dentist don't know much about our drugs do they but then I guess their job is teeth! I am not sure I will able to wait 3 months after Rituximab but I'm booked in for 6/12 that gives me a month and then probably antibiotics after as well. Sod's law it went now but like you say Cheers RA! Hope your gums have all settled down now too, I will be going for a dental implant too if the tooth can't be saved..but hopefully it can! Thanks again x

[Jackie1947]

My dentist actually rang my consultant to discuss my planned treatment

[3LittleBirds2 in reply to Jackie1947]

Hi Jackie, that's a very good Dentist you have there! X