Needing a filling whilst on Humira

[jbzm]

I rarely post . . . this is my second in a week (gives you an idea of the sort of week I'm having!)

I decided to use some dental tape after dinner and managed to flick out a chunk of filling. I aim to ring the dentist on Monday and at least have it assessed. I'm hoping it is repairable with minimum fuss - no excessive drilling or need for local anaesthetic, in which case I guess I'm ok to just have the work done?

If I need a more major filling - ie, the present one removing under local anaesthetic and redone, do I have to wait a few weeks before I can have it done in relation to my last Humira injection?

I injected Humira on Friday 05/11/2021

Covid booster booked for this Friday 12/11/2021

Due to then inject with Humira again (as long as all is well after the booster) on Friday 19/11/2021

I am going to email my Rheumatology nurses but as it can take up to four weeks to get a reply (and I want it sorted to prevent any infection setting in), I thought I'd see what experiences folks have had.

Thank you for your time

[Madmusiclover]

Can’t speak for your drug but for my drug, Baricitinib which I take daily, I stay on it for dental work. Even rather drastic dental work. 😢 your dentist might advise…

[jbzm in reply to Madmusiclover]

Thank you so much, that's reassuring. My dentist is pretty good so I'm hoping he will know. Humira is still new for me so it's a case of ticking off the various 'first time for' . . . grotty cold, suspect chest . . . filling falling out . . . there is no manual to tell you what to do!!

Unfortunately my nurses are snowed under and response times have gone from a couple of days at the start of the pandemic to weeks now.It doesn't help that I am also adrenal insufficient so have to balance the need for extra hydrocortisone too.

[Madmusiclover in reply to jbzm]

Oh gosh. Yes, I come off it for other operations. Sorry you have to wait so long for answer from nurses. Might a gp advise? Does your drug info mention dental work?

[jbzm in reply to Madmusiclover]

My GPs are great but very clear that Humira is not their thing! I'll hope my dentsist knows his stuff, he's good.As to the nurses, it has been very unsettling. I started Humira in mid-July and support has been pretty hard to come by. I do feel rather adrift at present. However, once I know the 'manage' dental visits, I won't need to ask again . . . just a a case of all the first's . . .

[Aporiac]

I agree with Madmusiclover - your dentist should be able to advise of any medicines that mean you can't have particular dental treatment. I always give my dentist a list of tablets I'm taking, and so far he's been able to reassured me that all have been fine for the dental procedures I've needed. I guess it's probably also mentioned on the leaflet stuffed in the packet with my meds, but I never read that (I don't want to know every possible side effect anyone has ever experienced - I just ask whoever prescribes the drug what symptoms should ring alarm bells, and to spare me the rest!)

[Lupusrelative]

Actually, my sister had a filling just last week and is on humira. No problems for her

[jbzm in reply to Lupusrelative]

Thank you!! That's amazing. Just what I wanted to 'hear' first thing this morning! I'm hoping the dentist will be able to repair the present filling (no fillings to speak of pre- first pregnancy and he's 23 soon, and none since, however, a few needed due to that pregnancy) but have a feeling the filling may be at the end of it's life in which case it will be a bigger job. I'm pretty sure it will end up as a crown one day, hopefully(?!) while Ben is still my dentist. I'd just rather that 'day' wasn't yet!!

[sylvi]

I am sorry to hear that your back is so sore, you must keep telling your dr you want to be sent back to the hospital dar;ing/ xxxx

[jbzm in reply to sylvi]

Hi sylviI think you meant this message for someone else but I'll take all the sympathy I can get! It has been a bit of a week . . . and the fact I started this hours ago and have just found that I didn't press 'reply' gives you an idea of where my brain is at.

I hope you are ok, you always manage to keep cheerful with everything life throws at you, and you take such an interest in others.

I do love your photos . . . I may have to pick your brains about our roses!

[sylvi in reply to jbzm]

I have got so tired now and i can't rememeber what i have written. so hugs to you darling. xxxx

[ruth_p]

I never had to stop humira for fillings when I was on it.

[jbzm in reply to ruth_p]

Brilliant. I'm hoping I can get away with a routine filling. I think the AI is probably more problematic by the looks of things.Thank you for your help.

[Paula-C]

I've been told to stop enbrel for any invasive dental treatment, i.e. extractions or root canal treatment. I've never stopped it if I'm having a routine filling,

[jbzm in reply to Paula-C]

Thank you. I have a horrid feeling that he said when he last replaced this filling (it has been there nearly 23 years in one form or another) that it may be the last time . . . and that it may have to be a crown. However, these days he is deemed an expert here in Birmingham for root canal . . . still doesn't appeal!I will bear your tip in mind if it comes to that and pursue my nurses more energetically if necessary.

[Runrig01]

I’m on benepali the weekly injection, and have never had to stop. If it’s something involving stitches I gave to stop till wound is healed.I also have severe adrenal insufficiency, which is more of a concern for me. I’ve been advised when I need local anaesthetic to ask for the one without adrenaline, as that eats into our cortisol fast. I know of many patients who are unwell following dental surgery. I was told to take 10mg extra hydrocortisone 30-60 mins prior, but if adrenaline was used then to also double dose for 24hrs after. My dentist used to point out procedures needed, now with AI he seems nervous to proceed. I presume you’ve got an emergency injection? I always make sure they know where that is if needed. Hope it gets resolved soon 🤗

[jbzm in reply to Runrig01]

Thank you for the heads up re the local anaesthetic and adrenaline. I was thinking this morning in the shower, I mustn't have had any work on the fillings I have (courtesy of no 1 son pregnancy) since before the AI diagnosis in mid December 2016. It does mean I must be getting to the stage where the odd one needs removing and replacing soon . . . ho hum. I'm already having to double-dose for 3+ days as of Friday as I've got my Covid booster. I spiked a temperature after the first AZ, I then vomited and ended up with three days full-board at the QE. One way to get a holiday. Deep joy. Endo came up with a plan for the second dose and it worked so repeating it this time. At this rate it could be a week of lots of hydrocortisone.

I've conflicting advice re how much hydrocortisone to take and when for dental procedures. Something I didn't bother to clarify as I didn't need to know until now.

As to injection, I will take one with me. I've never really found a good box/case to carry it around in. It's in a popper A5 folder. Do you mind me asking what you use?

[Lolabridge]

I’m on Rituximab and have recently had a filling done with a local anaesthetic so I’m sure there wouldn’t be a problem for you.

[jbzm in reply to Lolabridge]

Brilliant, thank you. If I knew my nurses were likely to respond I wouldn't be mithering now. It's the things you take for granted that suddenly make you think, isn't it?It doesn't help that it has been a week, final straw and all that!

[Tree6]

Just FYI my rheumatology nurse said not to inject my Humira/Adalimumab for 2 weeks after my booster jab. I guess to let the booster generate an immune response.

[jbzm in reply to Tree6]

That's interesting. I did wonder, but mine have just asked me to book it on my 'off' Friday if that makes sense, same with the flu jab. Each hospital seems to have different views on how to best handle the whole vaccination process.