Dentist

[JJackdaw]

Hi all. Just come from dentist and I am not happy! One of my teeth is very loose and causing me a lot of pain, but would he help me, no he wouldn't . He told me because of the medication I was on I would have to see my GP before he would treat me. Now I have to get a letter giving him permission to go ahead. I told him that I have not yet started taking alendronic acid pills but to no avail. Now I have to suffer until next week! Grrrrr I feel so mad! Sorry peeps , just had to have a rant. 😱

[DorsetLady PMRGCAuk volunteer]

Hi jjackdaw,

Sounds a bit off to me! What was your dentist's intended action? Does your tooth need extracting? I know they need to be aware of when you are taking AA and Prednisolone because of possible problems, but this seems to a very over the top reaction. My dentist has been aware of me taking these medicines for almost three years and has never refused to treat me, or required anything from my GP. Think your dentist is risk averse! Hope you get it sorted quickly, have you tried talking to your GP or his/her surgery? DorsetLady

[JJackdaw in reply to DorsetLady]

He said something about (not sure if this is right) necrosis of jawbone? He's a new dentist to me, Italian or Spanish? Not sure, but he speaks quietly and broken English. Very nice though. Anyway, am waiting for GP to ring back. My tooth is almost hanging on its nerve and I don't don't fancy pulling it myself lol. But if I can't stand the pain anymore, I will.

[DorsetLady PMRGCAuk volunteer in reply to JJackdaw]

If he is unwilling to treat you then ask him, or your GP to refer to the Maxillofacial Clinic at local hospital. DL

[PMRpro Ambassador in reply to JJackdaw]

If you are taking alendronic acid there is a risk in the long term of necrosis of the jaw bone. But powerful drug though AA is it doesn't have an effect until you start taking it!!!!

There is also a small risk of it happening when you are taking pred - but it is after being on doses above 20mg/day for a long period or a total cumulative dose of over 2000mg - which I suppose is 3 or 4 months.

I have never come across a dentist refusing to do an extraction because of pred - I was worried about having a wisdom tooth out last year because I'd been on pred for 4 years, most of the time at well over 10mg/day but the local dentist wasn't in the least perturbed and whipped it out in a flash, it was nothing like as bad as I expected.

If it is really uncomfortable you could try calling the health authority and asking if there is an emergency dental service. Or is there a dental hospital near you? Their emergency service is usually second to none - and if they don't know what they are doing, noone does. Apart from any other consideration - I bet you have to pay for a letter from your GP...

[JJackdaw in reply to PMRpro]

They best not charge for a letter after the runaround I've had to do. Going to try my mothers favourite and rub some tincture of clove. It's vile but it helps. If I can hold out til Tuesday I will because I want a replacement. Don't want to look gummy lol. That's a pet hate mine - people with missing teeth. Urrgghh!

[PMRpro Ambassador in reply to JJackdaw]

Yes, know what you mean! Big smiles and dark and very very crooked ones make me cringe too. I had some teeth removed when I was 19 and fought with a brace for a few years - the gaps aren't visible and the front ones are quite reasonable. Apart from the wisdom tooth last year I have the rest. Losing that wisdom tooth was a wonderful relief though - it was affecting my bite and making my shoulder and neck pain excruciating. SO much better now

[PMRpro Ambassador]

He's refusing to treat you because of a medication that's on your list but you aren't yet taking? That's nuts!

Is there the option of another dentist?

[JJackdaw in reply to PMRpro]

No pmrpro. It took me ages to get into this practice as my dentist retired. He will pull tooth with my GP s say so on Tuesday. Honestly, I feel like a child, not a 63yr old.

[Celtic PMRGCAuk volunteer in reply to JJackdaw]

Well it's a pity you're being left to suffer, JJackdaw, but at least this dentist will, hopefully, learn from your experience.

[JJackdaw in reply to Celtic]

Hi Celtic. I think it may be the escalating sue them culture over here, the medical profession are top of the hit list so it's no wonder they proceed with caution. No, I don't blame him, just a bit peeved. Lol

[AndyTheMac]

Hi JJackdaw

I just had a similar experience. I needed a tooth extraction and my dentist was wary because I was on a high dose of Pred (50mg at the time). She rang my GP who suggested I had it done at the hospital. It was all arranged the same day. The did it with a local anaesthetic and no immediate problems. The risk of jaw necrosis was explained but the hospital dentist didn't seem bothered by it.

The problems I had later were not related to my medication (pred and alendronic acid). I had Dry Socket and they managed to chip my jaw and a couple of fragments had to work their way out!

I think it's only a significant risk if you have a general anaesthetic.

Hope it gets sorted soon, tooth pain on top of everything else !!!

[JJackdaw in reply to AndyTheMac]

Hi Andy. Got an appt for Tuesday now so I guess I can wait until then, that's if tooth doesn't fall out first. Been rubbing clove tincture on it which has relieved pain somewhat. I'm on 7mg pred now reducing to 6mg tmrw so should be okay. Thanks for reply and you have a good day.

[PMRpro Ambassador in reply to JJackdaw]

I'd wait to reduce until the tooth is sorted if I were you. Even if you LIKE going to the dentist it is still stressful, especially if it is for more than just a clean. Better safe than sorry...

[JJackdaw in reply to PMRpro]

You're right pmrpro, perhaps I will give it another week before reducing. Dentist doesn't bother me and I couldn't have more stress than living next door to noisy neighbours. If they're not fighting or blasting out their music or baby screaming theyre banging doors or clomping on there uncarpeted floor. Stress! Come stay with me for a week and you'll be straight back on 80mg pred. Lol.

[PMRpro Ambassador in reply to JJackdaw]

Delightful!