Dentists and PMR/GCA

[Zebedee44]

I was a bit surprised today to find that my dentist knew nothing at all about PMR or GCA. I thought he might know something about the long term use of steroids and alandronic acid in connection with jaw pain, gum and tooth care.

I thought it would Be a good to know what state my teeth were in at this early stage so I can keep an eye on them. And I think an opticians appointment might be a good thing too,with possibility of glaucoma. Or am I letting myself be too anxious about the future. I'm just 60, not ready to be a complete ruin yet!!!

[venezia1]

I would tentatively suggest you change your dentist. You need someone who knows about steroids and how they interact with other meds, not to mention their side effects on dental health. My dentist is quite specific about the necessary care, etc. And one time refused to give me an extraction until I'd dropped my dose- also prescribed antibiotics afterwards.

[Marlenec]

Hi

I had a tooth extraction two weeks after starting AA. I told my dentist this along with the other medications, she said to watch out for infection. I had no choice about the extraction but I would have delayed starting on AA if I had known there could be a problem. I needed 3 lots of antibiotics to rid a very bad infection and it took about 6 weeks for the hole to heal but I am left with a piece of bone sticking out of the side of my gum, but am leaving it be. Good luck with everything and yes look after yourself.

[Hidden]

Hi Zebedee44

Even if he didn't know about PMR or GCA he should be fully acquainted with AA & the potential effects on the jaw. My dentist did a full set of X-rays before I started mine & my new dentist has given me a prescription for toothpaste.

You shouldn't have needed to drop steroids for an extraction but antibiotic cover is a good idea, this new guy said he'd send me to hospital if I needed an extraction but all my teeth look good so far.

And, yes an appointment with the Optician is a good idea as a base line & it's cataracts that are a risk with Prednisolone but they should also check pressure incase of glaucoma anyway.

Best Wishes

Mrs N

[Zebedee44 in reply to Hidden]

Thank you. I already have a cataract lens in one eye from a puncture injury ten years ago. I know only too well the fear of losing sight in one eye, I almost lost the eye itself. Thanks to an amazing NHS consultant in Swansea I still enjoy sight but it was a year in my life I do not wish to repeat.

I hope the local Optician knows something about PMR and GCA.

[PMRpro Ambassador in reply to Zebedee44]

The optician doesn't need to know a great deal about PMR and GCA - all they need to be able to do is use drops to dilate the pupil and examine the back of the eye to see the retina and where the optic nerve joins the eye. The appearance of both is what they have been taught to examine - and changes are signs something is wrong and you should see an ophthalmologist. The changes in the optic nerve in GCA are a symptom common to GCA and other problems.

[PMRpro Ambassador]

I think you are right on both counts - it is good to have a baseline to measure future events again.

Especially, it should be added, a dexascan! I wouldn't even consider AA until I had had one. And I wouldn't take AA until a dentist who DID know about it all had checked everything!

[Zebedee44 in reply to PMRpro]

Yes, I have insisted on a dexascan as a baseline before I poison myself with AA.

The shock is that my dentist is a young man with a very forward looking modern NHS practice! I honestly expected him to know what I was talking about!

[granny-b]

Hi. Yes get an optician and dentist as part of your care team. I wear a contact lens and have a contract for contact lens checks. Every time I see him he does extra checks, (pressure, field of vision and back of eye etc.) because he knows about GCA. My dentist also is clued up on GCA.

I consider myself lucky as obviously not everyone have these.

[DevonMichael]

My dental practice have recorded all my medications (now 5 since I was diagnosed with GCA) and they seem genuinely interested in any changes.

Before I got the GCA diagnosis I had a dental check-up and when I reported I had been experiencing pain in my jaw for over a week when chewing. The dentist said it was "jaw trauma" and sure enough when I went home and googled this new term it fitted the bill. Of course I had never heard of GCA and I think this just demonstrates how hard it is to diagnose!! And I thank God it was, some weeks later!

[tgca]

My dentist is very keen on listing any meds and I was reminded, before an extraction, to double the steroids for that day. The practice even telephoned me to remind me !!!!