Trouble with teeth

I have always had good strong teeth. At 63, I have very few fillings. In the past couple of months I have needed two fillings. I have just broken a piece off a tooth even though I wasn’t eating anything hard. I’m getting worried that my teeth will deteriorate quickly. I’m wondering if it’s the PMR or the drugs. I’m on Pred, Omeprazole, Risonate once a week. I take folic acid and calcium with vit D.

Has anyone else had problems with teeth?

Thanks for any information.

32 Replies

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  • Hi GerriMac,

    If anything would suggest Risonate, It’s a bisphosphonates and they can cause teeth problems in some patients.

    Do you actually need to be on it, have you had a DEXA scan to check your bone density, or are you susceptible to osteoporosis? If not, then you only need the Calcium &VitD supplement for your bones.

  • Thanks. Yes I had a dexascan when I was diagnosed. I was told I had osteopoena . My GP said it wasn’t very bad. I asked my Dentist about it and he said it only causes problems with extractions . The leaflet does warn about loosening teeth. But so far haven’t had that.

    I suppose it could just be age but the seems to have been more problems in the last few months than in the last 10 years.

  • Have you had a DEXA scan to escertain your bone density and the absolute need for the Risonate? I also didn't know that you could take Calcium with it. It does have jaw and teeth implications in its side effects and I would be turning a suspicious eye to that drug. Good luck - look into it.

  • Thanks Jane. Yes I had a Dexa. As I posted above. The Rheumy told me to take 2 Calcichews a day plus Risonate once a week. It looks like I need to question being on this stuff.

  • I too am on the same as you - including the Risonodrate and following a fractured tooth was also told by my Dentist (who is in my opinion really, really good), not to worry - he took the tooth out without a problem. I also chipped a tooth through grinding and clenching my teeth, seems to have been a habit since diagnosed with GCA.

    I wonder if it is just my body struggling with the condition, the drugs and just the general feeling of being ill. But I now make sure I see the doctor and hygenist as frequently as possible, floss and brush even more thoroughly. Oh and have the added joy of wearing a plastic guard at night to stop me damaging my teeth.

    Not sure if thats helped but at least you know you are not alone!

  • LESLEY, thank you. Yes, I have a mouthgard now too. I regularly wake to find it back on my bedside table. I’m taking it out in my sleep.

  • How funny - I have had mine for about 7 years - my gca was initially misdiagnosed as TMJ hence the guard - I feel almost odd without it now !

  • Sorry Lesley, what is TMJ. Excuse my ignorance.

  • Hey, I only know because I was meant to have it - its temporomandibular disorder - pain in jaw joint and often difficulty chewing etc. I was under a consultant and mentioned the other pains in my face and told it was sinusitis (for 2 years!), Rheumy finally diagnosed GCA when I was seen for the PRM asked if I also suffered headaches, which I did but did not relate the two.

  • Sounds awful, glad you got the correct diagnosis eventually.

  • These drugs ( excuse me sounding like an eight year old) if I understand it a bit, prevent new bone from forming in order to retain and protect old bone. New bone would replicate the damage of Osteopenia. It is dangerous to be on them for more than 5 years. The side effects are sobering, one being necrosis of the jaw. Doctors for some reason are pushing Biophosphonates really hard and yet there are recent, worrying studies about an increase in fractures in those who take them.

    Now I'll just wait for the real professors to turn up.

    Personally I have heard enough and they are not for me. My GP actually said " how would you like to end up in a wheelchair?" When I refused them. My subsequent DEXA scan showed and to quote " I have the bones of a 30 year old".

    Bewildering!

  • Your response just remind me of what I have read about the bone-building drugs. They “build bone” that you can see on the Dexa! But it is hollow (if that is the right word), “bad” bone....not strong...nothing like your original bone. I am sure you can look it up.

  • It's because old bone is not being removed, so new bone is built up on an increasingly brittle matrix. Bisphosphonates and denosumab stop the bone remodelling cells (osteoclasts) from removing old bone. There is another medication, teriparatide, or Forteo, which encourages the bone building cells, osteoblasts, but it also has side effects which must be considered. If medication is needed in desperate situations, best to limit their use to only a couple of years and put most effort into supplying the nutrition and exercise bones need to rebuild themselves naturally.

  • I’ve done a bit more googling. It seems Pred can also cause broken teeth. This complicates things. I can live without the Risonate but not without Pred. There’s a bit about it here.

    healingwell.com/community/d...

  • I've had very sensitive teeth but fortunately no other problems. This is very unscientific, however I was taking Vitamin K2 200 mcg per day for a while. My teeth seemed to be better. Then I thought maybe I would cut back the K as the recommendation on the bottle is for one capsule a day. After a while my teeth became a bit more sensitive again. I went back to the higher dose of K2, and generally I'd say my teeth are not as sensitive any more. K2 is important for guiding calcium into the bones so I think it could make sense that the jaw being one of the most responsive bones there could be a noticeable difference in months rather than years.

  • Thanks for that I must look into it. I’d rather be taking vitamins.

  • Please excuse me if anyone has mentioned this. I seem to remember someone on on this forum saying her/his dentist had said that adcal/calchew tablets had impact on teeth if remnants left on teeth after chewing. Obviously one shouldn't brush teeth straight after as this damages enamel (as does all food/drink). I do tend to rinse mouth very well after I chew them and after 40mins or more i brush my teeth.

    I have no other evidence to back this up but my sensitivity has been better since rinsing. I am a grinder so worry about grinding mine away. Bruxism guard helps but dentist/dental school going to make me better one. I also (controversely?) started using interdental fluoride gel on tepe interdental brushes. I know fluoride gets bad press but I want to keep remaining teeth as long as possible.

  • Interesting about teeth. Last month a whole molar cracked/broke, needed to be replaced. Yesterday another tooth chipped way in the back of mouth. No chewy food in either case. Going to dentist (obviously) soon. Going to ask if any correlation with Prednisone. I take D3 and B-12. No other drugs besides Pred. In January I will have been on prednisone 3 years. Current tapering is to 4mg.....down from a high of 60! May we all move nearer and nearer to complete healing. PMRJ

  • Let us know what the Dentist says. Thanks.

  • Yes I too have had problems with teeth. Last year on holiday a filling came out whilst eating soft food in a restaurant. Just recently I had to have another molar extracted. Due to a root canal becoming infected through the bad tooth.

    Now my Dentist is excellent but it took him 11/2 hours to remove as kept breaking up and then a small piece would not come out so had to go to another specialist Dentist to have it removed. Cost a small fortune x

    I’m on pred and omepraz nothing else, so. Not sure what’s going on. Have just had a dexa scan so wait results x

    Interesting reading others posts

    Good luck

    Carole xx

  • Yep recently two molars had pieces chip off them. At least it was easily and cheaply fixed and I wondered if it was anything to do with the pred or the alandronic acid. I did stop taking the alendroinc early this year as after 3 years I thought I should have a rest from it. Seems teeth chipping off is not that uncommon on the forum!

  • I had never had any trouble with my teeth until I started to take AA. Several of my teeth started to decay and some old fillings fell out showing decay underneath. Dentist couldn’t work out why this should be as I take great care of my teeth. I have now stopped AA and am hoping that the problem will be solved.

    Liz.

  • Hello, yes I am the same, have had a number of problems with bits coming off several teeth including old fillings, over the last two or three years. Don't know if it is just general old age stuff and the fillings being old plus teeth not being in such good condition, or extra help with PMR and pred! Just something else to have to deal with!

  • Yes I've had many more problems with my teeth. I'm on pred( 17 mg) and of late- Leflounomide but had problems before taking Leflounomide. I'm not sure if it is the pred but I'm just being extra cautious, going to the dentist on a regular basis, brushing and flossing well. I may consider K2 too as that makes sense- thank you Heron. I feel I have contributed significantly to my dentist's new extension of his practice!!!

  • I have heard people complain about teeth breaking and yes, pred CAN coincide with broken teeth. I have had two molars break but both are teeth that are mainly filling so I wasn't surprised when it happened at over 60!! One now has a beautiful ceramic inlay (and so it should be at the price) but the dentist insisted it was worth it as the rest of my teeth are in such good condition.

    I think it is fair to remember that we are all getting older and our teeth are only slightly younger than we are!!!! And are exposed to some hard work every day of our lives!

  • That’s a fair point, but having not needed any dental treatment for the last 10 years or so, six months after starting treatment for PMR, I need fillings and a tooth breaks, I’m a little suspicious. I suppose it could be a combination of factors.

  • If Risonate is like Fosomax, I have heard of people having a lot of tooth problems, jaw problems. I have refused to take any of those meds because f the people I know. It may not be in the medical books, and it may help some people...? Like all meds...risky.

  • It is a risk with all bisphosphonates - and that includes risendronate and most of the other options. Even denosumab/Prolia is classed as a bisphosphonate.

  • Glad to hear it's not just my teeth crumbling away. I've recently had two that have broken down to gumline - will be difficult to extract. As I've had to increase my pred last few months am loath to approach dentist at moment, as I feel they'll have to lance gum to remove them! Anyone had any dental implants to fill gaps?

  • Sorry. Another idea. Don't forget pred increases glucose levels in saliva too. That can't help.

  • I think that’s significant. One of the other forums I looked at didn’t seem to be Risonate users but all were on pred and mentioned tooth breakage as a problem.

  • I am on prednisolone for the past 4 years. About a year ago started problems with my teeth. Was told it is not the Prednisolone. Now it makes me wonder....

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