Broken Teeth

[stellafmdm]

My teeth keep breaking! is this due to pred or is it just old age and/or wear and tear? Whatever the cause it is a great deal of a nuisance!!! I can't eat apples any more or bite anything which is too hard! I'll soon be reduced to baby food!!!! If it is pred will it improve as I reduce? Any ideas anyone?

[PMRpro Ambassador]

I have never had problems with my teeth while on pred except for 2 broken teeth that are mostly filling anyway so I couldn't be surprised. But I know some people do have a lot of trouble.

[karools16]

I have a vegetarian friend who has this same issue as you. I asked her if it was because she doesn't have calcium, and being a veggie. Dentist told her to avoid hard foods. She is not on Pred so I wonder what does it then? When you know, I would like to know too.

[stellafmdm in reply to karools16]

I'll let you know if I find out1

[Hidden]

I've had terrible trouble with my teeth since pmr diagnosis. Some were probably old fillings and about to crumble anyway but a few were a surprise. No nhs dentists with vacancies around here but I think I may need to have some extracted at a hospital as broken down to gum level. Terrified of flare-up. Down to 9mg daily so hope no more cause trouble. Our old rabbit's teeth grew at a tremendous rate, always at vet having them filed down - wish mine were like that!!

[Daisychain12 in reply to Hidden]

hahaa love this. Me too, on 9 mg and teeth are like crumbling old digestive biscuits. I look hideous. xxx

[borednow in reply to Daisychain12]

That really made me laugh but it seemed rude to "like" your post!! My teeth are hanging on in there and certainly have been a lot worse since the arrival of PMR.

It's all part of life's rich pattern.

[stellafmdm in reply to Daisychain12]

Thanks for the laugh Linda!!!

[Angiejnz]

Had the same problem and dentist said some get a dry mouth from pred and it's that that does the damage. He's given me a mega mouthwash for over night to help. Hope that's useful ,🤣

[Daisychain12 in reply to Angiejnz]

OOOH great advice Angie. I am like a grinning toothless crone...xxxxxxxxx

[Hidden in reply to Angiejnz]

willing to try anything, thanks x I think lot depends on genetics, I've looked after my teeth but still had fillings.

[Blearyeyed in reply to Hidden]

Exactly the same , but the breakages happened long before steroids , since childhood , despite good dental care. I have Dry Mouth Syndrome too , so it increases the bacteria in your mouth and wear as you chew.

Good mouthwash does help and increasing your calcium and Vitamin D to help reduce it happening but for some of us I think it is the way of things .

Apples are beyond me unless sliced and I am only 48!!

Good luck with it ,xx

[DDKRM in reply to Angiejnz]

Me too. Dry mouth and crumbling teeth. Another gift I hadn’t realised was from generous Pred.

[stellafmdm in reply to Angiejnz]

Thanks Angie, I'll try it!

[SheffieldJane]

Poor you! Apparently Prednisalone affects absorption of calcium into our bones and teeth. Hence the Calcium, vit D and vit K2 we need to take. You’re not on anything else that might compound the problem are you?

[stellafmdm in reply to SheffieldJane]

No SJ, nothing else and I do take extra calcium!

[Jackoh]

Yes I had a lot of problems with my teeth the first year of diagnosis but they seemed to have settled down now( hope I haven’t spoken too soon!!)

[Suet3942]

Not got that problem but after having a tooth extracted 3 weeks ago I still have a dry socket and slight

infection. Teeth are a b....y nuisance!!

[SheffieldJane in reply to Suet3942]

Oh Sue that is sooo painful!

[Suet3942 in reply to SheffieldJane]

It sure is Jane! X

[Zhenya in reply to Suet3942]

Hello Suet

I am interested to read about your dry socket after 3 weeks since tooth extraction. How do you know what it is and what is the treatment for it please? I had tooth out 5 days ago and am still in a lot of pain. Dentist prescribed antibiotics straightaway to guard against infection infection but I am worried that pain is not easing day by day. Was yours like this?

[Suet3942 in reply to Zhenya]

Hi zhenya. Luckily it has only been slightly painful. I've had 2 lots of antibiotics. Seeing my dentist again on Thursday so hope it's improved by then. He did say that he was surprised I wasn't in agony. Have you been rinsing with salt water?.

[Zhenya in reply to Suet3942]

Thank you Suet

Yes I have been rinsing with salt water 3 times a day. Maybe I have dry socket. I will try to get appointment at dentist tomorrow

[mfremar in reply to Zhenya]

A dry socket happens when the blood clot that forms after extraction washes out.The extraction site bone is uncovered and the source of pain.Your dentist can pack the socket and the bone pain should diminish.Do not rinse out as that washes away the blood clot.

[Zhenya in reply to mfremar]

Thank you mfremar

I almost hope it is dry socket so at least I will know why I am in so much pain. The dentist did say it was a very difficult extraction and I was in the chair for over an hour, so I have been thinking it would take longer than usual to settle down but 5 days seems too long

[mfremar in reply to Zhenya]

The longer the surgery the more the pain.Go to the dentist and ask if It is a dry socket.If he thinks it is ask him to pack it with iodofoam gauze .

[Zhenya in reply to mfremar]

Thank you mfremar and Suet 3942 for your invaluable advice. I went to the dentist this morning and I do indeed have dry socket. He packed it with the iodine gauze as you suggested, and within a couple of hours the pain subsided. Now keeping my fingers crossed it will not return although Suet has spoken of it lasting 3 weeks. Does the gauze need changing every so often? The dentist didn’t mention anything about this. Thank you again.

[mfremar in reply to Zhenya]

It depends on if it reasorbs by itself.Healing may integrate into the area and nothing has to be done. Call the office and ask the nurse or dentist.It is like stitches that disolve.I would call as different materials your dentist uses may be different.

[Zhenya in reply to mfremar]

Thank you. I will call dentist as you say.

[Blearyeyed in reply to mfremar]

Great advice , good to remember for my next treatment, thanks ,x

[PMRpro Ambassador]

Once calcium is in the teeth it isn't that easy for it to be removed - unlike with bone where low blood calcium does cause calcium to be removed from the bones to top it up. And long term that can lead to osteoporosis.

The most common reason for calcium being leached from teeth is periodontal disease - where a biofilm of bacteria on the surface leads to softening of the surface and calcium being lost so caries can form.

Another cause may be silent gastric reflux - where you have regurgitated stomach acid, mostly overnight. This weakens the surface of the teeth in a similar way.

And too much brushing of teeth doesn't help either - always wait and hour or so after a meal to brush your teeth or the remaining acid environment from the meal means the enamel is weakened and hard brushing causes damage over time. The same applies to drinking fruit juices - especially if you swish it around your mouth to warm it up!

[Loco99]

I grind my teeth at night which can cause them to break and fillings to crumble, it’s worth investigating and usually solved by the dentist making you a plastic mouth guard to wear at night.

[Ventdunord]

Since starting on Prednisolone 6+ years ago I have lost five back teeth, four upper and one lower. When first asking about the possibility of implants I was told my jawbone density was not good enough to support them.

So it seems that in addition to the most common pleasures associated with long term steroid use, aches, pains, bruising, thin skin, fatigue, etc. I can now look forward to dentures sometime in the not too distant future!

Great!!!

[B4lamb]

I'm having similar issues with teeth that is too coincidental with the intake of pred. I was upped from 5mg to 60mg at Christmas because of a massive flair and developing GCA. My GP in conjunction with the Rheumatologist put me on Alendronic acid and daily calcium to offset the bone thinning and bone density effects of Pred at high dosage. The acid intake is designed to maximise the absorption of calcium but i was told to inform my dentist as it results in high risks of dental issues. It seems to correlate with recent dental problem and bank balance problems paying for dental work.

[Telian in reply to B4lamb]

Take K2 to ensure calcium is absorbed in the correct places - I buy it online as not available from GP.

[B4lamb in reply to Telian]

Is k2 better than Alendronic acid then? What is the main constituent of K2?

[PMRpro Ambassador in reply to B4lamb]

K2 is just a vitamin involved in transfer of calcium from blood to bone - not a pharmaceutical drug.

[Telian in reply to B4lamb]

See PMRpro’s reply.

[PMRdaughter]

I think it is related to the prednisone. It depletes your bones and teeth of calcium. Talk to your dr about Vitamin D3 with K2. You may need to do fluoride treatments at home. Talk to your dentist as well.

[Ventdunord]

I think most of us have been taking Calcium supplements from the onset of PMR, but perhaps not enough to offset the depletion caused by long term use of Pred?

Who really knows?

I should say " I'm fed up to my virtual back teeth".

[GerriMc]

Yep! I had really good teeth and after 6 months on Pred, I started to have breaks. I now have several fillings. My dentist got me a gum shield to wear at night as I was grinding too.

[stellafmdm]

I had a dexa scan recently and my bones have actually improved although they were not bad to start with! Pity the teeth don't follow suit!!!