You might recall my earlier post a few months back about a possible link with root canal treatment and PMR. Whilst nothing can be verified as research is quite speculative, I have been to see my dentist today with a view to having a 3D scan on my root canal tooth. However, I have decided just to get the tooth out and be done with it. This is very brave of me after experiencing an awful dry socket in 2016, but I am back with my lovely excellent private dentist who I have a lot of faith in. Whether having the tooth out will make a difference to my PMR, who knows? But I am willing to try, the tooth is not right and still sensitive. I would like to ask all of you out there who know, am I right in thinking I will need to double my dose of pred (am currently on 8mg) and is this before the extraction? If so, how long before, and for how long do I stay on the doubled dose? I am pretty sure I read before that I can then drop back after a week to my earlier lower dose? Any confirmations or advice, especially from those who have been through this, would be appreciated. Many thanks.
Update re:dentist and root canal link to PMR - PMRGCAuk
Update re:dentist and root canal link to PMR
Hi Londalelass
I had mine extracted when I was on 10mgms by by own dentist. I didn’t increase and I had no problems whatsoever. Just make sure you keep your mouth clean afterwards and don’t attempt to taper until it’s healed
You should be fine.
Thank you Edith Wales, I'm pleased you had no problems with yours. Maybe then I won't need to increase after all, although my dentist thought I would. I may need to check with my doctor. Thanks for the tips.
Hi...I had several abscesses in the remnants of a bridge. When the 3 tooth bridge was there they cantilevered against the remaining one so it was wobbly and then just started to get wobblier as each abscess burst. It was so troublesome that one day when I took the daily wobble scale it popped out. The absolute relief of pain in that side of my face, eye socket and up to my ear was amazing. I wished I had have given the go ahead to pull it earlier rather than wait. It was like my heartbeat dropped 10beats.
Sounds horrendous!!! Hope I don't ever have to go through that.
Gosh that was brave. I have found that once these teeth start playing up they are better out.
Missed the point I was making...I was at 7mg and had no problems. It healed nicely if slowly.
That's reassuring, I'm currently at 8mg.
Hi Poopadoop, I know you've replied three times but can't open your third one for some strange reason? Don't know why. Any chance of resending it please?
Must be a blip or a middle of the night delete!
I can only say that when I had a minor oral surgery, the surgeon instructed me to take my original dose the night before and the morning of the surgery. All went fine.
Good to hear all went well for you, without doubling your dose. Thanks for the reply.
I’ve just had a tooth out under a light anaesthetic. No problem and didn’t alter my dose at all. I’ve been very careful to follow the post op instructions, soft food, salt water rinsing etc. Good luck.
Thank you Mozziebuzz. I'm getting lots of positive feedback here. It's good to know.
It depends and you need to speak to your dentist about it. I had an extraction a few years ago while I was on a relatively low dose and didn't double the dose at any point, everything was fine.
If it were to turn out to be a traumatic extraction maybe you would need a bit more and it is unlikely to be a problem taking a single extra dose.
Thanks PMRpro, my dentist has said she thinks I may have to double the dose, I think this is what she knows from experience with other patients. She may also be thinking it would be a precaution in case I do have another dry socket, as she of course can't guarantee that I won't, although she has said she will make the extraction as trauma free as possible and allow plenty of time. She also advised I speak to my Dr unless he contacts her. So, if I do increase my dose, are you suggesting it may only be for a day? I'm just concerned I've got this far, from 15 to 8mg, and don't want to have to slow taper again back down if I can help it.
You should be able up the dose for up to a week to 10 days and drop back down to the old dose straight away without problems. I don't think the extra pred will prevent problems, just allow you to cope better with any if they arise, and if it were me, although I might take a double dose the day of the procedure, I'd be inclined to wait and see if it all goes OK before using it for longer. It used to be automatic to double the dose (not sure for how long though) for all procedures but more recently it has been recommended to monitor the patient's progress to avoid using as much pred.
Oh thank you PMRpro, that's really great advice. E
Oh thank you PMRpro, that's really great advice. E
Ignore that E!! Fat fingers typo!! 🤣
Multiple fat fingers 
I hadn't realised!! 🤣 🤣 🤣 🤣 🤣
Who cares!!!!
Ignore that E!! Fat fingers typo!! 🤣
Good luck hope all goes well. I have had lots of root canals in the last two years well 5 in total. I have had one tooth out and an implant done! I can only think the prednisone was a factor in terms of the issues.
Thanks JulieR2, gosh, you've done well to go through 5! And an extraction and implant too. You've probably guessed, I'm a bit of a wuss about the dentist!! 🤣
To be honest last year I saw the dentist more than key members of my family! I just wanted it to stop and thankfully this year I have only been for my routine check up and filling replacement that was cosmetic. I also spent a considerable amount of money but thank goodness I had denplan!!
Good for you. Bet you're really pleased you've had a better year this year. I know what you mean though, sometimes you feel like taking some overnight things and just staying there for the amount of time each appointment takes!! Perish the thought though!! 🤣
I had 2 extractions last week on 5.5 /6mg Pred, both GP and dentist advised it was not necessary to increase Pred, I have had no problems but did follow to the letter post extraction after care. Be very careful not to sneeze, last time I had an extraction I sneezed day 2 post extraction and the clot was dislodged and I ended up with a dry socket that was very painful!!!
Good luck
Oh, yes, that's what I will avoid hopefully, thanks for your reply. I'll be stifling any sneezes then.
I was told by the surgeon to double the dose on the day then continue as usual. I was also given antibiotics. Hope all goes well. Xx
Thanks Sue, much appreciated.
Before I was diagnosed with PMR I had a tooth extraction by my own dentist and a bit of the root was left behind. When everything had healed and I had by then been diagnosed with PMR, he arranged for a specialist to extract the piece of root. I was on 15mg at the time and I remember the specialist saying they would normally advise doubling the dose, just for the day of the extraction, but as I was on 15mg, he said to take only an extra 5mg, to 20mg, for one day only.
I've had a dry socket in the past. I'm sure you know to leave the blood clot intact in the socket by being gentle with rinsing your mouth.
Hope it all goes well.
Hi there Rugger, yes I'm going to be very careful. Thanks for your reply and advice. It's good to know how others as yourself have gone through this whilst on pred.
I have a root canal done in 2008 that has never settled and still tender. I want it out but no dentist will do it and the endodontist/ wants to do it under anaesthetic in hospital. it is root canal and he says it will make a hole in my sinus. I know the root canal specialist was really careful and he said it went nowhere near my sinus. I really want it out but I'm scared of anaesthetic and being completely out, and just want him to pull it out. the other endos said its fine and will not do it. sorry forget the name of the specialist dentist wo extract teeth, and these who do root canal! I am getting bad. I have moyamoya as well as PMR so I do not want an anaesthetic to be put out.
Hi Jan
I do empathise as this happened to me. I was referred to an endodontist a
Sorry finger slipped. for a root canal filling, it cost £300 and lasted 11 months. When I went back he said he could do it again but would only give it a 30% chance of surviving a year. I said I would have it removed. This was an expensive private Practice so he said he couldn’t do it himself and referred me to his colleague. I had to wait to go back to see him which involved a sixty mile round trip. When I sat in the chair he asked if I was on any medication and I said that I was on 10mgs of Prednisolone, he would have known that if he had looked at my notes as I had written it in Capital letters. He then said that if he took it out in the chair I could die. I needed to be in hospital and have a steroid drip. He was going to refer me to a local hospital and I refused. I contacted my own dentist and he laughed and said this creature was 20 years out of date and he would take it out. I checked with other dentist friends who all said this was nonsense. The offending tooth was removed under a local anaesthetic and was gone in minutes. It healed normally and I didn’t have a minute problem.
Unless you have some complicated medical history it’s worth you getting a second opinion, an infected tooth isn’t doing you any good
Please let me know how you get on.
Take care
I was terrified about having a wisdom tooth out - pred and anticoagulant therapy and had been told it would have to be done in hospital in the UK. The dentist here just laughed - as the hospital had done when I has asked them what I had to do - and did it. Since his practice was opposite the hospital entrance I assumed they could call the Notarzt (emergency duty doc) in a couple of minutes. The tooth came out in about 2 seconds and I neither bled nor even felt wobbly.
Your post intrigued me as I also had a root canal done before developing PMR. But when I checked my records, I realized it was TWO YEARS before, so no connection.
Hi. Had a “complicated” extraction in September on 7mg, no talk of increasing pred. Hardly bled and healed quickly. All the best cc 🤗
Thank you.
If it was me I wouldn’t bother unless the extraction was a complicated undertaking. I’d rather have the best chance of healing. Years ago I had my tooth removed after a root canal caused a chronic ‘silent’ infection that went into my jawbone. My health was so much better.
Thank you SnazzyD.
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