Extra cover for dental extraction

[Orpheus82]

Hi. This is my first post and I need some advice. I’ve had PMR for just over three years and am currently taking 2.5mg pred. I also currently have raging tooth ache and although I am trying to deny it I’m pretty sure I am going to have to see a dentist and pretty sure they’ll want to extract it as I’ve had a lot of problem with this tooth. I don’t mind dentists and can cope with extraction but am scared stiff of another adrenal crisis. I had 8hr surgery in December for mastectomy with reconstruction and my long term steroid use was totally overlooked so I ended up in HDU with BP as low as 40/20! Very unpleasant! Has anyone had a tooth extraction and been advised to increase steroid beforehand and after?

[Hidden]

Hi Orpheus

Some people can be blasé about cover for dental procedures but as you have had a past bad experience following your Surgery then you really need additional steroids.

I had a Mastectomy & told the Anaesthetist plus anyone who’d listen or asked my Name/Date of Birth that l was on Prednisolone, l was given 100mg of IV Hydrocortisone in Theatre & again during the night Post Operatively as l was very sick.

On your Blue Steroid Card it does tell you to inform your Dentist for up to a year after you’ve taken Pred.

I would recommend you consult your Doctor or Rheumatology Team if you have one for advice on what dose to take, it certainly needs taking before & not afterwards.

Kind Regards

MrsN

[Orpheus82 in reply to Hidden]

Thank you for the advice. The medics where I had my mastectomy were woefully lacking as I too told everyone that I came into contact with that I was on long term steroids.....even the anaesthetist! My dentist is excellent and well aware of my steroid use but unfortunately is on hols. I think I may have to give in soon and seek help as the pain is escalating. Why do these things always happen at weekends?!

[Hidden in reply to Orpheus82]

It always the weekend, when is your Dentist back?

There are Emergency Dentists sometimes attached to the local A&E when l worked in the NHS we always had a Duty On Call Dentist List.

Let us know how you get on.

Mrs N 🌷

[Hidden in reply to Orpheus82]

Get yourself orajel and lots of painkillers. Warm sensodyne rapide on your finger and if you can bear it cover the tooth. Warm salt water gargling. Obviously not all these at once but salt wash, then orajel the toothpaste over an hour. Good luck it's horrid.

[Orpheus82 in reply to Hidden]

I’ll try that as well. Taking four hourly paracetamol. I’ll see how it is tomorrow but if it’s worse I think I’ll admit defeat and seek help. Maybe I should have ‘I am on steroids tattooed on my forehead!’ 😂

[Hidden in reply to Orpheus82]

I bet you're not the first to think that. I hope it calm a bit so you can get to Monday. 😁

[jinasc in reply to Orpheus82]

Have you some whisky in the house and cotton wool..............if so dip cotton wool and place over tooth............................your raging toothache should subside and you can keep on doing it

[Orpheus82 in reply to jinasc]

Good idea! I like the sound of that. No whisky but have got some brandy so might try that 😋

[Hidden]

I agree with mrsN....once bitten twice shy. Have everything in place to ensure your health and safety, you don't need another terrible experience.🌻

[scats]

My dentist doesn't mind the steroids but panicked at the mention of alandronic or zoledronic acid. He insisted that I had the extraction at the local hospital, even 2 years after I had stopped taking it. There is a risk of osteonecrosis of the jaw, and even though he admits it is very small he does not want to take it. The hospital was happy with me on 10mg.

[JulieR2]

Hi There I did have a tooth extraction and later the work for an implant. I also had 5 root canals in 12 months. I didnt increase but didn’t decrease either for that month and I was fine. Good luck. Toothache is horrid x

[SheffieldJane]

I want want to increase to 5 mgs at least, especially with your history. Talk to your dentist, he gave me Novocain without Adrenaline in it for some reason, related to my PMR.

[alvertta]

I had tooth extraction in May. Dentist gave me 8 mg prednisone pre surgery. All good After I continued on with my current level. 25 mg. GCA since October 2018.

[Suet3942]

Yes I had an extraction in February and was told to double the dose of pred on the day.

[Hidden in reply to Suet3942]

Thanks Sue & what dose are you on now, as that may be helpful to others.

[Suet3942 in reply to Hidden]

At the times was on 10 mg pred. On 8.5 now.

[Hidden in reply to Suet3942]

Thanks Sue x

[PMRpro Ambassador]

Having a tooth out is not in the same league as a mastectomy and reconstruction! You should have had hydrocortisone during the surgery and SOMEONE should be on the carpet for the failure then,

Having a tooth out shouldn't be a problem, especially if you don't have a GA, which I haven't had the last couple of times which have also been on pred and didn't need any extra pred,, but if the dentist doesn't give you a boost there is no reason why you shouldn't take more for a few days to stop you worrying.

[Orpheus82]

Thank you so much for all your replies and advice. I have a reprieve for a while as was seen by emergency dental service this morning and given antibiotics to try and settle it. I’m seeing my own dentist when she’s back off hols in 10 days so can discuss with her. You have all been so helpful.

[EdithWales in reply to Orpheus82]

Hi Orpheus

I had fun and games with mine, I was referred by the Endodontist to the partner who did extractions. Having told them on the form I was on 10mgms of Prednisolone , he hadn’t bothered to read my notes so when I reminded him, he told me if he took it out in the chair I could die, I needed to be in hospital on a steroid drip. I was horrified and when I checked with my own dentist he said this over paid private person was 20 years out of date. He took it out under a local and I didn’t realise he had done it. I didn’t need to increase my dose and it healed normally. You will be fine

🥂

[PMRpro Ambassador in reply to EdithWales]

Was just about to scream "what tripe ..." but I see you have a rather more sensible opinion. I'm definitely not dead ...

[EdithWales]

They really are irresponsible. He was going to refer me to a MaxFax Surgeon. Just imagine if you weren’t in the trade and totally uninformed🥂

[El50]

I was referred to the Dental Hospital by my dentist for a difficult infected root extraction that he had failed to remove as the root had fused onto the bone.This might have been why the Dental Hospital refused to treat me without getting someone over from the main Hospital to give me an IM. booster dose of steroids before starting the procedure. (They had forgotten to give me instructions re. increasing the steroids with the appointment letter) I needed no increased steroid dose afterwards just a course of antibiotics.The treatment wasn't that bad and sorted the problem out permanently.

[Lonsdalelass]

Hi there. I had an extraction in May. Was due to reduce a week before, and my gp said just to carry on, but I didn't and played safe, so stayed on my current dose (8) and reduced a week after the extraction. Healing time probably took a little longer, but all good in the. Good luck.

[braininjurythepits]

I had a tooth extracted last Thursday (at the back, next to my wisdom tooth) it was painless, quick, and the next day I went in for him to check it, he was very pleased how well it was healing. I didn’t reduce or increase my steroids (on 8mg Prednisolone), or need antibiotics.