Sensitive Teeth

[holty]

Hi I've been taking 20mgs of prednisolone since the beginning of December 2019. This last couple of weeks I've developed sensitivity in most of my teeth if eating something cold. I've never suffered with this before, visit the dentist regularly and thankfully my teeth are in good condition. Im beginning to think it must be a side effect of the steroid. I'd be interested to know if anyone else experienced this? Thanks

[Marijo1951]

It's certainly something I've experienced a lot since starting on pred, although mine isn't particularly triggered by cold (or hot) food, just by eating in general. When it first started, my dentist examined my teeth and gums carefully and took x-rays, but there was nothing wrong from a dental point of view. He said it's not uncommon for sensitive teeth to be a side effect of steroid treatment, but to be on the safe side he checked again six months later. The verdict was the same - it must be the pred.

[Lonsdalelass in reply to Marijo1951]

I agree, I am the same with my teeth. Still sensitive now, after starting on steroids on Oct 2018.

[cmgarner]

Yes! This started a few months ago; I was probably on 20 or 30 mgs at the time. My teeth are still cold sensitive at 12.5 mg, although not as pronounced. I started using “Act” restoring mouthwash daily. I think it helps.

I’m also interested to hear if this has happened to others. I never thought to associate this with prednisone ( although I’m pretty good at blaming prednisone for all things bad!)

[SnazzyD]

Whilst some have teeth pain when developing GCA, I got it further down the line after a few months of being on Pred. It got better as the dose reduced but it hasn’t ever gone, but in my case it’s heat that gets them going.

[Hidden in reply to SnazzyD]

My teeth are still painful when I bite down on top back teeth on something hard...like a nut, but know mine is GCA related. Not sensitive though. All I want to see improve is my eyes...hate the blurry feeling !! Wondering how often our pressures should be checked.

[SnazzyD in reply to Hidden]

My optician said every three months until the dose got down to about 10mg. He did it for free bless him. The blurriness was still there even with only very slightly raised pressures that never changed until about 15mg (I think). He said the eye muscles just don’t work properly and can’t correct the depth of field efficiently. There was no point in changing my glasses because dose change just caused a new state each time. It drove me nuts.

[PMRpro Ambassador in reply to Hidden]

Have you increased your dental hygiene? The vasculitis in GCA/PMR can affect your gums and inflammation there can cause that sort of pain. I was sure I needed another root treatment on the other side of my mouth - no, just a good clean out of any pockets in the gums.

[Hidden in reply to PMRpro]

Interesting re dental hygiene perspective. Most people, even those with scrupulous dental cleaning will have small pockets or gingival infection due to an inability to mechanically clean minute area(s). Their mouth may be extremely clean, but lack of chemical disclosure (vegetable dye - as plaque is invisible) inadequate interstitial cleaning, whether by floss or other, and barely visible inflammation may occur. The resulting bacterial inflammation may protect the sensitive enamel exposed as we get older (alveolal resorption) ergo inflammation is targeted and resolved by steroids, gums shrink as the inflammation is reduced, with dentine subsequently exposed, hypersensitivity presents. Just a theory and obviously dentists should be approached.

[holty]

Thanks for your replies. It's very interesting. I'm convinced now that it must be the prednisolone. Hopefully when I eventually manage to reduce my dose it will improve.

[piglette]

I was in a similar position to you. I had never had sensitive teeth before either. I bought Sensodyne and I think I got through about two to three tubes and I did not need any more after that as it went away as I reduced the pred.

[Rimmy]

Yes my teeth seem much more sensitive to cold especially since raising my Pred dose (again). I had to ask my dentist to be very 'careful' when cleaning my teeth as the blast of cold air and water on my teeth and gums (which are generally pretty healthy) made me jump - seems silly but was quite excruciating. (Luckily I am in Western OZ which is relatively 'safe' for dental visits right now.)

[pamela4215]

I've also had this since I've been taking Pred - over two years now. My dentist found me some toothpaste to use but it still happens intermittently. I'm now down to 8 mg from 60 but it is still happening from time to time. It usually happens with cold food - I've given up icecream - but happily, much less than it used to be.

[magmapearl3]

Yes, this happens to me even though I am down to 1/2 mg ! It's intermittent but happens every time I reduce.

[NZShez]

I have had PMR for 4 years. No longer on Pred due to the side effects. I have sensitive teeth too. I tried every toothpaste on the market to no avail. My dentist said my teeth were ok and referred me to a Specialist. He said that it can be related to PMR and said it’s a form of migraine which affects the central face. I was so relieved to have a diagnosis. I am now on Gabapentin and Nortriptyline and the pain has reduced from a 10/10 to a 2/10 which I can manage.

My pain happened due to temperature change that could not be replicated by the dentist.

[Mrsd12f in reply to NZShez]

This is so interesting to me, as I’ve been suffering for about 18 months, now, and posted about it at the time it started. As appears to be the case with others, my dentist can find nothing wrong with the teeth, despite 3 X-rays and a cone-beam CT scan at the dental hospital. What’s interesting is that I’ve asked, specifically, about the possibility of its being the steroids, and was told categorically, that it was not.

I now feel that at least there’s a reason and that I’m not being neurotic!

[PMRpro Ambassador in reply to Mrsd12f]

I do wish they wouldn't say "it isn't ..." so categorically!

[Dambusters]

I have this too. Have had since shortly after starting Pred. last year.

I am 75 and have good teeth. I am waiting for a lost filling to be replaced as soon as I can get an appointment but I have no problems with the actual tooth. Just sensitivity

I have seen the dentist twice and she says to use a sensitive toothpaste and, at night, put it along the gums and, in my case, the tops of the lower front teeth. It helps.

[holty in reply to Dambusters]

I'll try this..thanks

[PMRfacebook]

yes I've experienced this - especially at higher doses - I find rubbing sensitive tooth toothpaste onto the actual teeth really helps

[holty in reply to PMRfacebook]

Thanks I'll try this.

[PMRpro Ambassador]

I had sensitive teeth with PMR - which improved some after starting pred. But most people experience it after starting pred. I tried various toothpastes for sensitive teeth but the only one that worked was Sendodyne. Of their range at the time the best was the Pronamel version - both from effect and taste point of view!

You have been on 20mg for a very long time - has no-one suggested starting to taper the dose yet? Most approaches (even mine) would have you below 15mg/day by now.

[holty in reply to PMRpro]

Yes I've had 3 attempts to reduce but each time within 3 days the pain starts to return. I actually managed a week on one attempt but by the 7th day I couldnt get out of bed so had to go back up to 20mgs which then took nearly two weeks to get it back fully under control. My GP has referred me to a Rheumatologist but still waiting for an appointment.

[PMRpro Ambassador in reply to holty]

Was just going to say - that has all the hallmarks of needing referral.

Though how MUCH were you trying to reduce at one go?

[holty in reply to PMRpro]

Twice by 2.5mgs and once 1.25mgs I've asked my GP for 1mg to try that but she told me I could only have 1mgs once I've dropped below 10mgs. I'd drop by 0.5 if i thought it would work.

[PMRpro Ambassador in reply to holty]

How silly can you get!!! If the patient can't reduce by 2.5mg - then let them try smaller doses! No chance of a different more sensible GP?

What happened when you reduced by 1.25mg? When did the pain return? Have you tried a slowed taper like this:

healthunlocked.com/pmrgcauk...

That way your body gets used to the new dose just one day at atime - and you wouldn't be the first to need to try this way at 20mg. Whatever your doctor thinks ...

[holty in reply to PMRpro]

On 1.25 reduction I was in slight pain till about day 7 then I felt like I'd been hit by a bus. That was 4 months ago. I have tried twice since then by 2.5 and pain returned with 72hrs the latest was 4wks ago. I would love to try the very slow taper as I'm sure that's what I need and I very much want to taper down as I've been on 20mgs for 7 months but as I say my GP thinks I only need 1mgs when I drop below 10mgs. At this rate I'm never going to get there ☹ Hopefully I can convince the rheumatologist to prescribe some for me. Thanks for your feedback it's been very helpful x

[PMRpro Ambassador in reply to holty]

Can you not see a more sensible GP? She is being very silly - for no good reason.

[nuigini]

Teeth sensitivity developed soon after starting prednisone. Only to cold not hot foods. At times even room temperature foods bothered me. Toothpastes designed for sensitive teeth helped somewhat and the degree of sensitivity reduced as the dose of prednisone was reduced.