Pain in mouth and jaw

[Pistachios]

Three weeks ago I had a tooth removed due to suffering pain in my mouth for a number of weeks. The alternative was root canal treatment which was priced at around £900. Having had the tooth removed I still have real discomfort in my mouth and jaw on a daily basis alongside a PMR flare up I am, at present, experiencing. I am in the process of increasing my pred. to 10mgs per day for a week to deal with it before going bach to 5 mgs. I am now wondering if the discomfort in my mouth and jaw is part of my PMR along with the pain in my neck, upper arms and thigh!

[SnazzyD]

Did you ever have an x-ray of your jaw at the dentist’s? Has infection in the bone or an abscess been ruled out?

[Pistachios in reply to SnazzyD]

I did have an x ray and there was definitely no abscess. There was no mention of disease in the bone. This was a new dentist as my dentist of 20+ years had just retired.

[Portobello in reply to Pistachios]

Have you been taking bisphosphonates by any chance?

[Pistachios in reply to Portobello]

I take pred. alendronic acid and adcal- D3

[SnazzyD in reply to Pistachios]

Good point from the others about the Bisphosphates. Did the dentist know.

Both times I had an extraction I had to go to the osteopath to get my jaw sorted out and prior to that I had jaw pain and headaches. Same with my daughter after she had to hold mouth wide open for a long time during orthodontic work.

[HeronNS]

You aren't on osteoporosis medication by any chance are you? That aside, if you aren't already taking it, add a Vitamin K2 supplement (not K1) as well as making sure your magnesium intake is adequate, These are what make sure calcium goes to the bones and although it's easy enough to get magnesium from a well balanced diet we are often deficient in Vitamin K2. It may help healing. I've found my super-sensitive teeth have become far less so since I've been taking 200 mcg Vitamin K2-7 every day for some time (two doses of 100 mcg).

[Pistachios in reply to HeronNS]

I am on alendronic acid.

[HeronNS in reply to Pistachios]

That can affect bone healing after dental surgery. Does your new dentist know?

[SheffieldJane]

Others have mentioned the things I first thought of. I wonder if it could simply be all the pulling and tugging involved in tooth extraction?When I had root canal work, I feel sure that I was given antibiotics for the infection that triggered the whole thing.

How are you with chewing? Does is get worse as you chew? We need to be alert for signs of GCA too. Don’t tolerate it for too long before seeking help.

I would talk to your doctor about jaw claudication in relation to GCA that can follow PMR, it did with me.

[Pistachios in reply to SheffieldJane]

Chewing does seem to bring it on.

[Pistachios in reply to SheffieldJane]

Thank you

[PMRpro Ambassador]

Did the dentist know you have been taking alendronic acid before deciding to extract the tooth?And what is the jaw pain when chewing like? Does it ache and then go when you stop chewing? If so, I think it would be a good idea to speak to your doctor - you do need to rule out GCA.

[Rache]

Just a thought - it could be a ‘dry socket’ which is incredibly painful. Both I and my daughter have had it after a tooth extraction. It’s caused by the clot either failing to form or being dislodged I think. I think antibiotics are called for if this is the case. It happened to me as a young woman long before PMR.

[Pistachios in reply to Rache]

I'm not sure but I think if it was a 'dry socket' the pain would be very localised whereas this pain seems to over the whole of my mouth.

[Rache in reply to Pistachios]

Yes I think you’re right. It’s a long time ago but I remember my jaw ached terribly around the area of the extraction. This link may help:

mayoclinic.org/diseases-con...

[Lonsdalelass in reply to Rache]

Good idea. I also had one of those, and it was really painful! Yes, I had mine before PMR too.

[jinasc]

Follow this link and read up and I would be contacting my GP and Dentist pronto.

netdoctor.co.uk/medicines/a...

[Louisa1840]

I too had an extraction two weeks ago. It's taking some time to heal but I think is on the mend?....... We have to remember that pred inhibits healing. But take heed of the previous advice if you think you're in unusual pain. Check it out with your dentist.

I had had Aclasta (for bone density) infusions but over two years ago so the dentist felt I was an okay risk. Sometimes all my teeth ache which I put down to PMR?

[HeronNS in reply to Louisa1840]

Take Vitamin K2 in addition to whatever else you are taking for your bones. The jaw appears to be more prone to losing density and Vitamin K2 does seem helpful with bones generally, including the jaw, and even reducing tooth sensitivity - over time of course.

[Pistachios in reply to HeronNS]

Thank you . I will do that.

[Louisa1840 in reply to Pistachios]

Thank you Heron - I didnt know that Off to buy some Vit K2. ....

[Pistachios in reply to HeronNS]

Hi, I did as you suggested and went off to buy vitamin K2 and have now been taking it for two weeks. The pain has subsided considerably and I have reduced my pred, from 10mgs, back down to 6 mgs. which is a little more pred than I was taking before the flare up. I feel so much better and feel I am back on track. Thank you so much for all your help and advice - I am so grateful.

[Vidag]

I had tooth extracted early December. Dentist was most concerned as I am taking AA. She explained the possibility of osteo necrosis. I had a check up 10 days later to ensure normal healing was taking place.

[Pistachios in reply to Vidag]

I am having a checkup today .

[Helipad]

Hi, one of my very first noticeable symptoms was of pain in my jaw which was made worse when I attempted to eat anything and also, as I now know, pain in my tongue which radiates down my throat. I am now been on pred, Leflunomide and Tocilizumab and I still have the pains, though not as bad as initially and was told by rheumatology that it could take a long while before they go away. I have GCA and PMR.

[AdoptMeow in reply to Helipad]

I am going to start leflunomide. Actemra is too expensive. I'm interested in the reasoning for taking both DMARDS. How has each one helped with your symptoms? What is your tapering schedule for prednisone?

[Helipad in reply to AdoptMeow]

I was initially started on 60mg of Pred, at the end of August, which I took for 6 weeks. This has gradually been tapered down and at the moment I’m taking alternate doses of 10mg and 7.5mg for the next 3 weeks and then 7.5mg for another 3 weeks. They started me on Leflunomide as i was showing symptoms of flaring. They then put me on Tocilizumab as the auxiliary ultrasound on my right axilla had got slightly worse from the initial ultrasound last August, so concluded that my large vessel GCA was getting worse and not under control with Pred and Leflunomide.

[Amkoffee]

What you're probably experiencing is something called a dry socket. They can be quite uncomfortable and it's not uncommon after tooth is pulled. It's called this because the blood clot that forms in the cavity where the tooth was covers the nerve. If that blood clot becomes dislodged it exposes the nerve to the air which causes a great deal of pain. There is a solution but you must call your dentist. What he should do is pack your hole with gauze that's been soaked in oil of clove. This numbs the tissue until it heals.