Removing a wisdom tooth

[Littlejan22]

I have been advised I need a wisdom tooth removed is this safe whilst on 10mg pred? The dentist expressed concerns about slow healing?

[PMRpro Ambassador]

I was terrified being on both pred and an anticoagulant. When I asked about hospital dentists I was looked at as if I'd gone nuts. My usual dentist assured me it would be FINE. He was right. It was an upper wisdom tooth that a previous UK dentist had told went right up to the sinus and it would cause more trouble taking it out than leaving it. He didn't have the sore mouth where it rubbed! It didn't go into the sinus, it wasn't a problem and it healed quickly after being thoroughly packed for a few hours. I have come to the conclusion that a lot of UK dentists will say anything to get out of doing something they don't fancy ...

[Littlejan22 in reply to PMRpro]

Thank you I was so worried

[MrsNails]

‘They’ are always concerned about healing, there was a big post on this last year, l’ll see if l can find it!

Don’t ever stop Pred before you have a tooth out & you may well need an extra 5mg depending on how you are.....

MrsN

[SanG55]

I had to have broken tooth roots out recently (not a wisdom tooth). Dentist did a thorough pre appointment check and asked me to double Pred dose on day of extraction and then 1.5 times dose next day - all went well and healed as expected.

[Littlejan22 in reply to SanG55]

Hi my tooth is bearable and I am wondering if I should put if off until my Pred is reduced I am now on 10 mg and have been told by my rheumy to reduce by 1 to 0.5mg every 4 to 6 weeks, condition started 7th October, it is self limiting so hoping to be steroid free eventually, hopefully within a year or so, maybe I should just put it off? Is the concern about over bleeding do you know?

[PMRpro Ambassador in reply to Littlejan22]

Despite what some doctors will try to tell us, I'm afraid self-limiting is a rather movable feast - half of patients with PMR need up to just under 6 years to get off pred. The rest of us need even longer, remaining at a low dose for some years.Only 1 in 5 patients is off in a year, by 2 years it is 1 in 3 - but that still leaves well over half who need pred for longer, some much longer. There is no way of predicting who will need it for longer - even some people who were diagnosed quickly require pred at some dose for 4 or 5 years at least.

The perceived risk is not for bleeding - I had no problem even being on anticoagulant therapy and proper post extraction precautions should deal with that anyway- but slower healing. I can only say mine healed normally.

Another question has to be whether your doctor has pushed you onto alendronic acid or another bisphosphonate to "protect your bones". If so, or if there is any likelihood of that happening, the sooner the tooth is dealt with the better as any invasive procedures should be carried out before starting it or very soon after.