Prednisone and teeth.

[YuliK]

Since I was diagnosed with PMR over 30 months ago, I, like everyone else, was given prednisone...

During the past four months I have found a deterioration in my well kept and cared for teeth.

Two of my front teeth have broken 🥲, and three teeth have started to wiggle.

This is quite a shock to me, as only last year my dentist was praising how well kept my teeth were.

I’m sure this is prednisone associated , or lack of calcium. ( although my bloods show calcium is fine )

I’m curious if anyone else has found a deterioration in their teeth whilst taking prednisone.

Thanks

YuliK 😷

[PMRpro Ambassador]

I know a few people who have had similar problems but it doesn't seem to be terribly common given the number of us on pred! I have had no problems so far even after nearly 12 years of pred.

The main cause for loosening teeth is gum problems and I think pred may cause them to recede more than normal aging does.

[YuliK in reply to PMRpro]

Yes I think you are most likely correct. Gums

It’s so easy at my age ( 78) to blame the medications, 🙄but it really came as a huge surprise that I’m breaking and losing my teeth.

Probably age related too. 🥲

Yulik 🌹

[PMRpro Ambassador in reply to YuliK]

I confess to not really understanding why teeth break - although I have had a couple of teeth needing some close attention with inlays/crowns but they are teeth that have been more filling than tooth for the best part of 50 years and cracked! Once calcium is in the teeth it doesn't usually leech out other than wear and tear unless the enamel is damaged. I use Pronamel toothpaste and an electic brush and have done since I had PMR, even long before pred. But lets face it - our toothypegs have done us well for a long time

health.harvard.edu/diseases...

[Boss302Fan in reply to PMRpro]

I use Pronamel also, been doing so for years, ever since my Periodontist noted my gums were sloughing from using Colgate Total. Recently my dentist suggested I continue using Pronamel in the morning and Arm & Hammer PeroxiCare in the evening indicating it would further aid in reducing plaque. Also, as a result I notice my mouth feels a whole lot fresher when I wake in the morning!😁

[PMRpro Ambassador in reply to Boss302Fan]

There is a very popular brand in Germany that has had 2 different toothpastes for mornings and evenings, been around at least 40 years! I tried all sorts originally - hated the taste of Sensodyne originalbut it worked for painful teeth, nothing else did. Can bear the taste of Pronamel - used to be able to get it from our supermarket when on offer but they revamped, went very Italian and a load of things I used to buy have disappeared! So full price at the pharmacy. But it works!

[YuliK in reply to PMRpro]

That sounds just the job. Do you remember the name ?

[PMRpro Ambassador in reply to YuliK]

Elmex and Aronal - the Big A appears to sell it

[DorsetLady PMRGCAuk volunteer]

Could it be from your jaw, rather than the teeth themselves....could account for the wiggling if not holding teeth as securely as it should....and as PMRpro says gum problems.

You’re not on AA are you?

[YuliK in reply to DorsetLady]

No AA

[YuliK in reply to YuliK]

The wiggling teeth, are not all together in one place.

[DorsetLady PMRGCAuk volunteer in reply to YuliK]

Ok, but a bit disconcerting for you - and difficult to stop yourself touching them! Repeat after me...I must not twiddle with my teeth! 🙄

[YuliK in reply to DorsetLady]

OK DL, I promise I’ll try , no twiddling with my teeth. 🤣🤣

But I can’t control my tongue all the time. 🤣 it just wonders off on its own, and finds the wiggly ones.

Have a lovely weekend. Thanks for your input ladies. 🌹🌹🌹

[DorsetLady PMRGCAuk volunteer in reply to YuliK]

Know what you mean about controlling tongue! But in my case that’s usually with mouth open🤦🏻‍♀️

[YuliK in reply to DorsetLady]

🤣

[2013mayo in reply to DorsetLady]

HiWhat’s AA?

X

[DorsetLady PMRGCAuk volunteer in reply to 2013mayo]

In our context - Alendronic Acid - a Bisphosphenate (bone protector).

[2013mayo in reply to DorsetLady]

👍Thank you 😀

[pomeranion in reply to DorsetLady]

What are the gum problems you mention from PMRpro? Started having some sensitivity and pain. Is it just the gums or jaw? Should I be concerned about GCA?

[DorsetLady PMRGCAuk volunteer in reply to pomeranion]

Gums can recede at any time and therefore don’t “hold” the tooth root in place as well as they did. Not necessarily related to GCA.

[Devoid]

Hi I’ve got large vessel vasculitis and have had dental problems, my dentist suggested it was the illness not the medication

[YuliK in reply to Devoid]

That’s very interesting indeed. Thanks. 👍

[Devoid in reply to YuliK]

Just to add I had one that got so wobbly it had to be extracted but the others have settled down as my health improved, the dentist also gave me a prescribed tooth paste

[YuliK in reply to Devoid]

I have a dental appointment in two weeks, so I should know then what’s what.

👍

[magmapearl3]

Yes, I have lost several teeth which broke unexpectedly during the time I was on Prednisone. Lots of dental costs over the 6 yrs I was taking it but it's hard to know if this would have happened anyway?

[Sophiestree]

I have definitely had more dental issues since being medicated. I had to have one tooth extraction and the other day had a large piece splinter off from a tooth that I've had no issues with at all. I'm lucky my sister is a dentist and has so far sorted them for me, the cracked one next week, but it's getting a bit depressing now. And I can't now have implants for years due to the zalendronic acid infusion... I am obsessed with dental care, but it clearly has made no difference sadly.

[YuliK in reply to Sophiestree]

That’s sounds so similar to my situation Sophie.

You’re certainly lucky to have a dentist in the family. 👍

It’s pretty costly to do implants, but at the moment it’s looking that I will have no choice.

Thanks for the input. 👍

[Sophiestree in reply to YuliK]

She came out of retirement to help her old practice as they are so overbooked. The PPE is very very strict and the room has to ventilate for an hour after any procedure, hence the poor person running it didn't have enough hours in a day. A literally as soon as she went back I needed her. I would love implants, but sadly, after the zalendronic acid infusion, they won't touch me for years.... I can only put it down to the drugs as they were all perfectly OK, well the ones I have left, before all of this. So many things that I'm noticing, muscles are my other big issue at the moment, and then went and slipped walking my dog in the forest and now how a touch of tourettes again every time I bend down to pick something up! Will be interesting to hear what your dentist says. Good luck, and lucky you being able to have the implants.

[Cosmos22Marigold]

My teeth are getting worse now. 1 loose one and the rest need attention. I am hanging on to them for as long as I can but they have got worse since pmr diagnosed. Dentist did say I was losing bone in my gums before my pmr. Good luck. I

[TURQ8]

I had Dx in March. I have held off taking pred as yet. I’m now reading about tooth problems from Pred or PMR and wondering about Alondric Acid which I believe is recommended for everyone on Pred to protect bones. Dentists will not treat anyone taking Alondric acid. So I wondered if those of you taking Pred, were you taking the other as well? I am asking ad I am wondering whether to accept the Alondric acid or not. Hope this is not too confusing

[DorsetLady PMRGCAuk volunteer in reply to TURQ8]

My dentist certainly treated me when on Alendronic Acid - for 4 years. Fortunately didn’t need any extractions or invasive work doing - that’s what they are a bit worried out.

But it is recommended that if you know you are going to need something done, to sort that out before you start AA.

[PMRpro Ambassador in reply to TURQ8]

It depends on the dentist and by no means all patients take AA. If you have a dexascan done before starting it you can find out if you need AA at all or whether you can watch and wait, supplementing calcium anc vit D and a few other things and exercising. That can reverse loss of bone density too:

healthunlocked.com/pmrgcauk...

I took 4 AA tablets, had my dexascan which showed slightly under normal bone density (for a 30 year and I was almost double that) and have never taken it again. After 11 years of pred my bone density had only fallen marginally.

[TURQ8 in reply to PMRpro]

Thankyou. I was intending to ask for a dexa scan as I already take calcium, vit D3 and magnesium and am pretty active but also am 80 so automatically put into geriatric category

[PMRpro Ambassador in reply to TURQ8]

True - but I know at least 3 former "PMR/GCA and pred" octogenerians who all have as good as if not better bone density than I do and at least 3 of them didn't even take calcium supplements!

[TURQ8 in reply to PMRpro]

Brilliant info. Makes me confident to stick to my decision

[Amkoffee]

Another possibility is dry mouth. If you suffer from a constant dry mouth it can cause dental problems.

[YuliK]

Is there any part of the body that is NOT affected by prednisone. So far I’ve lost hearing in my left ear, both eyes need to have cataracts removed. 😱

Not to mention the Buffalo 🦬 hump, dry flaky skin, and now my teeth. 😛

Not fun PMR at all. 🙀

[Sally001]

I have the same problem. After years of taking excellent care of my teeth, which include veneers and crowns, I too have been losing them. I've been on pred for the past 10 years and my teeth starting loosening and falling out about 4 years ago when I was 61. I have lost a total of 9 teeth so far, which is devasting to say the least. I know how you feel. It's bad enough we gain weight, get a moon face and a pregnant looking stomach, but to add missing teeth to the mix is unacceptable and especially not being able to get off of this drug as well. It is a great drug but a bad one at the same time. I have been taking calcium, vitamin D, Vitamin B and Vitamin C but doesn't seem to matter. I look forward to any suggestions as well.

[YuliK]

Sally you are still a young chicken 👍 ...

When one reaches my age, 78 years, I suppose it’s only natural that things start to deteriorate pretty quickly.

well as others have pointed out, it looks like the prednisone is the culprit for our teeth loss.

YuliK 🌹

[Jackoh]

Same here Yulik - just going for second canal treatment, on same tooth as I have an infection. I may have to have it out but she won’t know until she starts the work, she isn’t sure if under the crown it is cracked. She is an expert in canal root fillings. That will be 3 teeth lost on that side. Now I notice also on that side that another crown has a very small hole! My dentist surgery has been modernised, new equipment, extended etc. I feel I have made a huge financial contribution to that work!! 😱😂💐

[Blossom20]

Yes, I'm having real problems with my teeth since I started on the PMR and Pred journey. Have lost 3 and now have inflamed gums and waiting to see dentist for an xray to check the 2 wobbly teeth on the other side! It's a bit of a nightmare knowing what to do for the best. Apparently I haven't got enough bone for implants (but could have a bone graft, but that doesn't sound very good, and anyway they are so expensive). Root canals have a bad press - they seem to get infected easily. I have a plate but it doesn't really help much and all the food gets trapped in it!Sorry for all that - well you did ask! Are there any dentists on here I wonder? Has anyone got any experience of those 'smile in a day' sort of things?

[YuliK in reply to Blossom20]

Blossom sorry for all you teeth and gum troubles.

Unfortunately today, implants seems to be the best option...

YuliK 🌹

[Rimmy]

Just saw your post Yulik and can empathise. Severe tooth pain sent me to the dentist to discover a bridge I had dome some years ago is probably failing and some other deterioration in my teeth he commented was very rapid cf. a year ago. In my 5th year on Pred and can't reduce below 12mg without a flare - so nothing much I can do about that - but thinking my teeth (the ones I have left) are at considerable risk and the alternatives ain't 'attractive' or 'cheap' !! Hope you are currently doing OK.

[LizMitchell]

Hi Yulik

Yes I have! Every year for the past 3 years I have had a trip to the dentist for a broken tooth, which could be attributed to long term steroid use since 2015. I naively thought it would be the 1-2 years that my Rheumatologist suggested it would be, how wrong was that! There appears no light at the end of this long dark tunnel 😩

[PMRpro Ambassador in reply to LizMitchell]

The median duration of pred management for PMR is just under 6 years and there is increasing evidence to support that sort of figure. In my experience 4 to 5 years is very common. I;ve been on pred for 12 years - my teeth are still pretty good for my age. A few beaks that have now got fancy inlays or crowns but they were teeth that were more filling than tooth and have been since my teens and 20s.

[YuliK]

A few days ago my front tooth fell out. ( it’s a perfectly good tooth. Not a sign of decay or discoloration. I have a dental appointment next week. In the meanwhile my young grandchild are having a good laugh. I don’t mind, I do look rather funny with a huge gap.

[PMRpro Ambassador in reply to YuliK]

Suppose they think it's hilarious - not just them losing front teeth!!!