Tooth/gum pain?

[Loopy65]

Hi

I’m 18months into PMR and down to 3mg Pred which is pretty much ok but not dropping further any time soon.

This past week I’ve been getting awful tooth pain - randomly and in different areas of my mouth. From Thursday it was so bad I couldn’t touch the tooth without pain. Today though it’s improved a bit and this evening I’m starting to feel in another area!

I really don’t think it’s anything sinister and it’s not my jaw but rather my teeth.

Before I contact the dentist (no clue what they could do as it’s in so many places!!) I’m wondering if anyone has heard of this with PMR at all?

I also have ME but in my 30+ years of that I’ve never had tooth pain unless I needed dental work doing!!

Thanks all

[piglette]

It does sound that there may be a dental problem with the tooth that is very tender. I am sure your dentist will help you. Do you take Alendronic Acid as that can be a problem?

[SheffieldJane]

I get horrible tooth sensitivity - like a needle going deep into my gum. Like you, in random areas of my teeth. Somebody told me that it was damage to the dentine possibly caused by Pred use. Sensodene toothpaste rubbed into my teeth relieves the symptom quite quickly. I did mention it to my dentist but he wasn’t able to suggest anything.

[SnazzyD]

Since high dose steroids I’ve had intermittent intense tooth pain. It was worst during steroids but even without it is still there if I eat hot food. Then I found there is a thing called steroid induced dentine hypersensitivity.

[SheffieldJane in reply to SnazzyD]

Ah! You told us. I’ve only had it since GCA doses of Pred.

[Kendrew]

Hi Loopy65,Although I've not experienced anything quite as severe as yourself, I have developed a heightened sensitivity with my teeth. I've been on pred for over 2yrs and I also take alendronic acid. The pain comes on like a dull ache or a niggly 'irritation'.... sometimes just in one tooth, but sometimes across a whole area of mt teeth. It's a bit like the feeling you get after you've eaten an ice cream and your teeth hurt afterwards.

Like SheffieldJane, I also use Sensodyne toothpaste and this has made a real difference....easing the discomfort to the point that it's almost disappeared completely.

I think your issues may possibly require further management so I hope you can find a satisfactory solution to them quickly. Wishing you all the best.

[Marijo1951]

When I'm eating I experience extreme tooth sensitivity in different teeth, though it does tend to be far worse in the teeth on the left hand side. However as I gradually reduce my pred dose (now 5 mg per day), the pain does seem to be getting less intense.

[Loopy65]

Thanks everyone. I’ll contact the dentist tomorrow. I’m not on Alendronic Acid (desperately avoided it earlier on because so aware of potential tooth problems).

It feels like stereotypical ‘toothache’ but can’t be in so many different places (only one place at a time, it’s very polite!) when there was no pain anywhere in my mouth until about a week ago!

Dentist will probably do X-rays which will at least help rule things out?!

Will try rubbing sensitive toothpaste on the tooth today, thanks for that idea 🙂

It’s no worse if I try hot drinks or cold drinks on the area so doesn’t seem to be sensitivity per se.

[Rose54]

Hi Have you considered sinus pain ?

[Loopy65 in reply to Rose54]

I have chronic sinusitis - this is quite different, thanks though 🙂

[PMRpro Ambassador]

I had tooth pain with PMR alone - long before pred. I started using Sensodyne - tried all the sensitive teeth toothpastes, it was the only one that worked for me. I've used the Pronamel version ever since. Even eventually learned to like the taste!

[Loopy65 in reply to PMRpro]

I already have duraphat prescribed - it’s made a huge difference to the state of my teeth. I used to use pronamel - it’s an acquired taste lol

[PMRpro Ambassador in reply to Loopy65]

I don't think Pronamel was on the market back then and the ordinary Sensodyne then was utterly disgusting but it worked! Pronamel is delicious in comparison

[Mindful3]

I complained to my dentist recently about painful gums and she said steroids change your mouth flora. She Recommended Gengigel gel and mouth rinse. They do help. These days the pain doesn’t last too long thankfully. Just another of the joys that is PMR!

[Loopy65 in reply to Mindful3]

Thanks for this - the bit that was super painful yesterday has eased today so I really don’t think it’s tooth decay! Will phone dentist tomorrow and try to speak to him on the phone about it all 🙂

[kimsaunsc]

I have experienced the same thing! Have always had “perfect teeth”. The sensodyne does help.

[Alchemy8]

I had an acute incident only two days ago for about half-an-hour and then it went. I ensure I use Neem toothpaste and mouthwash.

[Vanlose]

I've just had to have 2 teeth removed in fairly quick succession ...just really glad I decided not to continue Alendronic Acid (I took the first 2 and felt so ill both times, I decided I couldn't cope with that and PMR and OA and possible Sero-neg RA!My dentist (of 30 years) was hesitant to carry out first extraction, as I had had 2 AA tabs, albeit several months previously. Due to my pain and distress, he took the first tooth out....thankfully no major drama and it healed well...only for another tooth to become seriously infected (whole left side of face sore, swollen and tender. Again, he was hesitant, but as I'd been fine with the previous extraction, he elected to remove the troublesome tooth. Infection started to drain immediately, short course of antibiotics and corsodyl mouthwash....3 days later my mouth has healed and feels really good. My concern is the state of my nails...pitted, lumpy, brittle...ugly! I'm convincec its related to suspected sero-neg RA, but ?? I'm 16 months PMR diagnosed and currently on 5mg pred....and battling at that dose. I want to reduce a tad more, but don't feel confident to. Telephone apot with Rheumy later this week so will discuss then. Hoping your mouth feels better soon. Please take care and chat to your dentist for reassurance

[VicSat]

Not long after I had finished 18 months on prednisolone for GCA, I started getting painful teeth too. Hopefully that's all it is in your case. Unfortunately for me my dentist informed me that all my upper gum teeth were disintergrating. He is currently in the process of finishing removing them. He says it's a result of prednisolone. (Although I did find out this is a very uncommon side effect of Alendronic Acid)

Good Luck

[dancersize2]

Recently had a very painful mouth that eventually developed into an abscess on my gum. Got on to antibiotics and abscess burst so no pain. Problem is dentist Xrayed and said abscess still in root cavity and only way to drain is to remove the tooth. Since it is a front tooth and now no pain, I'm very reluctant. I'm hoping getting off methotextrate will get my immune system working again. Not keen on any dental procedures. Good luck. I'm going to try the sensodyne, thank you for suggestions.

[Tonylynn]

Tooth sensitivity can be caused by acid foods (eg pineapple) and acidic drinks. Your dentist or hygienist can apply a number of different materials (such as Duraphat or Tresiolan) to the exposed dentine surfaces and these can help reduce sensitivity. Your dentist can also prescribe a high fluoride toothpaste (Duraphat) which is likely to be more effective than over the counter desensitising toothpastes.

[Loopy65 in reply to Tonylynn]

I’ve been using Duraphat for about 10 years now and it’s made a huge difference to my tooth health. I’ve not needed any extra fillings in that time and haven’t lost any teeth (so far!) - it was a real turnaround for me.

[TamiJerez369 in reply to Loopy65]

I had a similar experience with my left bottom molar, where I began to feel severe sensitivity, pus, and tiny swelling around the region, and this scenario, combined with the sharp pain, began to alarm me. I went to an emergency dentist who told me that the abscess had caused an infection that couldn't be cured with antibiotics alone and that I needed a root canal or an extraction. Because the dental x-ray clearly indicated a chronic abscess, I would recommend that you get treatment as soon as feasible, based on my experience.