Tooth extraction

[Dukeyears]

Hi I did write this post a few days ago but think it might have gone astray, probably my fault, so here goes and if it has appeared somewhere here in the last few days please forgive me. It is necessary that I have a complicated tooth extraction, because I am on Steroids 5mg at present the Dentist says I must take 100 mg of steroids two hours before the extraction. I can handle the thought of the extraction although being once a dental nurse I know what the procedure entails, but the thought of taking 100 mg of Steroids really freaks me out. Can anyone tell me if this is normal and if so what may be the concequences /after effects of such an enormous dose to my body, thank you one and all for you past help to me and all the others who seek your help.

[PMRpro Ambassador]

I'm not surprised, it'd freak me out and I think it really is a bit OTT!! I have had root canals stuff done without that amount of pred - how complex IS the extraction?

The Sick Day Rules seem applicable - and if you were having surgery in hospital I would expect the anaesthetist to give hydrocortisone i.v. during the procedure. But I cannot imagine it would be the equivalent of 100mg pred. Sick Day Rules (see a post in FAQs) would tell you to double you current dose up to a maximum of 20mg/day for the duration of the problem.

This might be useful if you can get the full text:

pubmed.ncbi.nlm.nih.gov/155...

and in fact that is easy: nature.com/articles/4811857

and judging by it, if it is a local anaesthetic you will be fine. If it is a GA - then the anaesthetist should have the last word.

[Nextoneplease]

I had a complex dental procedure while on 15 mg daily, and was advised by my GP to simply take an extra 5mg that day. All was fine 👍

Just a thought - it couldn’t be a misprint and you’ve been advised to take an extra 10mg not 100mg??? That sounds more likely…..

Good luck, hope you sort it out 😊

[Constance13 in reply to Nextoneplease]

I certainly hope it was a misprint! Surely taking 100mg would be dangerous?

[PMRpro Ambassador in reply to Nextoneplease]

I wondered if they had confused pred and hydrcortisone which is what would be used in the infusion - and there is a 5-fold difference in dose, 100mg HC would be 20mg pred.

[SnazzyD]

100mg?! Not sure I’d sit still long enough to be able to do the procedure after that. If it was me I’d be happy with 10-15mg. I’d question that especially if it is just at the dentist’s surgery.

[Jampad]

I recently had a tooth out and two dental implants. The dentist knew I was taking 10mg steroids but didn`t mention increasing the dose. I had read on this site that it was a good idea so just decided to take an extra 5mg. I only did it for one day. I was fine.

[Sophiestree]

hmmm, I think they are confused. I certainly wouldn't take anything like that much for an extraction. I had an extraction on pred 12.5mg at the time and didn't change anything.I think you need to get back to them to confirm exactly what they were talking about. A tad concerning at the very least.

As PMRPro say, maybe they got confused with pred and hydrcortisone. But if they did, that's also a worry in my book.

[PMRpro Ambassador in reply to Sophiestree]

Mine too - not sure they'd be my dentist much longer ...

[Bcol]

Not surprised you were "surprised" by that figure, I had to read it twice before believing it. Nothing to add to the thoughts already offered.

[Sandradsn]

I'm also a dental nurse.My dentist has never requested patients to increase their dose.

[borednow]

I'm on 2mg a day and recently had an extraction. Mentioned preds to dentist who said that was no problem. She said there could be a risk of excessive bleeding on much higher dose (didn't specify how high). Maybe have a word with your dentist to clarify? Hope all goes well.

[AncientMariner]

That sounds a lot. I recently had root canal work and increased the Prednisolone from 2.5 mg to 10 mg two days after because of pain and swelling. I had radio therapy due to cancer in the tonsil and the bone on that part of the jaw is slowly deteriorating as a result so I have to be careful about any dental work but 100mg would certainly raise my eyebrows and I would be wanting to query that.

[Lonsdalelass]

I've had four teeth extracted whilst on pred, at different times, and never increased my dose for any of them. Each extraction has been fine (but I now do have an excellent private dentist). I think your dentist is being excessive, and I would definitely question it.

[S4ndy]

I've had several extractions whilst on prednisolone. At no time did my dentist day I needed to take a larger dose. I asked each time and the answer was no. Last procedure I was taking 5mg and am taking 5mg long term at the recommendation of my Rheumatologist.

[Mirrordinghy]

I had a tooth extraction 10 days ago while on 30mg Prednisolone per day. No mention was made of upping the dose.