Teeth

[Uglow]

Hi I’m due to have 3 teeth removed and 1 filled under sedation. Do I need to change Prednisolone dose to compensate. I am currently on 12.5mg. I am worried as I don’t want a set back.

[SnazzyD]

If it was me I wouldn’t bother. There’s no need to worry about adrenal problems because 12.5mg is more than enough for that to be an issue. What sort of setback are you worried about?

[Uglow in reply to SnazzyD]

Only Iv read about having dental treatment I didn’t realise it was to do with Adrenals. So I will just stay the same thank you.

[SnazzyD in reply to Uglow]

It’s also to do with flaring, but really you need to speak to the dentist because Pred can also slow healing. It’s mainly a personal attitude because I’ve always avoided upping just in case because it feels to me that we need to learn to trust our bodies and not live in fear all the time, a big driver of stress. Perhaps I’m a bit hard about it but dentistry often strikes fear like no other treatment and the thought of it is usually worse than the actual physical trauma. I speak as someone who has a congenital disaster area in the dental department which is rather like the San Andreas fault in California. I suspect this opinion will be a bit contentious.

[PMRpro Ambassador in reply to SnazzyD]

I agree with you!

[Bcol in reply to SnazzyD]

I agree, I've never upped mine for dentistry.

[Nextoneplease]

When I had a nearly two hour dental session recently (new crown) I took an extra 5mg for that day only, on my doctor’s advice. I don’t know whether it was actually needed, but it did me no harm and kept me steady on my current dose (also 12.5mg, as it happens!)

Good luck, hope it goes well x

[Blearyeyed]

You need to speak to your Doctor and dentist about what they recommend in your case and make sure they know your current dose , and what it is taken for, to help them make a decision. I have seen a variety of options given to people.

Some have been told to reduce their steroids on the day , or for a couple of days before but then take increased doses afterwards for a few days to help balance the risk of infection against pain management.

Some people are just told to keep an eye on their pain and increase for a few days if they flare after a treatment.

I've even read of some people increasing their dose before and after.

I believe it all depends on the type of treatment you are getting done and what dose you are on when it is due to occur.

PMRPro will be able to give you more detailed advice on this and as I said double checking with the people treating you is important.

[S4ndy]

I had various extractions, root canal and fillings last year. I am on 5mg pred and spoke to the dentist and consultant oral surgeon. They didn't ask me to increase it. So I suggest you check with your dental practitioners.

I do think after having the bad tooth extracted I had less PMR pain within a week and felt so much better.

Hope it goes ok for you 🙏

[Blearyeyed in reply to S4ndy]

I agree, a number of my flares in PMR and other Pain conditions occurred because of tooth issues and died down afterwards

[Uglow in reply to Blearyeyed]

I didn’t know tooth problems affected pmr!

[PMRpro Ambassador in reply to Uglow]

I think any source of pain will prod the pain of PMR - it's the stress on the immune system. Often see people able to reduce the dose of pred after having a hip replacement for example.

[Blearyeyed in reply to Uglow]

It has more to do with the tension you have in your body when you have any other pain , not just tooth ache , you stiffen up and hold yourself differently , the stress on the body can trigger more pain from the PMR, and vice versa if your PMR is playing up if you have other places where you get regular non PMR Pain it can make them feel more painful.

[Uglow in reply to S4ndy]

I’m really surprised I didn’t know tooth issues were pmr related