Gum boil - ouch!

[jaycee444]

I had a gumboil come up quite quickly after a couple of days niggly tooth. It burst in the night. Pain stopped great relief. Been rinsing in salt water. If I visit dentist today and he wants to extract it , being immuno compromised is it safe to let him do so as there will obviously be some residual infection. I am thinking that the infection needs to be cleared first? Have to add…. My dentist very reluctant to prescribe antibiotics

[SnazzyD]

My brother-in-law who is fit as a fiddle had the same a few months ago and the dentist made him go away and take a week’s worth of antibiotics before he’d even entertain taking the tooth out. On the other hand my dentist years ago didn’t wait, even though I had a low white cell count but then gave me antibiotics after. Their reasoning was that it needed to be able to drain quickly. I can see both sides but not being a dentist I don’t know what the evidence base for either approach is. We both had a good outcome. I’d certainly raise the question and ask what their reasoning is.

[MrsNails]

Sounds Awful 😣 what dose of Pred are you on? Pred usually isn’t an issue it’s more about people who take Alendronic Acid or similar that there’s more risk.

But if the tooth’s bad it may need to come out however, antibiotics may clear it up.

Don’t forget to remind your dentist you are on Steroids as you may need to increase your dose (it often depends what dose you are already on)

Good Luck 🍀

MrsN

[PMRpro Ambassador]

I'd want to know why he won't give you abx - no reason at all I can think of. I have had an infected root canal dealt with in the past while on pred, no problem at all and I don't think I was given abx then and I was surprised but this is Italy. But with an abcess - different matter as Snazzy says

[jaycee444]

Am on 8mg. My dentist away so saw another. The abscess was contained in the gum and the tooth itself is ok. She said that as it had drained itself she would not prescribe antibiotics but suggested that I keep the area extra clean and use a water jet flosser which I already do)

[DorsetLady PMRGCAuk volunteer in reply to jaycee444]

They don’t like giving antibiotics unless absolute necessary nowadays -used to hand them out like sweeties in the past which lead to some not being effective for lots of illnesses/people.

[PMRpro Ambassador in reply to DorsetLady]

Yes - but when they are needed, they need to be used. Very interesting article in the Guardian today about British dentistry and their fear of doing anything in case it goes wrong ...

theguardian.com/lifeandstyl...

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

Not saying they don’t have their place -obviously they do -but there was a lot of publicity about them being overused a few years ago.

Now everyone is so concerned about litigation in most walks of life it seems you can’t do right for wrong!

Becoming a bonkers world!

[PMRpro Ambassador in reply to DorsetLady]

And it is probably the abx used in mass food production that is the biggest problem!

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

Very true! 🤔

[Constance13 in reply to DorsetLady]

It’s been going bonkers for the last two years and it doesn’t look like there’ll be a happy world very soon either!

[DorsetLady PMRGCAuk volunteer in reply to Constance13]

😔

[Lonsdalelass in reply to PMRpro]

Thanks for the link PMRpro, super reading. I've always thought, since becoming ill myself with PMR and reading much about it, that what goes on in the mouth re:teeth affects our bodies, and still believe that a bad root canal was the cause for me. Obviously I'll never be able to prove it. I feel for the author of that article. My dentist agreed to remove both the root canal tooth, and more recently the one beside it after my request to do so, so I was lucky. And I have been feeling somewhat better ever since.

[PMRpro Ambassador in reply to Lonsdalelass]

My dentist is very sharp about infections - not least because they can be a cause of cardiac problems.

I suppose it is a bit like tonsils - they used to remove them at the drop of a hat. Then it went the other way about 50 years ago - they just wouldn't. My daughters both had terrible throat infections which triggered asthma attacks. I remember the ENT King at our local Uni hospital having a rant about the fashion to keep tonsils - he maintained it kept a load of children in poor health and it was all GPs' fault as they were so reluctant to refer the kids for surgery.

I went in with the older one to have hers out - and the younger one came with us for examination under anaesthetic as she was too young to really do otherwise. They took her down to look - they were so enlarged they were surprised she could breathe at all and removed them then and there! They were like different children.

[Lonsdalelass in reply to PMRpro]

There you go! I've got large tonsils, my mother used to tell me as a child, but touch wood they've not given me problems with throat infections. My mother also told me this story, only recently, about her grandfather I think it was who had troubles with his sight and almost blind, went to the dentist who took out all his teeth and yes you've guessed it, his sight came back!! B....y hell! Years ago, that was a common thing to have all your teeth out in one go...my mother in law had all of hers out at the ripe age of 21!! She's still here with us at 92! 😀

[PMRpro Ambassador in reply to Lonsdalelass]

My mother had all hers out at 21 too - I have always assumed due to peridontal disease causing loosening as it was pre- the antibiotic era. A world without any effective antibiotic drugs would be very scary!

[Lonsdalelass in reply to PMRpro]

Yes, wouldn't it just!

[MrsNails]

Hi jaycee444

How’s the tooth? How did you get on with the Dentist?

MrsN

[jaycee444 in reply to MrsNails]

Hello Mrs N. I saw a different dentist as mine was away. She said as it had already drained I didn’t need antibiotics and just to keep it clean using a water jet flosser. The abscess was contained in the gum and Xrays showed the tooth itself was unaffected. I was still concerned however as I could feel there was some residual infection and it was tender under my jaw and down my neck. I did some rigorous cleaning and used antibacterial mouthwash and today things are a bit calmer. It does end up being a worry. I do of course realise that antibiotics should not be doled out willy nilly but I wonder sometimes if (especially dentists) still really take immuno suppression seriously. Another reason I guess to want to be off of steroids. They have wonderful positive benefits but ………

I certainly have had more trouble with my teeth and gums since being on steroids. Gum recession is becoming a problem. i have always been vigilant about oral health but whether it age or something else that’s happening I’m not happy about it 🥴

[MrsNails in reply to jaycee444]

Yes - it always makes you wonder if it’s really all gone? But hopefully your regime should keep it under control 🍀

What dose of Steroid's are you on now?

[jaycee444 in reply to MrsNails]

8 mg. seem to be a bit stuck on this dosage. My body does not want me any lower right now.

[MrsNails in reply to jaycee444]

It’s a tough one - just around the Physiological Dose - ie the dose we need to exist with nothing to spare or back us up in a crisis. I’m just on 9mg (first time in single figures for longer than l care to remember) going to start a slowwwww taper to 8.5mg when l return from France.