hi. Am sitting in dentist chair just been told I need to have a tooth extracted. Yikes. Am on 7mg a day and was about to do slow slow dead stop reduction to 6.5mg pred.
what should I do? I think I may need more pred for a few days? Should I take more today? Am feeling pretty anxious about this so any advice from you wonderful folk most welcome. Thanks
The question is are you taking Alendronic Acid?
I had a tooth extracted earlier this year and my dentist referred me to a specialist dentist who understood the possible complications.
She explained that the risk is not so much the extraction as the healing of the jaw bone and possible infection. This is not helped by being both immuno-suppressed and the open tooth socket not clotting due to having an increased blood flow from the Alendronic Acid. As I understand it the infection can cause bone damage to the jaw called Osteonecrosis.
Suggest you talk to your dentist and explain about this. Take the information leaflet from the box of Alendronic Acid as it refers to tooth extractions and insist that you are treated by a dentist who specialise in this area of work.
My tooth came out quickly and easily, bleeding ceased before I was allowed to leave and was then prescribed anti-biotics to avoid infection with saline mouth wash three times daily for a week.
There is also a lot of information on tooth extractions in 'Related Topics' (top right of this page) or search for 'Extractions'. You are not alone!
Mine went well, hope yours does too.
Thanks for swift response very much appreciated was feeling very scared. Not on Alendronic acid (phew). Will go steady and put off next taper step as PMRpro advised. BW GA
Just put off the reduction for a week or two. I've had a wisdom tooth out and had no problems, AsYorksman says - any problems would be associated with a bisphosphonate-type drug. You don't mention it in your profile?
Thank you for the advice as always much appreciated. Rather panicked in the chair. 😱. Will put off next tapering for a few weeks.
My dentist appreciated being told and gave me a slightly different anaesthetic. I thought he said adrenaline free but I could be wrong. He didn’t advise me to change my dose. However, it might be an idea,if you feel knocked about, after the procedure.
I hope the extraction went OK. I had an extraction when I was on 30mg and had had a Zalendronic infusion. Those are the issues. I was given antibiotics after prophylactically and told to do salt water mouth washes as often as I could. All was fine. Hope you're OK today. Paracetamol helps with tooth pain if you have any.
I had an extraction a couple of years ago when I was on (I think) 9mg. The dentist told me to double the dose for that day only, and a pharmacist confirmed that was good advice. I had no ill effects (other than those you’d expect from the extraction itself)
Ask the dentist to put a dressing in the socket to allow a blood clot to form....it helps to prevent having a 'dry socket', which you wouldn't want, believe me I had one of those a few years back and the pain was hell. Since then I've had three teeth out and dressings gone in so no problem.
Having read the replies so far, is it a case of ‘suck it and see’, ie continue on current level and only increase if you get signals associated with insufficient cortisol / corticosteroid. That’s what I would do. In fact I was on a similar dose when I had a stent fitted to a heart artery (12 months ago) and did not take extra Pred.
I had a tooth removed last Xmas I was on 11mgs Prednisolone, absolutely no problems.
Hi all and thanks for v helpful and reassuring advice. Was kinda freaked when dentist said tooth had to go. Have had one other extraction some many years ago and I cried for 2 days. After much discussion with (lovely) dentist she and I decided to wait till after my holiday next week for the extraction in case it anything went wrong esp given that the healing process may be a bit longer cos of pred…she said, so am having it on 30th. Dreading it. But found all your reassuring stories and advice vvv helpful. Sorry not to have responded sooner but I find my usually stoical approach is failing me on this and I have become a bit of an ostrich and trying not to think about it at all. All the best and thanks again GA
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Advice needed please
