Possible root canal

[catdance]

I went to see my local dentist due to finding what looks like an infection inside of my upper lip right next to the base of my nose. They couldn't figure out by xray, tapping or using something cold to verify which tooth. So they gave me an antibiotic that I started last night and have had 3 doses of so far. I woke up at 7am and took a dose of the antibiotic, had a cup of coffee and bit of breakfast. Shortly after I felt sooooo tired I laid down and rested, not sure I actually fell asleep. I still feel very drowsy. I have an appointment with an endodontist at 1:50pm today and is 45 minutes away. I'm wondering if Is this playing havoc with the PMR? Should I up my dose of the pred? How far? Currently at 10.5 mg, due to start tapering to 9.5 mg. I was feeling it was too big of a jump and not quite ready to continue tapering and was going to go back to 11 mg for a few days before going back to 10.5 mg. I've only been at 10.5 mg for a week tomorrow. I'm not sure the root canal will be done today as they don't know which tooth and didn't know how much time to schedule.

Any input from those of you with much more experience and wisdom is, as always, greatly appreciated.

[PMRpro Ambassador]

I had a root canal done a few years ago - shortly before Covid I think. I had no problems at all, no pain, just a long time lying in the chair with my mouth open which wasn't comfortable at all! I didn't increase the pred and I must have been at about 12mg then. In your place I certainly wouldn't reduce any further until it is all done and dusted.

[catdance in reply to PMRpro]

Thank you so much for your quick answer! I have decided to go and at least find out what tooth is causing all this or if it is sinus related. I just didn't want to have this cause another flare. I was thinking maybe I should treat it like a sick day?

[PMRpro Ambassador in reply to catdance]

Maybe - it will depend on whether the abx have sorted it and how traumatic the procedure is. See how you feel - and add a bit for a few days if you feel you need it

[catdance in reply to PMRpro]

Yes that is a good idea. I don't want to add more if I don't need it. I may just go up to 11 mg since I wasn't feeling 10.5 mg was quite doing it.

[piglette]

I would hang around on the current dose for a while until you feel OK to start reducing again. A lot of people do try and reduce by 1mg a month under 10mg although I found 0.5mg worked better for me.

[catdance in reply to piglette]

Thank you! I wasn't going to do 1 mg once I reached 9.5 mg. I was applying the no more than 10% rule. I definitely will wait til all this is done and things settle. I may have to take it a bit slower and do the .5 mg from here out.

[piglette in reply to catdance]

Good luck and I hope the dental treatment goes well.

[catdance]

Update: Back from the endodontist. Root canal is scheduled for tomorrow 9:15am. It didn't look good. I have an area of the bone around the root of my right front tooth that the infection has been preventing the bone from growing back. It is up to the bottom of my nose bone and the root is surrounded by the infection. So it is important that it gets taken care of. She said the bone should grow back after the infection is cleared out but it will take a while. Not really what I wanted to hear but it is what it is!

[DorsetLady PMRGCAuk volunteer in reply to catdance]

Good luck with that….and certainly don’t be in any rush to taper..make sure everything has settled down before you attempt.

[PMRpro Ambassador in reply to catdance]

You aren't on bisphosphonates are you? Tell her if you are. And good luck

[Broseley in reply to catdance]

I had a similar thing. The xray showed a big abcess going up past my nose almost to my eye. I had the root canal done and the dentist xrayed it every few months. It has taken over a year for the bone to grow back, and it's still not completely healed. Absolutely no issues with my PMR or AA though.

[catdance]

No they wanted me to but I didn't think I needed them because I was improving. Thank you!

[Ozziedays]

Hi, I’m in Australia and hadn’t realised that you might need to increase the pred if undergoing other health treatments etc. Since starting on 25mg a day about 21 months ago and now on 1mg, I’ve had wisdom tooth removal, colonoscopy, endoscopy, laser capsulotomy, bridge work, root canal treatment, Covid……. I always told my doctor / dentist how much pred I was taking and why but none ever suggested upping my dosage. I never experienced any problems - and because I was ignorant I didn’t worry about it!

[Francesbarbara]

Had root canal treatment just two weeks ago. Was ready to increase my Pred dose (3.5 at that time) but felt fine so did nothing. All very simple and with VG local anaesthetic there was no problem. Hope you are the same.

[Myfoe]

I just passed on getting a new crown fitted this week due to the pain and stress it causes methotrexate makes my teeth extremely sensitive I did have a root canal when only on 40mg of prednisone like yours it was infected into the bone repair did fix it all healing took about a month.. Increasing/decreasing prednisone is a personal choice imo only you know how much stress being at a dentist will cause you we all know stress causes flares a reduction would seem Ill advised