Hi, i was diagnosed with PMR a year ago and around that time I lost a piece of a tooth and got it capped and then the cap came off. Decided to wait until off pred to go back. I have lost another piece. I have been on prednisilone and AA for a year.
I don't have any pain but think i need to book another appointment just to get things checked. I was thinking of just asking for a check to see if I can wait for any filling or whatever until off medication.
Any thoughts would be appreciated.
Well I wouldn't wait until I was off pred if I were you - could be years!!!
The dentist may get iffy about the AA but it is only a problem for invasive procedures where bone healing may be affected and replacing a cap doesn't.
Yes you are right. Thank you
I recently suffered an abscess on a back tooth, took 2 lots of antibiotics to relieve the infection. On my follow up to the dentist she x-ray'd and found that the tooth had fractured causing the abscess and that it would require removing, but due to my health issues and medication she referred me to a specialist as she didn't want to take any chances. A specialist removed a large rooted offender without too much pulling. I also mentioned to my dentist at the time of the x-ray that I had a feeling of something loose on the opposite side, she looked and gently removed a crown on a post. She said she would re-cement it in but when she tried it wouldn't fit and upon closer inspection, it appeared that the remaining root in which it previously sat had fractured also and withdrawing the post made it collapse. Is there an issue with teeth from taking steroids and Alendronic Acid? If there is I'm going to turn into a toothless wonder the way it's going!
Some people develop tooth problems after being on pred. There certainly can be with alendronic acid as it can affect bone healing after invasive procedures and everyone who is put on AA should be told to get a full dental check and have any expected work completed BEFORE starting the AA.
In the case of pred I suspect it may be something to do with blood flow - which could also be due to GCA/PMR or to an effect on the gums otherwise in that the bacterial balance in the mouth may be upset. Have you had a thorough dental check? Including measuring the pockets alongside your teeth? By an honest dentist - not like the two my cousin had. She won a claim against them!
OTOH - I have been on pred for nearly 14 years and have had a few dental problems in the last few years including a broken root in a molar which meant an extraction which was the result of bitting on a pomegranate seed, My dentist doesn't seem concerned - after all, I am 70 and still have most of my teeth,
I am 66 in July and always had check ups and had quite strong teeth. I bit on some toast last year and broke a piece of tooth and it was a peanut this weekend.!!
I felt so ill last year it was hard just to drag myself to the dentist. However I am in a better place now so will sort out an appointment if I can get one . Thanks for the info.
I am wondering whether the loss of three teeth in eighteen months and two more shortly, is because of being on steroids for many years? There's definitely something "going on" in my mouth, and I seem to be programmed for dentures soon - a bit early at 76?
I wouldn't say 76 was a bit early for dentures! OK, it's a few years ago but I remember my aunt being inordinately proud of having all her own teeth at 70 - there weren't many of her peers who could say it!
Only about a third of persons between 40 and 64 do not suffer tooth loss. I have missing teeth from years ago and orthodontic work but also a couple of teeth that were unsalvageable. It so happens they don't affect eating and aren't visible gaps but had I been unlucky I/d have had partial replacements some years ago.
Right - I suppose I've been lucky to have good strong teeth until now, albeit having lost a couple of molars years ago. I'm completely ignorant of the choices available for replacements nowadays, but am pretty sure they will cost a fortune, especially now my dental practice is leaving the NHS, along with all others in this locality.
Thank you for that info I was concerned that maybe all my teeth will fall out!
My dentist mentioned a 'pocket' alongside the tooth to be extracted when she looked at the x-ray, but didn't make a fuss about it or mention measuring it and I didn't question it further. I had my specialist appt. 2 weeks later, he showed no concern whatsoever, just got on with jabbing me and then with the help of his assistant holding my head down while he pulled ... and pulled... then said he needed to cut the tooth in half to get it out or it may splinter and make a worse job of it. That seemed to do the trick and it came out in 2 pieces with a very large root. He then put a few stitches in to aid healing and gave me a wad to bite on for a short while. A few more weeks on and I think the gum has healed although it feels a little lumpy, maybe because the dissolving stitches came out a tad early because I couldn't stop my tongue playing with the dangly bits and out they came one by one. I don't know what my dentist is intending to do about the root that the crown came out of especially if it has fractured like the other, although she didn't x-ray that one. At the moment it is a nuisance as food keeps getting stuck in the gap, she threw my crown away and I don't want to pay for another to fill the gap if it can be done. I have always had regular check-ups but my teeth have always been weak and the amount of crowns I have... or had... mean that my normal teeth grind on the crowns which help wear them away. All my life I have never been a fan of the dentist.... talk about a bell on every tooth, more like an abscess on every tooth ............oh woe is me.
By the way I'm only 60 and just about half way through my molars now.... a bit too soon I think.
I wouldn’t want to be waiting because of potential infection getting in causing problems that may be way worse to deal with, especially with AA in the mix. Better an easier solution now.
yes you are right. I will be brave. thanks
I wouldn't wait,crowns need to be put back in,while they still fit.I had a new crown ,filling and root canal done while on pred,with no problems.
thank you that is helpful.
I would get that sorted ASAP. I had similar during the pandemic. It was incredibly difficult to see my dentist and by the time I did, nothing could be done and I lost the tooth. Dentists understand about steroids, well my dentist did, so I had no difficulty with being on 5mg a day long term. Good luck with the tooth.
thanks thats reassuring.
If you aren't already taking it, Vitamin K2 (not K1) is recognised as improving dental health. In fact if you google it you'll find a lot of the info is posted on dental clinic sites! My previously very sensitive teeth have become much less so since taking Vitamin K2 as part of my bone health regimen.
Panicking after visit to Rheumy
Rummy first visit yesterday confused & frustrated 
How long should I stay on initial dose of a Pred for PMR
Visit to Rheumatologist 
Extreme reaction to injection at dentist
