I went to the dentist yesterday who said 4of my teeth are becoming loose, probably due to Alendronic acid and Carbamazepine ( for trigeminal neuralgia ) He said my dental hygiene was excellent.
The only available treatment on the NHS is a denture!
I am being referred to a periodontal specialist but I think that could be very expensive!!😳
Has anyone else had this problem?
Over the years I have come across a few people with tooth problems but it isn't very common.
hi I had several teeth that were loose when on high dose pred and active vasculitis. I did have to have one removed as it was so loose , but fortunately the others settled down and became very fixed again which I found quite remarkable
this is encouraging-were you referred to a periodontist?
No I wasn’t referred but that may have been because it was at the height of the pandemic. I was given some prescription toothpaste, but it did just seem to sort itself out once the vasculitis was under control and the pred was reduced
I have Ehlers Danlos Syndrome so while on steroids the tooth movement I got anyway got worse and I did get two very loose teeth that finally needed to be removed because they had the chance of damaging the teeth next to them. I already had a partial upper plate because of damage on my moving teeth.The partial plate is not noticeable and has made a big difference.
You could stop the wiggle and help reduce the possibility of loosing the teeth by being measured for a night guard and using it as soon as possible. This reduces the effect of tooth clenching or grinding during sleep making the teeth more loose. The support also helps to keep the teeth in the place they should be at night giving the gums chance to settle. This also helps reduce your TN pain by reducing tension in your face at night.
Eating less chewy and hard food and chewing on the opposite side of the mouth also helps. As does using a softer tooth brush.
Taking a daily oral combined vitamin and mineral supplement after your fattiest meal of the day and extra vitamin D and possibly Calcium helps from within. Increasing your consumption of collagen boosting foods also helps you to improve the connective tissue. That's foods that contain more animal based proteins like dairy foods , chicken and fish.
The reason steroids and other medications can make teeth loose , or looser , is because of the effect that the medications have on your collagen production. It makes your gums less elastic so the gum around the tooth is more lax / loose without the extra support the teeth can wobble and then loosen. This happens with EDS anyway because it effects connective tissue and collagen production so I had a double whammy.
It should not be expensive if you are being referred to a Periodontal Specialist because your dental issue is caused by a medical condition. You should be classed as getting the work done as an NHS patient for medical reasons and therefore get the work done by the Orthodontics Department at the hospital for free. If this hasn't been explained to you and they do discuss charges it would be worth asking further you may need to request to go on their NHS books as a medical patient or have the request done via the GP , although the dentist referral was enough in my area. I get all of my dental work done free now by a Dental Consultant because it is more complicated for me to have work done and it is caused by my EDS.
What do you take AA for?
I have TN but cannot tolerate Carbemezapine anyway , but you can take other pain relief options for the TN with less side effects .
I take Pregbalin ,,and took this on its own for TN . There is also Garbapentin but the Preg is gentler on the stomach.
I now take Pregbalin and Duloxetine in low dose combination for my Fibromyalgia and that helps my TN too ,,as well as avoiding the triggers for TN flares by protecting my face in cold and wind , taking care in hairbrushing and washing , and the dental recommendations I described above.
Perhaps , you could consider a medication change by tapering down the Carbemezapine while slowly introducing in and tapering a new pain medication with less side effects and risks.
thank you for your reply. The AA is to help absorb the Adcal, I believe.
The dentist said that some medications cause dry mouth which contributes to periodontal disease .
I don’t appear to grind my teeth.
The AA is to promote and improve bone health .You don't need it to help absorb Adcal , Adcal is just often prescribed at the same time as certain drugs to increase your intake of Calcium and Vitamin D. They are often prescribed for conditions like oestoporosis if you have had bad bone density confirmed with a Dexascan.
You can improve your absorption of Adcal by taking it with a few tablespoons of full fat probiotic yoghurt and a little honey if you need it , and with a Vitamin C supplement or a little orange juice . Taking the Adcal with or after some food with fat in it keeps it in your digestive system longer and vitamin D is fat soluble (needs some fat to be absorbed properly) so it gives you the maximum absorption you can manage.
It is recommended to have a Dexascan and to confirm that you really need AA often on this forum because , often, Consultants will prescribe AA without checking that you need it ( rather than just the Adcal which is important) when you are taking steroids or have a form of Arthritis " just in case" bone density problems could be caused by it . They seldom think about the problems the AA can cause itself.
If you haven't had a Dexascan , or not had one for two years, it would be advisable to request an urgent scan via the GP now , explaining that you are having issues with loose teeth and dry mouth and would prefer to reduce the amount of medications you are on , especially the AA, if you don't require them. If your results are within a range that does not require AA it is better to taper off it and not take it until scans show you do. The GP will probably say you need the AA , and you might , but it is better to check you do rather than just take their word for it if the medication is causing you other problems.
More often , the combination of Adcal , increased calcium , protein , B vitamins and vitamin D in your diet along with gentle regular weight bearing activity like walking ( even a 15 minute stroll every other day will do the job) and isometric exercises for the arms and back will be enough to improve bone health, bone density when minor reductions are found on a Dexascan, and osteoporosis symptoms.
The Carbemezapine also causes Dry Mouth , and can cause harsher side effects than drugs like Garbapentin and Pregbalin, including more issues with thinking and memory loss . If you haven't tried these other options for your TN pain it might be a good time to request to try them now voicing the dental side effect as one of the reasons to try it.
You can always return to using Carb if the other drugs aren't right for you , but dry mouth and tooth issues also makes TN worse so changing a drug that can cause TN triggers us worthwhile. Otherwise it's like a vicious circle with the Carb treating the pain from the triggers it helped to cause.
You can get sharp saliva producing pastilles from your dentist or online to increase your saliva and reduce dry mouth , I get them on prescription to help the dry mouth I get from Sicca Syndrome. The pastilles are called Salivix.
Sharp and bitter foods in tiny amounts can also do this , and drinking green tea can improve mouth health and moisture as well as being antibacterial and antiinflammatory . It can reduce the chance of decay occuring if you gums are looser and food gets within the gum gaps around loose teeth which can happen even with great dental care. You can also use it cold as a less astringent mouthwash ,as mouthwashes make dry mouth worse.
Even if you don't grind your teeth the night guard protects against clenching of teeth and the jaw which also increases the risk of loose teeth and morning TN pain.
Hope that helps ,,Bee
I’ve never had a dexascan. I asked the rheumatologist who said I didn’t need one if I take AA and Adcal !
I have organic natural yoghurt every morning and milky hot drinks during the day.
I might try and ask if I can come off Carbamazepine. Does Pregabalin make you sleepy?
Sometimes I despair at the plain ignorance! It is a useful thing to have a baseline before pred and other medication. I made taking AA conditional on the dexascan result and a different GP agreed with me. The result was fine so I never took more AA and after 12 years, much of it above 10mg/day, my t-scores were very little different from the start. I would have been taking a quite unpleasant drug for 12 years for nothing.
But I do know a lady who took AA for 8 years religiously before developing multiple osteoporitic spinal fractures which required vertebroplasty - the injection of "cement" into the vertebrae. She commented on the years of AA to the surgeon - and he confirmed it had been a waste of time for her. You still need a dexascan.
Not as sleepy as Garbapentin did, if you are on very high doses it can make you feel a bit drowsy or spaced out.The good thing about long term Pregbalin or Garbepentin is that in studies their long term use has been shown not to cause the memory loss or thinking issues that can happen with Carbamezapine and other Antiepiletic medications. I have IBS with Constipation as well and I found Pregbalin was easier on the stomach and didn't make the constipation worse. It is more effective so you take lower doses for the same effect of Garbapentin and many other drugs for nerve pain.
If it doesn't work well enough alone rather than increasing the dose higher and higher it's good to try it in combo with a low dose of Duloxetine.
They also don't have the risk levels of contributing to the development of Dementia or Alzheimers that Carbamezapine, benzodiazapines, Tramadol and many other Antiepiletic and triptyline medications can have.
Not yet ! I have been on an infusion of Alendronic acid nearly 2 years . I am very careful with my teeth : so floss frantically as you obviously do. At present no loose teeth but constant battle with gum disease . Had one tooth remember now removed . best of luck .
Whatever it is it isn't alendronic acid - the infusions are of either ibandronate or zoledronic acid. Different substances.
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