teeth again!

[Gardening2811]

I posted previously about having 4 loose teeth .

My new dentist wants to do a deep clean and root planing due to periodontal disease.

I am concerned about the healing process and it causing tooth sensitivity.

Any advice is welcome please?

[PMRpro Ambassador]

If you have periodontal disease you need to do something done or it will get worse.

I have never had any problems with healing of dental stuff on pred even in the upper teens doses. What dose are you on? Are you still on tocilizumab? If so, you need to make sure the dentist is aware as my dentist insisted an antibiotics when he had to do something last year - just a single dose though, not a course.

[Gardening2811 in reply to PMRpro]

Thank you for your quick response.

yes, I’m still on Tocilizumab and am reducing to 8 mgs at the moment.

[LucilleG in reply to Gardening2811]

I’ve had periodontal issues for ~15 years and been on prednisone for 2 years. I get deep cleaning and root planing every 3 months and there hasn’t been any issues for me. My periodontist knows that I’m on prednisone, and since last July, on Apo-Risedronate DR weekly.

[Gardening2811 in reply to LucilleG]

Thank you so much for this, Lucille. I find it very reassuring.

Have you had any treatment for loose teeth?

[LucilleG in reply to Gardening2811]

Not so far! I do have braces on my bottom teeth and so my teeth are moving slowly. I recall that one of my lower teeth was slightly lose, but my periodontist and orthodontist don’t seem too worried about for now.

[Hidden]

Hello,

I notice you haven’t made any reference to calcium. Alendronic acid was suggested to me to combat calcium deficiency whilst on pred and I refused it, because of certain side effects. Instead I have been taking calcium in tablet form. Would loss of calcium be at the root of your problems ?

[PMRpro Ambassador in reply to Hidden]

AA doesn't "combat calcium deficiency", it directs calcium to the bones and can itself cause systemic calcium insufficiency if your diet doesn't have enough calcium. You mostly need calcium supplements while on AA to avoid that,

[Hidden in reply to PMRpro]

I can’t understand what the advantages of AA are really.

[PMRpro Ambassador in reply to Hidden]

It maintains the density of bone by reducing the leeching of calcium from the bones - blood calcium levels must be maintained within a relatively narrow range or you can become very ill. Pred tends to make you lose calcium through the kidneys so the body tops it up from the bones if there is none anywhere else. A good dietary level can be enough for some but others may need the stablisation of a bisphosphonate.

[Hidden in reply to PMRpro]

Thank you. I’m keeping to my calcium tablets, so far I’m not low on calcium. I’m returning to my tomato growing I feel like a bear of little brain today. 😀

[Merryfield]

Gum disease can affect other parts of your body, including your heart. I am guessing you will have to take antibiotics before the deep cleaning and maybe after.