PMR like symptoms r/t chronic tooth abscess?

[SMH4CRNA]

Most recently it's been discovered I had a tooth abscess. The dentist belive I had tooth infection for a long time. Prior to leaving for the Camino I had this tooth removed. Is this the root (no pun) cause of my infection raising my inflammatory markers since 2021 which return inflicted PMR like symptoms?

Rheumatology has believed I do not have PMR. I have suffered from myalgia, low grade fevers when not on prednisone. Just now speaking with my yet again new Rheumatologist, he wants me off prednisone for my next week's appointment. I told him about my chronic tooth infection. He seemed to have interest in this. There has been studies linking tooth abscess with raised inflammatory markers, and when not resolved causing joint pain mimicking RA. Is this cause of 2 years of suffering?

I will be off prednisone by tomorrow and will have repeat labs following. Let's pray all my markers have returned to normal. My markers have never been normal despite being on prednisone. So we will see.

[SnazzyD]

They might be right but infections can trigger PMR so they are not mutually exclusive. Time will tell.

[PMRpro Ambassador]

There is a form of RA that is triggered by certain bacterial infections - and as SnazzyD says, none of thse things are mutually exclusive. It will be VERY interesting to see what happens.

[Sharitone]

Fingers crossed for you. I just hope he won't seize on the tooth to justify saying you haven't get PMR (unless you really haven't, of course!)

[SMH4CRNA in reply to Sharitone]

My thoughts exactly.

[Chewy21]

I had an abcess going back some years and was admitted to hospital as the infection had spread to my sinuses but they told me that my inflammation levels were sky high because of it. This was long before I was diagnosed with PMR though but it can have an effect on your inflammation markers. Hope your markers return to normal 🤞

[Broseley]

Soon after diagnosis with PMR I was also found to have a long standing tooth abscess, so I'm very interested to read this. The only symptom was a slightly wobbly upper incisor which I queried at my annual check up. A precautionary XRay found a large abscess, going all the way up to my eye.

The dentist put me on antibiotics, and by this time I was also on 40mg pred for GCA. My ESR and CRP had both been in the 80s. The dentist also root filled the tooth.

That was 19 months ago. The last XRay showed the cavity from the abscess has almost gone, but it is taking forever.

So I am now wondering if there is a connection between the abscess and the PMR and GCA, though they were diagnosed before the abscess. I am now down to 3.5mg and have had no flares just a slight stiffness on 7mg in one hip that panicked me so I stayed on that dose for a while longer. I still get the slight stiffness, and it hasn't got any worse.

[SMH4CRNA in reply to Broseley]

What were latest lab results after resolving the tooth infection?

[Broseley in reply to SMH4CRNA]

My CRP and ESR both fell dramatically as a result of the high pred dose, down to @5. So they were already low when I started the antibiotics. The dentist thought the abscess must have been draining naturally, which is why I felt no pain. However the steroids might have been masking the infection. Can you confirm this please PMRpro ?

Since then, my ESR has crept up again to 20 ish but the rheumy doesn't think this is a problem. He says symptoms are more important.

[SMH4CRNA in reply to Broseley]

The Rheumatologist stated due to my age there is no way I have PMR. If it's not the tooth than I am plainly out of luck. I only hope all my.labs nor.alize and physically I feel normal. Fingers cross.

[PMRpro Ambassador in reply to SMH4CRNA]

Age has nothing to do with whether you have PMR - he is very behind the times ...

[Broseley in reply to SMH4CRNA]

You need to find another rheumy!

[PMRpro Ambassador in reply to Broseley]

It won't mask infection - it will reduce inflammation but an abscess would create pressure pain as well if it wasn't draining.

Brilliant description here

jacksonavedental.com/post/t...

[Broseley in reply to PMRpro]

Whoa that's scary! I always clean my teeth, use tepes and visit the dentist regularly, but my teeth have always caused problems. I had the gum boil mentioned in the article! Because it was in lockdown, I had to send a photo of it to the dentist! Not easy - you try!

[PMRpro Ambassador in reply to Broseley]

I can imagine. Piece of nonsense mind - my dentist worked all the way through except the first month of the first lockdown here in Italy when it was emergencies only.

[Broseley in reply to PMRpro]

So did mine, but she was suffering from a weakened immune system so her appointments were emergencies only. I guess she wanted to check me out first. The other dentists and hygienists all carried on, except you had to fill out a covid form, wear a mask, and they didn't do high speed cleaning or drilling.

[BeachsideVia]

an abscess can be such a hidden menace! Years ago I had an anscess unknown to me, had knee surgery, Had a root canal, put on amoxicillin, and had a horrible reaction over a holiday weekend, everybody on vacay. I was told it has to do with that type of bacteria and it’s toxin reacting to the antibiotic! Everybody please take care of abcesses. I had mine for years and was missed by my dentist.

[Broseley in reply to BeachsideVia]

It's amazing how it can be hidden. However my previous experience of an abscess was excruciating pain. So bad, the dentist drilled it out with no anaesthetic.