implant Surgery Tomorrow

[Janet57]

The dental surgeon says to take 10 mg prednisolone in the morning before having the tooth extracted and implant put in. She knows I’m currently on 3-3.5 mg and has PMR long term. She says the extra is to help with the anxiety/stress and that as my body likely isn’t producing cortisol of its own this should help. Sounds right. I’ll also have normal painkillers like paracetamol. Anything else I need to be aware of from a PMR perspective? Thanks. P.s. I’m a dental scaredy cat 😩

[Charlie1boy]

Hi,

I’m a little puzzled, as your post seems to imply an extraction and implant on the same day? I’ve had two implants in the past year, and on both occasions the dentist waited for a number of months for the extraction site to heal before inserting the implant.

If you feel you need a bit more pred, and the dentist does too, then do as suggested. Personally, I chose not to take any extra pred, and I experienced no problems. I was just really happy to get the implants done.

Yes, they prescribed the paracetamol, and a week’s antibiotics.

Good luck

[Janet57 in reply to Charlie1boy]

Thank you for your reply. They hope to do both on the same day. If not, like you, the extraction site will need to heal first and I’ll go back in a couple of months. Years ago when I had another implant, before PMR, they did as you’ve had but this time they will try it on the same day. We shall see.

[Charlie1boy in reply to Janet57]

Ok, and good luck. Hope it all goes well.

[Janet57 in reply to Charlie1boy]

Thank you

[Merryfield]

my dentist has me take antibiotics before dental surgery, as well.

[piglette in reply to Merryfield]

Have you had a hip/knee/shoulder op? They usually suggest anti-biotics in that case.

[Janet57 in reply to piglette]

I’ve not had any other ops - except another dental implant long before I had PMR.

[Janet57]

yes I think I will get those too.

[Merryfield]

I have had more implants than you can shake a stick at and yes, two new knees — the last one a year and a half ago. It is the knee surgery that makes me have to take antibiotics before teeth cleaning and implants but not my temp and permanent crowns. 🤪

[H8062073]

Hi,

I enquired about implants and was told that while I’m on alendronic acid they will not the implants!!! I’m just curious what your dentist said about taking alendronic acid??!!

[Janet57 in reply to H8062073]

Yes, my dental surgeon checked with me. I’m not on Alendronic acid but if I had been then implants would not have been possible. It’s an increased risk of medication related osteonecrosis of the jaw. I’ve recently been offered infusions of Zolendronic acid which is similar to Alendronic but I’ve delayed this until all my dental treatment is over and in any case will review whether I actually need them given my latest Dexascan results.

[H8062073 in reply to Janet57]

Thank you for the prompt reply. I will wait until I’m off the steroids and alendronic acid and try again. Have a lovely day 😊

[PMRpro Ambassador in reply to H8062073]

Many dentists won't do implants if you have a history of AA - it remains in the bones indefinitely.

[Janet57 in reply to PMRpro]

Yes, that’s exactly what my dentist said.

[Sophiestree in reply to PMRpro]

is that the same if you have had Zolendronic infusions ?

[Janet57 in reply to Sophiestree]

Yes, it is.

[PMRpro Ambassador in reply to Sophiestree]

Yes. A bisphosphonate is a bisphosphonate, all work the same.

[Sophiestree in reply to PMRpro]

grr so i'll never get my implants 😔

[PMRpro Ambassador in reply to Sophiestree]

Depends on the dentist - some will do them. Shop around.

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

Shop around.

In the UK?.. you’ll be lucky..🤦🏻‍♀️

[PMRpro Ambassador in reply to DorsetLady]

True ... Though the cash in the pocket for implants would be quite enticing for some!!!!

[Janet57 in reply to PMRpro]

Yes - it’s costing about £4k. Hoping it will last 20-30 years so if you look at it that way not too bad. 😩

[PMRpro Ambassador in reply to Janet57]

Like the replacement ceramic inlay my dentist used when a gold developed caries under it. I was having a whinge about the price so one of the nurses said "It'll last far longer than a gold filling". Hmmm - the gold was free (patient for a finals student when they had to learn how to do them) when I was a student 50 years ago. I pointed out I wasn't convinced I'd be caring if the ceramic lasted that long since I was 70 ... She didn't appear to get it!

[Twinkling1 in reply to H8062073]

Mine too advised against implant due to alendronic acid. Had to have crowns

[Stills]

Note my diagnosis is Adult Onset Stills Disease which for me manifests as rheumatoid disease, I don’t have PMR. Despite diagnosis being made in 1979 aged 17 and now 61 my dentists always insist on antibiotics for regular cleaning and polishing and for any work required which is rare. I should say I’m not on pred and never wanted the antibiotics but work was refused unless I agreed. Upon moving dentists I decided not to inform them of Stills and therefore no antibiotics were pressed on me. Twenty years have passed with regular cleaning and polish visits, two fillings and even a small dental operation to remove an overgrowth of gum tissue have taken place without antibiotics, without any infection and without any problems. Maybe I’m lucky and we’re all different but thought I’d share my story as I know none of like to take meds unless we have to and in my case I seem to have been ok thus far. Hope your procedure goes well.

CAVEAT: maybe that’s why I’ve become unwell this year, from years of not taking them.,,, who knows.

[Janet57 in reply to Stills]

Thank you for your reply

[PMRpro Ambassador in reply to Stills]

It isn't your mouth that is the risk for infections - it is your heart,

uspharmacist.com/article/cl....

The bacteria are released from their home in the mouth into the bloodstream and if you are unlucky they reach the heart.

[Janet57 in reply to PMRpro]

I had no idea that was the issue. I will most certainly take the antibiotics when they are offered.

[PMRpro Ambassador in reply to Janet57]

It isn't everyone - just people with clinical histories that make it a higher risk.

[Stills in reply to Janet57]

Me too

[Stills in reply to PMRpro]

I never knew that and now am going to tell dentist next time I go given I’m 61 now and have unexplained health issues this year. Thank you PMRpro

[Bridge31]

Hi Janet

Do you mean extraction and bone implant on the same day ? That was the procedure for me and I didn’t take any extra Pred . I was on 5mg.

I did take the antibiotics prescribed and I didn’t have any problems. It didn’t even hurt 😀

[Janet57 in reply to Bridge31]

Thank you so much for posting - I’m a nervous person at the dentist. You’ve cheered up my day. 😀