PMR/Prednisolone and dental implants

[Tiggy70]

Hi, I’m enquiring as to whether anyone else has experienced issues with their dental implants since being diagnosed with PMR and taking Prednisolone.

I’ve been having trouble with one of my dental implants for a couple of weeks and on seeing the dentist today have been told that the implant has loosened and will eventually fall out as my jaw bone is compromised. I’ve had the implant for quite a number of years and PMR for three. I took alendronic acid for the first year and then stopped and now pay privately for a yearly DEXA scan. I’m a type two diabetic and currently struggling with a high hba1c because of the effects of the steroids (10mg) which may also be a contributing factor. I’m just wondering if anyone has had similar issues.

Thanks.

[PMRpro Ambassador]

It is possible the alendronic acid had an effect on bone resorption in the jaw, as could the pred, and the double whammy is simply too much. AA is the thing that scares many dentists witless.

[OldPenny in reply to PMRpro]

Good morning, Pro. Could you recommend a source of information about the effects of AA on bone resorption in the jaw, please?My dentist should know that I've taken AA weekly for more than 2 years now, but it has never been mentioned as a potential problem. Thanks, OP.

[PMRpro Ambassador in reply to OldPenny]

Nothing that you couldn't find yourself using google I'm afraid. This may help you

stgeorges.nhs.uk/wp-content...

as a simple outline of the risks associated with using alendronic acid etc.

Have you specifically asked your dentist? Some are more risk averse than others - it is a very rare effect so not seen that often.

[OldPenny in reply to PMRpro]

Many thanks for the link. Good to know it's rare and apologies for wasting your time but it does seem to crop up regularly as a worry for many.

No, I haven't asked my dentist but he does know about my PMR and I'm pretty certain that I mentioned it a couple of years ago.

[PMRpro Ambassador in reply to OldPenny]

But bear in mind - he has loads of patients and it is so easy not to remember.

Not a waste of my time at all - why we are here!

[SheffieldJane]

What a blow! I have 2 crowns that are ok touch wood, and I know with age there is gum shrinkage. I don’t think that my dentist would advise dental implants for me, although I could use them. I have teeth that I will eventually lose apparently. So did my mum though, without the drugs I am on.My first thought is the Alendronic Acid which has a well documented adverse effect on the jaw in some users. It is unlucky to have this happen I think. I know of no link with type 2 diabetes which I also have.

[Nightingales]

oh Tiggy. So sorry. It’s never ending isn’t it. I have two dental implants but so far so good. But I am very nervous about it because I have necrosis in my hip and I know you can get it in your jaw. I wonder if some more imaging would be good like a MRI just to see what is going on in your jaw.

[SnazzyD]

I agree with others about the AA. Regards the HbA1c, Pred makes the liver generate more glucose from its stores even before you’ve eaten. Most of us find a standard healthy diet is insufficient to keep blood sugars and weight down. The usual and effective approach is cutting carbs drastically. I had to cut out pasta, potato, rice, flours, maize and of course sugars. Worked a treat but some find they need a bit more carb than I had.

[GrandmaPirate]

I can tell you that my two implants, which I have since about ten years have never caused any problems during the 3 years of prednisolone starting at 20 mg/day and now since a year at 1 mg/day. Since september a new double implant was made and the healing process in the bone is excellent. I have to tell you that my bone densitometry shows excellent results and is density maintained by daily intake of Steovit Forte (Calcium + Cholecalciferol (Vit.D3)) prescribed by my rheumy.

[Jampad]

I had two dental implants while taking high doses of prednisolone. I had discussed the alendronic acid with the dentist who seemed to think I was being unnecessarily wary. However, I waited until both healed before starting alendronic acid. I was then diagnosed with osteopenia and now take it regularly. I am concerned about my teeth but also about my bones. What can we do? We just have to do what we think is right at the time.