tooth extraction - Pred increase?

[Thiago1396]

I am having a large molar extracted on Friday next. I have tapered down from 20mg per day beginning of May 2023 to 7mg for last week.

This is my first tooth extraction for some 15 years and my biggest molar (which has cracked) which caused an infection, now on antibiotics for 5 days.

Should I increase my Steroids for a few days?

I’m also on Xaralto (blood thinners) for Atrial Fibrilation, I’m considering missing the one dose due to be taken Thursday evening (apparently they have a 24 hour span in my blood) hence the taking of one per day.

Advice appreciated - thank you

[SheffieldJane]

My dentist’s concern was infection , steroids can make us vulnerable to infection. He gave me antibiotics after the procedure and the anaesthetic did not contain cortisol. He was well versed in this. I didn’t increase my Pred and I was fine. A couple of paracetamol and a cosy rest day should suffice. Good luck!

[PMRpro Ambassador]

I didn't take more pred in a similar situation - one root totally cracked across in the rearmost molar. I had taken my anticoagulant that morning, but it was the tocilizumab the dentist was more bothered about as he then sent me home to take a large dose of antibiotic and return in the afternoon for the extraction. He used a plug of treated gauze in the socket to prevent bleeding which worked fine despite having taken the morning dose, I think I took the evening dose as normal.

I don't know how fussy UK cardiologists are about your anticoag - mine here throw a hissy fit if I forget one or need to miss some doses for other procedures. They even got upset at my taking the 110mg dose instead of the 150mg - we had MEASURED the blood level and it was still at the upper level of therapeutic dose instead of above it with 150mg. I was good, upped the dose up to and past the ablation procedure, the bruising has been worse but not too awful and my shins have been OK which is where the day-to-day bumps showed.

[Thiago1396 in reply to PMRpro]

Thank you

[Gimme]

I didn't need more pred for similar procedure, but I did need anti biotics when I got the dry socket thing after.

[Hulotsholiday]

I had two adjacent lower molars extracted in September and didn’t increase pred before or after. I also take anticoagulant, Apixabin, twice daily and didn’t interrupt the dose. There was no excessive bleeding and the wound area healed well. Good luck.

[Thirkelly]

I would just add that my dentist gave me a very nice but serious instruction to do absolutely nothing for the rest of the day after extraction and to treat it as a medical direction not an optional thing!