Dental work- loosing a tooth : Hello! What a... - PMRGCAuk

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Dental work- loosing a tooth

Snowyplover profile image
16 Replies

Hello!

What a wonderful forum. I thank everyone for their knowledge & experience & I’m so appreciative!

I wanted to check on having a tooth pulled and being on 8mg prednisone. I’ll be numbed ofcourse and the deed will be done.

Don’t know if I need to worry… but probably will do so anyway.

Thank you!

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Snowyplover profile image
Snowyplover
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16 Replies
SheffieldJane profile image
SheffieldJane

Mention it to your dentist ( your autoimmune disease and Pred dose. Mine was more concerned about infection than anything else. He also gave me adrenaline free anaesthetic. He also gave me antibiotics to take just incase. Good luck!

Snowyplover profile image
Snowyplover in reply to SheffieldJane

I hope you actually received a reply from me already- I didn't save it because I 'm learning how to use the system! If you did not hear from me just know I was happy to have your thoughts and thank you very much!!

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer in reply to Snowyplover

You don’t have to save it as such, but you do need to tap the Reply button in bottom right hand corner… otherwise it disappears… If you’re using PC/laptop is does remind you before you close page -but not always on iPhone/iPad.

Snowyplover profile image
Snowyplover in reply to DorsetLady

Ha! I was on the phone originally and second time the lap top. Lesson learned. You were absolutely right!!! My memory isn't the greatest so I need to save! So now to only use laptop - plus easier to read!

Kendrew profile image
Kendrew

Hi Snowyplover,

I've just recently had a lower back molar tooth extracted with 'conscious sedation' given.

I was on 2½mgs of prednisolone and didn't take ( or need) any extra steroid at any point over those few days.

I also didn't take any antibiotics afterwards (they would have been prescribed though should I have developed any signs or symptoms of an infection at any point)

It did take the wound site a good few hours to stop seeping blood, but this is not abnormal when taking steroids.

As steroid users we are obviously at slightly more risk of infection setting in but I put certain things in place to help prevent this, and thankfully they worked for me and everything has healed up well now.

Healing time will also probably be longer because of the steroids and its taken just over 9wks for my mouth to feel back to normal and for me to be able to eat comfortably on that side again.

My strategies were:-

- to only eat soup and sloppy food for first couple of days

- to only eat 'soft' foods for next couple of weeks ( fish, veg, porridge etc....things that don't require hard chewing or biting)

- to avoid hard foods ( such as nuts, seeds) for at least 4 to 6wks

- and always to rinse out my mouth with saltwater after every time I'd eaten anything ( just fill a cup with boiled cooled water & put 2 teaspoons of normal table salt in it. One cup would last me a day.)

I also had a small syringe to syringe the salt water over the wound site too, but only began the syringing after the second day when there was no more bleeding.)

Don't rinse your mouth (or suck anything through a straw) for at least the first 24hrs, as this may cause any blood clot that forms to dislodge and therefore delay the cessation of bleeding.

Just be very careful not to eat or bite on that side for a while as its easy to open up the wound site and set it off bleeding again.

If anything does begin to go wrong, you'll definitely know, so look out mainly for:-

- any notable of severe escalation in pain.

(It's normal for it to hurt and feel very sore for quite a few weeks though)

- any persistent or excessive bleeding.

- any persistent or escalating 'angry' or inflamed tissue around the site of the extraction.

(Note that again, the area will be naturally inflamed for a number of weeks. Mine didn't settle down until week 7)

You may also notice some discolouration of the tissue in or around the site where its healing. It looks white/greyish and can be a bit alarming, but this is perfectly normal and is part of the natural healing process

Most of the aftercare is common sense really but I hope that's helpful and hope all goes well.

Snowyplover profile image
Snowyplover in reply to Kendrew

Hello - learning to use the system when it comes to replying to you! I have already sent a reply but I didn't save it so in case you didn't hear from me - thank you for all your input on the subject, really appreciate it and will follow your strategies!!

Kendrew profile image
Kendrew in reply to Snowyplover

I didn't receive any previous reply but I obviously have received this one. Please don't worry....more important you receive any help or advice offered by forum members.

NinnyB profile image
NinnyB in reply to Kendrew

Having tooth out this week so found this information very helpful. I hadn’t even considered that pred needed to be considered. Thank you

Snowyplover profile image
Snowyplover in reply to NinnyB

Hope it all goes well! I asked for the adrenaline free anaesthetic (per Sheffield Jane)! which my dentist was happy to do. I think he gave me two lots as the numbness doesn't last long. My tooth obliged by coming out easily.

PMRpro profile image
PMRproAmbassador

For most people having a tooth out while on pred isn't any worse than it is without. You may bleed a bit more - my dentist used a bit of gauze soaked in a substance that encourages clotting to bite on.

What is more of a concern may be if you have been taking alendronic acid or another bisphosphonate and many dentists are very wary of extractions in such patients. But make sure that your dentist knows every medication you are taking.

Snowyplover profile image
Snowyplover in reply to PMRpro

Thank you PMRpro! Luckily I haven't been taking above mentioned medicines. The dentist does have my information but I will repeat it all verbally when I see him!

Pixix profile image
Pixix

Yes, had a tooth extracted a month ago. I was on5mg. Dentist did not want me to increase as it could increase risk of bleeding more than normal. Everything went well. Alendronic acid was my only problem. I’d been on it for some years. I also had other health issues. I was put on antibiotics because I had an infection the two weeks before extraction. They gave me a sheet of instructions & I followed them. All easy, try not to get stressed is my only advice!!

Snowyplover profile image
Snowyplover in reply to Pixix

Thank you Pixix! Yes that stress does get in the way, but you managed well it seems!

Pixix profile image
Pixix in reply to Snowyplover

no, I wouldn’t say that! 6 dentists had refused to remove my tooth (for other health reasons, not due to steroids). Including the hospital surgeon I was referred to. But after about 6 years & 7 infections I’d had enough. My new dentist had a colleague who had worked in London hospitals for many years, & she did the job, but all paperwork marked as extraction of special difficulty…& she discussed it with me for 15 minutes before getting on with it…I nearly left & went home!! S x

oscarina profile image
oscarina

Kendrew's suggestions are textbook and more than one gets from the dental practitioners usually, may be worth sending in to the dental boards as a very useful handout to give to us Pred users

Snowyplover profile image
Snowyplover in reply to oscarina

Thank you for your message - yes Kendrew's suggestion were great.

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