Increase pred dose for dental surgery?

[spacevoyager]

I have looked at past posts on this topic, but can't figure out how to adjust to my current dose.

I am on 2mg pred after a vey long tapering period. I have extraction and implant surgery on Friday. How much should I up my pred and how long?

[Toasteater]

Hi spacevoyager, I've never posted on here before, but I've been following posts since my diagnosis last August. I see no-one has replied to you yet and I have a dental appointment tomorrow so I've looked into this. Following Sick Day Rules for Minor Dental Surgery it is recommended you take an extra 5mg of pred an hour before the procedure and take a double dose for 24 hours after the procedure, then return to your normal dose. If it is Major Dental Surgery you may need 100mg of IM hydrocortisone. If you look in the FAQs for Sick Day Rules you should find all this. I hope this helps.

[PMRpro Ambassador in reply to Toasteater]

Hi and welcome and thanks for replying, How do they define minor and major, do you know? One source says implants are minor which seems reasonable.

[PMRpro Ambassador]

Have you asked your dentist what they recommend? I never raised my dose for an extraction but have never had an implant which is why I didn't reply when you posted, hoping someone who has had one would.

[Toasteater in reply to PMRpro]

Oops, now I'm confused? I think I'll just carry on with the planned temporary increase at least the 5mg on the day and see how it goes.

[PMRpro Ambassador in reply to Toasteater]

Sounds like a plan. If it is just for that couple of days it isn't going to be a problem anyway really. Hope it all goes well.

[Toasteater in reply to PMRpro]

Thanks PMRpro, that's what I thought. It might help with any extra 'stress' involved.

[spacevoyager in reply to PMRpro]

The dentist gives 3 mg to EVERY normal patient. I am on 2mg now and he just said that's fine. He didn't say to top it up but I don't think he knows much about it.

[PMRpro Ambassador in reply to spacevoyager]

Ah, right. If he gives it to normal patients that is a zero baseline. So I would think you could/would add 3mg to your 2mg baseline dose and take 5mg. If he thinks normals need a boost - you are more likely to need a bit extra. And for one day - no problem.

[spacevoyager in reply to PMRpro]

That makes sense. Thanks.

[Pollyone in reply to spacevoyager]

Wow wasnt aware this was an issue as I have an implant coming up. Will discuss with dentist although can’t see the connection but I’m new to the steroid saga!

[PMRpro Ambassador in reply to Pollyone]

It depends on the dose and whether your adrenal function is able to respond to stress - often minor stress isn't a problem.