Tooth extraction

[Pippah45]

I am having a tooth out at the dentist at midday and haven't been looking forward to it. I am on 3mg Pred and reading the post about the broken tail bone - wondered if a slight increase might help? Last extraction was pretty unpleasant and although I am hoping this one won't be too bad I am not counting on it!

[SnazzyD]

From my logic - If you are looking for a pain killer, then Pred isn’t the thing. It isn’t given for acute traumatic pain. There will be an acute inflammatory response to the procedure especially in the first 48-72 hours but that is useful to recovery. If you are worried about the pain and stress due to previous experience causing an adrenal crisis then I might double the 3mg on the day.

[Pippah45 in reply to SnazzyD]

Yes it is the stress I am more worried about than pain. I have plenty of paracetamol and codeine handy for that (allergic to ibuprofen). Thank you I will take an extra couple with the snack I am having before I go.

[SnazzyD in reply to Pippah45]

Stress doesn’t necessarily cause adrenal crisis and one does need to try to go through events without popping Pred every time just in case. I suggest it this time because you don’t have this done frequently and you are already getting yourself wound up because of a bad one before. You should, if you don’t already, carry Pred with you when you leave home as routine.

[SheffieldJane]

Talk to your dentist, mine was keen to know about my steroid dose and he adjusted the anaesthetic accordingly. The last treatment I had was a root canal. It was so gentle and careful that it was almost pleasant. It was either that the equipment is better these days, or my young dentist is very good. Or, perhaps, that with all we’ve been through I have become pretty brave. There was honestly nothing to it. Lots of TLC after the extraction, paracetamol, a blanket on the the sofa, a soppy film. It’s quick, you will be fine. If need be you could do sick day rules for a couple of days.

[Kendrew]

Hi Pippah45,I had a molar tooth removed earlier on this year. I took no extra prednisolone (I was on 2mgs) and everything was good.

I took paracetamol for the pain (every 4hrs for two days) and this kept things comfortable but not completely pain free. I would not have expected to be totally pain free though without something much stronger, and I chose not to go down that road unless absolutely necessary. Thankfully it wasn't.

[Pippah45]

Thank you everyone. All went well and of course I worried too much! Didn't take extra pred. Discussing with dentist was a waste of breath. I believe he comes from Ukraine so a neurotic old bird might try his patience a bit with all that is going on over there. He was kind enough though. Tooth was loose so it came out far more easily. It was a molar and the problematic last extraction was hence the apprehension. He has left quite a mark under my lip but I will forgive him! Thank you for the support.

[PMRpro Ambassador in reply to Pippah45]

All's well that ends well!!!

[Pippah45 in reply to PMRpro]

Indeed and as the saying goes "You die if you worry. You die if you don't so why worry at all?" Wish it was as easy as it sounds but I am miles better than I used to be!

[PMRpro Ambassador in reply to Pippah45]

It is how I try to operate!!! Can't change something? Accept it and get on with it ...

[diana1998 in reply to Pippah45]

👍👍👍Well Done

[Pippah45]

Here here!

[Miacaro45]

Ice is your best friend. So glad things went well.

[Stella3]

sorry about your tooth extraction. I had to have two removed and couldn’t have dental implants as it is not recommended for people who Have taken steroids for GCA. So I have a plate. Good luck. It’s no fun I know.

[Pippah45]

Thank you Stella. I have been avoiding implants for ages because of being Hypothyroid - I didn't know GCA and PMR rule it out too - very interesting but not surprising. I already have a plate which may be suitable to adapt but I hardly ever used it before. Now with that tooth gone I don't really have a choice but to get a plate. I didn't like the fact that I was swallowing so much of the adhesive stuff although I am sure they will say it's perfectly safe!

[PMRpro Ambassador in reply to Pippah45]

GCA and PMR per se do not rule out implants - there are people on the forum who have had them. They may increase the risk of failure of implants because the healing process is slowed. It depends on the dental surgeon and whether they will take the risk.

[Pippah45 in reply to PMRpro]

I did have a dentist who pushed really hard for implants - I suspect to feather his nest with so I didn't play his game! Unhealthy gums is one of the (many) symptoms of Hypothyroidism which I why I wasn't interested in implants. I suspect I haven't got enough bone to hold them. Spending a lot of money on something that has a fairly good chance of not working didn't appeal to me!

[PMRpro Ambassador in reply to Pippah45]

Me neither! Luckily I still have the majority of my teeth at over 70!!

[proactive]

I had a tooth extracted, a hip replacement and 7 weeks ago fractured 3 ribs and my pubic ramus. I chose not to increase prednisone for any of those things and recovered from all as expected. I am afraid that our lives bring many "excuses" to up Prednisone for relief, but it isn't really necessary and I want to get down to lower doses with less side effects in a reasonable time frame and I don't think many increases help me with that goal. There are other pain meds that can help with post dental work pain. Just let your dentist know what you are already taking.

[Pixix in reply to proactive]

I agree! People seem to increase to go on holiday, or due to any illness etc. I didn’t increase for a “dental extraction with severe problems” as the dentist put it, or falls, including breakages, or stress when my husband was ambulanced to hospital three times etc etc etc. But when I had Covid my Dr advised raising it as he would have put me on steroids due to my ongoing lung problems, not because I have PMR. People seem to think steroids have pain control, too. But PMRPro and DL always tell them the right answer! I think if people are truly stressed because they are a Carer, or have a close bereavement etc, then it’s different as the body and mind cannot cope well. But to keep putting it up…hm.

[Pippah45]

I had a hip replacement two and a half years ago and anaesthetist recommended a slight lift in Pred but only for maybe two days. I agree with you about wanting to get down although in the early days my rheumy tried to rush it and it really isn't fun having a flare. This forum told me to ignore the Rheumy and I felt a lot better doing so! I was on 7mg when I had a new hip and that took a long time to drop but am now on 3 and will be reducing further very soon. It is a balancing act it seems and while I am pretty brave - flares are not something I wish to go through again. Good luck with your reducing.

[proactive]

Yes, I've had two flares, both trying to go form 9mg to 8 mg. Held, then tried 9 to 8.5 mg. that was okay now in the middle of a slow taper from 8.5 mg to 8 mg (all thanks to advice from this website. If I had followed the Doctor's instructions I'd still be struggling with flares!) I don't want any more flares, either....