dental extraction and Pred

[Beebo8]

hi there, I’m due to have a molar tooth extracted that has previously had root canal treatment and had a crown on it, so it could end up being a surgical extraction. I’m wondering if it’s wise to up Pred dose for all this- does anyone have a similar experience? I can contact rheumatologist but it’s not easy to get a response at the moment in nhs hospitals. Advice would be much appreciated x ( I’m loathe to up my dose as I’ve got to 2.5mg - started on 80/60mg 3years ago for GCA.

[PMRpro Ambassador]

Difficult to say - but since you should only need to up the dose for one or at most 2 days, it really isn't a problem in terms of returning to your usual dose. I suppose you could say that doing so is erring on the side of caution. I had a molar out that had a broken root so that root remained after the rest came out relatively easily. In fact it was no problem for my dentist to get out altogether.

[sidra1968]

I've had two extractions in the last 1.7 years..was on 20 mg and 17 mg for them and had no problems. Just my experience. Good luck!

[Beebo8 in reply to sidra1968]

Thank you

[Carrollee]

I had a molar out last Friday. Emergency appt as I had an abscess and he decided it couldn’t be saved so he took it out there and then. Never gave it a thought to increase when I got home. 🤔 I am on 4mg and it’s healing very nicely. Hope you get on ok too 🤗

[Wildlifephotographer]

I am in a similar quandary this coming Monday. I have one that's got a vertical fracture that might break during the extraction. Mine is with sedation though as I am an anxious dental patient.

I first asked the dentist who said once upon a time the protocol was to double up on the day and the day after. I am on 7mg pred just now and he voiced concerns about if my BP was to drop, not being able to tell if it's the sedation, or me needing more pred to cope with the extra stress. But he isn't prepared to make the call. Says it has to come from my consultant. Asked them, they said they don't generally advise it "for a normal extraction" but if your dentist wants you to then it's up to them. Talk about buck passing 🙄😂.

I have no answers but I wish you well Beebo8. Hope everything goes to plan.

[PMRpro Ambassador in reply to Wildlifephotographer]

As I said earlier - doubling the dose for a couple of days won't hurt and saves the question!!!

[spacevoyager]

My dentist said all his patients are given 3mg pred, including healthy ones. So I took 3 plus my regular dose of 2, just for that one day. Everything went fine.

[PatriMac]

Hi Beebo8, not sure if this is relevant for you but I'm waiting to have exactly the same op and have been advised by dentist not to be taking Alendronic acid for a few months leading up to it (cos of risk of necrosis of jaw).

I've refused the treatment anyway /trying homeopathic option for a while to see if bone loss stabilises.

Best of luck

Patti

[PMRpro Ambassador in reply to PatriMac]

Stopping AA for a few months willd make not a jot of difference. It remains in the body indefinitely.