GCA, prednisone, and the dentist

[ngchgc]

Chipped a molar tooth, and finally got in to see the dentist. 20 mg Pred in the morning.

Anyone had a severe panic attack while having their tooth fixed while on prednisone?

I am usually OK at the dentist, but this time it was the worst moment ever. Absolutely shaking all over the whole time.

Should I have upped my usual dosage?

[DorsetLady PMRGCAuk volunteer]

Oh dear… very upsetting for you.

Some have said similar - but usually when on much lower doses and the adrenals have required an extra boost. The problem is whatever dose you are on, it’s a constant dose, and your adrenals are asleep so don’t have the capacity to react to the “fight or flight” scenario they would normally.

In future it might be worth an extra few mgs, but also tell your dentist beforehand what happen on this visit..

[ngchgc in reply to DorsetLady]

Thank you, I hope not to break any more teeth ATM!

[PMRpro Ambassador]

Sorry to hear that - not a nice experience at all. I hope your dentist was helpful - I'm sure it happens to them on occasions.

Even using sick day rules, the instructions are to double the dose up to a maximum total of 20mg which you were at. Another time maybe ask for suitable sedation as is often used, just in case?

[ngchgc in reply to PMRpro]

Thank you, I will remember that now.

[Menno1525]

Something to check is whether the anaesthetic your dentist used contained adrenaline - most modern ones do and I find they make me tachycardic and bring on a panic attack. Non adrenaline based ones are fine. I also find that not being laid completely flat or worse still practically standing on my head also helps. Don’t have to be bolt upright but just high enough to keep my head above my heart makes all the difference as does having someone skilled operating the suction so I don’t feel I’m drowning. My dentist also is very understanding about keeping the room cool and calm and taking more shorter sessions when possible to lessen the stress. For particularly stressful procedures I also sometimes take a Valium before the appointment just to take the edge off. A single 2mg tablet seems to do the trick (even if it’s just placebo effect) and my GP is happy to prescribe me a pack of four when I have a course of difficult treatment coming up. Using this regime I’ve managed to get through a whole sequence of appointments this year whilst on Pred, including root canal and getting a bridge fitted without too much problem and each little experience of success builds my confidence to overcome what was quite a significant fear of dentists resulting from a run of bad experiences. Now it’s just looking at the dental bills that brings on the panic…….!

[PMRpro Ambassador in reply to Menno1525]

You can say that again about the bills!!!!!

I had to have a gold filling replaced last year after 50 years, it was done as a finals patient for a friend when I was at uni. Of course the replacement is a ceramic with the appropriate bill to accompany it. The dental nurse hastened to assure it me it would last FAR longer than the one it replaced and failed to understand my reply that I doubted I would need it to last anywhere near that long ...

[singingloud]

Before prednisone I never had issues at the dentist but now it makes me so nervous that during a cleaning I have to talk to myself to relax. No fun.