Tooth extraction

[laidbackreader]

I have what my dentist called 'an extensive infection' beneath one of my lower back teeth. I was in a lot of discomfort last weekend but I've had 5 days of antibiotics and it is less painful.

The dentist told me to think about whether I wanted root canal work or an extraction. He thought that root canal would have a limited likelihood of success. So I've decided extraction is the better option.

I've taken allendronic acid for ten years because of the amount of pred I've had but stopped about six months ago as it was causing stomach problems.

My question is about dental surgery when there's been long-term use of allendronic acid. Any thoughts would be appreciated. Thanks.

[Suzym2u Moderator Vasculitis UK]

Does your dentist know about your long exposure of allendonic acid? Does your dentist understand the implications of this?

[zoe69 Moderator Volunteer Vasculitis UK in reply to Suzym2u]

My dentist and my rheumy cooperated and I had a lot of dental work done before I started taking aledronic acid. My sinuses scan showed a tooth root problem and ENT and rheumy are trying to find a solution. My dentist said it will take 2 years before the aledronic acid is out of my body and until then he will only do maintenance work if it's not a "life and death" situation.

I would do the canal treatment and extract the tooth if there isn't another solution.

[laidbackreader in reply to Suzym2u]

Not yet. We didn't get into that conversation last week as he was just discussing the options with me.

I know that the tooth has to come out but I'm feeling a bit anxious about it as I know I've read things about there being an issues if you've been taking this.

[PMRpro]

You must tell your dentist about the long exposure to AA - and he may decide he wants to refer you to hospital for an extraction. It all depends on the state of your jaw bone after all that time on AA.

[Hidden]

I know when I was on both Prednislone and AA my dentist ( who checks what meds everyone is on at the start of each consultation ) highlighted the fact in my notes.

She said at the time that I may run into problems with extractions but that oesteonecrosis of the jaw wasn't a given with AA, I think it's classed as a rare side effect. She would have been happy to do any treatment in her surgery but I know of other dentists who refer to the local dental hospital.

I am on biologic drugs and had a nasty abcess in a crowned tooth in the summer ( I was expressing pus from my gum ). It cleared with a course of Metronidazole after Co amoxiclav had failed to treat it. I was looking at an implant due to the position and length of the crown post but my dentist and I decided to leave it for a while to see if the infection would settle and it has. This is despite ongoing Infliximab and Methotrexate. I hope that everything settles soon and that you have a complication free extraction.

[Jools52]

I have now lost 4 teeth due to prednisone. They crack vertically or just snap. IF you have an extraction then make sure the dentist stitches the gums as vasculitis makes us very prone to dry socket & I had 8-10 weeks of extreme pain. The root was growing down but also under the next tooth. I am an NHS patient and was told they didn't cover such complex stuff & it would cost me 2K to have it done elsewhere

Teeth and prednisolone don't mix well. Make sure your dentist has knowledge of treatment while immunusuppressed. I didn't and now feel very insecure due to missing teeth. One if my central front upper tooth so is very noticeable.

Wishing you all the very best and no dry socket

[laidbackreader]

Thank you all for your replies. Much appreciated. I've been back to the dentist and he said that he is unable to do the extraction because of my medication history. He is referring me to the hospital for the extraction.

If it becomes more painful while I wait for the appointment he will prescribe more antibiotics/pain relief.

[michichgo]

Only want to wish you a bit of moral support as you await the extraction.

I've undergone a few extractions and lost some mighty expensive crown work, all due to prednisone.

May you be free of tooth pain and woes soon!