I have been taking antibiotics for a reaccuring tooth infection but have noticed that there has been an increase in pains in my joints.

[James_Apps]

I am currently taking prednisolone and mycrofenolate and simvastain, I have been diagnosed with WG for approxamatly two and a half years, I am due for another blood test and a check up with my consultant next month and will ask him about this then, but wondered in the mean time if if anybody knew of any complications that could occur when taking antibiotics, many thanks.

[John_Mills Volunteer]

It is most probabl that your dental infection is causing stress on the body and this is allowing the WG to cause the pain in the joints. Antibiotics are not a cure for dental infections they merely supress the symptoms and the problem will keep reoccurring until it is dealt with properly. EG:- extraction/root canal treatment/treatment of gum disease. Talk it over with your consultant or return to your dentist and talk to them. take care.

[James_Apps in reply to John_Mills]

Hi, thankyou for your reply and advice, because of the reaccuring problems I am going to have that tooth extracted, it had prevoiusly been capped but according to the x-ray the roots or tooth is rooten, it is an upper back tooth so I am just glad to sort this out finally. But I will also bring this up with my consultant, the joint pains are less today and with this condition as you probably know, it is sometimes hard to know if it is just a flare up or something is triggering it off. I forgot to mention that I am on alondronic acid as well, you brought up an interesting point and I will mention this to my dentist, though I think I have given them a list of my medicaion, again many thanks.

[Tony-LakeDistrict]

the use of steroids over a period of time can cause joint problems," necrosis," normaly in the hips & shoulders.

As far as the dentist is concernedI have been told not have dental treatment if possable while on immune suppressant, I don`t know if this my consultant for me or the norm`

[James_Apps in reply to Tony-LakeDistrict]

Hi, thanks for your reply, I am 5mg a day prednisolone at the moment, this does vary due to flare ups, interesting that you mentioned shoulder pain as that is one of the areas where it seems to occur, though so far not my hips but knees and hands,, thanks again.

[John_Mills Volunteer]

If this was the case it would pose a massive potential problem!! Many people are on immune suppression for many years. Thus an untreated dental infection could and does lead to septicaemia even in non-immune suppressed people, so imagine the result if the immune system is restricted. Oral health is even more important for we immune suppressed people. So do get your dentist to check your teeth, gums and oral tissues regularly. but do advise him/her that you are taking immune suppressing drugs. If you do need a particularly invasive process, your dentist should discuss treatment with your consultant/GP to assess the risk - WBC count etc. If the risk is high, antibiotics are appropriate to cover the treatment. The intention with immune suppressing drugs is not to knock your immune system out, but to control it.

As an ex-dentist I can say categorically that if you have an infected tooth or a dental abscess, antoibiotics will NOT cure it, just supresss the symptoms. It will recur.

The best solution get your oral health in good condition, then keep it that way through good oral hygiene. There was an article on Maintaining Oral Health in the Spring edition of the Vasculitis UK newsletter - you can read it online at Vasculitis-uk.org.uk follow the link Spring Newsletter 2011.

[BooBoo39 Volunteer]

Hi James,

obviously John (bless him - 'The Wise Owl) has the professional knowledge on this subject and he is correct that anti biotics will only suppress an infection/abscess etc for the time that you take the anti biotics. so seek help from both your consultant and your dentist. From experience when i was first on Prednisone i developed a very painful abscess, my dentist at the time suggested an extraction, as my teeth are one thing that normally cause no issues i refused and asked a second opinion off another dentist who immediately gave me a weeks supply of antibiotics to reduce the infection and then over two appointments performed root canal and a new filling my tooth intact. Other than the time taken up in the chair the experience was quite painless. My only concern which is where problems can occur is when you take Prednisone over longer periods, the case for me now, i also am required now to take an alondronate(alendronic acid) to help maintain bone density this can cause serious issues for dental work especially invasive work like extractions. Possible this is where a consultant will advise a sufferer taking steroids to seek expect advice re dental work because of the complications . I have not had any issues with antibiotics and joint pain and in fact currently taking them for a chest infection i only experience the joint pain as the prednisone is reduced i.e greater chance of vasculitis and inflammation again...Good luck James .. Hope this helps.

[John_Mills Volunteer in reply to BooBoo39]

Yup Boo Boo, Spot on. Antibiotics plus Root CanalTreatment is ideal (apart from the cost) as it represents little threat in terms of infection - if the infection is not too far advanced. Certainly, the prolonged use of alendronic acid can cause reduced vitality in the bone so greater risks of infection & bone necrosis with extraction. So again RCT is better if it is an option. But prevention is still the best option of all!

[James_Apps in reply to BooBoo39]

Hi, thanks for your reply and for reminding me about the importance of mentioning the alendronic acid to my dentist, its was also good to know that you have not experianced any joint pain when taking antibiotics, hope you get rid of your chest infection soon, thanks again.

[BooBoo39 Volunteer in reply to James_Apps]

Thats great James... pleased to help......All The dentists i have spoke to were well aware of steroids and alendronic acid so it won't be quite the headache of explaining what vasculitis is. thankfully.

Chest infection definitely taking a hike now pleased to say just wish my CNSV would get the message it's not welcome either... Oh well ! project for another day eh?