Dental surgery when on prednisone?

[Xlator]

I have had PMR for a year and have slowly tapered from 10 mg to 4 mg prednisone. I’m still tapering very slowly. I can’t tell if my adrenal glands have kicked in again yet or not, but in general I am doing pretty well.

I am now scheduled for a tooth extraction that I had been putting off because of Covid. Unfortunately, in the year I have been on prednisone I have lost so much bone in my jaw that after the extraction I will also need a bone and tissue graft before I can get an implant. I have a call in to my rheumatologist for risk assessment and guidelines for dental surgery when on prednisone, but would like to hear from the hive, too. Please share with me your experience with dental surgery, prednisone, and PMR flare ups under these circumstances. Many thanks!

[SheffieldJane]

Will you be under general anaesthetic ? The anaesthetist will also need to advise on the need for supplementary steroid treatment, to cover the operation and recovery. A conversation with the surgeon should be sought as well. Sometimes it can be up to the patient to ensure that all necessary information is communicated, to everyone involved. Good luck with your operation, I hope it is a complete success!

[Xlator in reply to SheffieldJane]

Thanks for responding, Jane. At this point my surgeon and I have decided on local anesthetic. Unless I am told a good reason to have general, I would prefer local. And, yes, thanks for the reminder! I’ll make damned sure sure that information is communicated. If I have learned anything from this rollercoaster year with PMR, it is to take charge of my health and not to count on the medical community to know what’s best for me. The hive knows more!

[PMRpro Ambassador]

I have had a tooth extraction while on pred - I was worried, my dentist here in Italy wasn't and he was right. But I do not have any bone loss to cope with and that does make it a very different situation.

Is the loss of bone entirely due to steroids? Are you on any other medications?