Tooth Extraction on Prednisone

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OlderThanDirt
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Date Joined Oct 2010
Total Posts : 192
   Posted 3/3/2011 7:41 AM (GMT -7)   
Has anyone had to have a tooth extraction while on prednisone?  My GI wants me to have two teeth pulled because I am going to be going on remicade or 6 mp and he wants the teeth out before I do.  I know the healing time will take longer on prednisone.  How much longer?  Did anyone get an infection as a result of the extraction?  I know this needs to be done - I'm just not too thrilled with the idea.  Looking for any anecdotal info you can help with. 
OlderThanDirt
Misdiagnosed 25 years w IBS. Crohn's dx 8/10.
Gallbladder out '97. Taking Lialda, Prednisone, B12 shots, Vit. D, Prevacid
"Thank God for fellow crohnies. They know the words to the song in your heart when you've forgotten how they go."

tsitodawg
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Date Joined Sep 2006
Total Posts : 845
   Posted 3/3/2011 1:06 PM (GMT -7)   
I had an issue where I had to have a tooth removed due to prednisone. Prednisone was horrible on my teeth and jaw due to the fact that it drains your body of calcium and vitamin D when you are on it long term. How long have you been on prednisone? My G.I.( now former due to this) kept me on it for a year non stop at a huge dose. This along with the many previous years of use had caused me to develop osteoporosis and vitamin deficiency. I had 7 root canals done in about 6 months and the who knows how many cavities filled despite brushing like mad. I developed a staph infection after the last root canal that led me to having the tooth removed and a couple weeks of I.V. antibiotics. This is a little different than your situation but you can have a tooth removed while on prednisone.
Having the tooth removed was the only thing that actually helped with the pain and swelling. During all of this, my primary care had me start to taper off of the prednisone so that I could heal correctly. Are you tapering at all since you are starting remicade?It sounds like you have a pretty good G.I. if he wants the teeth removed before starting remicade. He is looking out for your welfare by eliminating all chances of infection.

cupcakespinkgal
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Date Joined Jun 2010
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   Posted 3/3/2011 2:02 PM (GMT -7)   
My fiance is a dentist, in most situations you can have a tooth removed while on prednisone, but probably the lower the dose you are on the better it will heal.

The other thing is to make sure the dentist knows. I know my fiance has had patients on prednisone before for various reasons, but depending on the dose, length of time on prednisone, and procedure he has them take an additional dose the day of the procedure or has them bring it with them as a precaution, in case of adrenal crisis.
Diagnosed with Crohn's in 1998, father has UC we were both diagnosed at 20 yrs old.
Previously on Remicade, Humira - No surgeries so far

Meds ~ Sulfasalazine 2/2xday, 1.5 mg LDN, increasing at 2 week intervals
Supps ~ Culturellle, psylium seed, olive leaf extract, magnesium, D3, K2, Calcium/Boron, multi-mineral. Modified Fodmap/low fructose/no sugar

tooth
Regular Member


Date Joined Jun 2010
Total Posts : 336
   Posted 3/3/2011 4:29 PM (GMT -7)   
I'm a practicing dentist and what cupcakespinkgal said is absolutely right. Sometimes your dentist will premedicate you (depending on your dose) with extra steroids the day before, of and after. It's usually only done on high doses, though everyone is different...

Can't say how long it will take you to heal after the extraction...normal is 7-10 days. People with decreased immune systems will heal slower then those with higher ones. It could be anywhere from 7-10 days to a month (from the tooth removed to healing to where it should be). Your dentist also might want to give you an antibiotic after the extractions.

Just remember to tell your dentist about the prednisone (and remind him when he does the extractions.)

You will be fine!! Hope you feel better!!

Homeboy
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Date Joined Dec 2005
Total Posts : 575
   Posted 3/3/2011 7:36 PM (GMT -7)   
I have had several teeth extracted while on pred. Imuran, and Humira.

The only problem I had was the healing time. It took me several months to heal up, fill that hole in with tissue, depending on the tooth pulled.

Having things healed up very well, was something I am so glad I waited on.

I got my lower partial denture last year, and it fits so well, I forget I have one.

OlderThanDirt
Regular Member


Date Joined Oct 2010
Total Posts : 192
   Posted 3/3/2011 8:33 PM (GMT -7)   
Thank you all for your valuable comments.  This is just the kind of help I was looking for.  I go tomorrow for the extractions and have the prednisone in my purse. 

OlderThanDirt
Misdiagnosed 25 years w IBS. Crohn's dx 8/10.
Gallbladder out '97. Taking Lialda, Prednisone, B12 shots, Vit. D, Prevacid
"Thank God for fellow crohnies. They know the words to the song in your heart when you've forgotten how they go."

tsitodawg
Veteran Member


Date Joined Sep 2006
Total Posts : 845
   Posted 3/4/2011 12:26 AM (GMT -7)   
I love having a member on the board that is a dentist.

cindywchrones
Veteran Member


Date Joined Mar 2005
Total Posts : 1064
   Posted 3/4/2011 8:23 PM (GMT -7)   
I have had severe bone and gum loss with extractions from predisone usage. My dentist was not concerned about the extractions while taking predisone. When I had albation done, I know I was injected with something right before the procedure by the anesthesiologist?? I do know it took forever for the holes to heal up in mouth, but I did not get dry socket or any infections. My son who has CD was given a stint to Flagyl when he had his wisdom teeth out.
Cindy

drleac
New Member


Date Joined Mar 2011
Total Posts : 5
   Posted 3/5/2011 7:58 PM (GMT -7)   
been living with crohn's disease for appx. 14 yrs. now--had ileocecal resection Jan. 21, 2011--feel worse now than before!--lower right quadrant of my belly--when the pain comes, it literally takes my breath away and cannot hardly walk--it subsides usually within a few minutes--was told prior to surgery, that it may not be for me, i guess it wasn't!--i was reading the column when i saw older than dirt's question about a tooth extraction while on prednisone--it struck a nerve with me--i need 6 top teeth extracted, i guess from probably prednisone, entocort etc...--does anyone know who can do the extractions at a very very reduced cost--i'm dying here, with all the medication costs, medicare costs, part b, part b supplement, medicare part d payment, etc.., the list is endless, it just does not stop! i do not have dental insurance, or i would have addressed this issue a while back--not only do i need the teeth extracted, but also need a full top denture--i live in DE and did not know if anyone knew any body who could be helpful?--i never knew that prednisone could cause harm to your teeth--i guess i should have known, since crohn's can affect you from head to toe--i am starting to look into natural healing methods, because i am too afraid to go back to my GI, because she will want me on the biological meds.(remicade, humira, imuran or cimzia), which i cannot seem to bring myself to wanting this type of treatment!--i am i guess what you would call, a complicated case, meaning since this past flare-up, i have had severe weight loss,(90+ lbs.), go through bouts of going and bouts of not going to the bathroom, malabsorption, general ill-feeling, but maybe i guess that goes with the territory, huh?--what a horrible disease!--i am open for any suggestions and/or comments that would be helpful--thanks for the ears!

tooth
Regular Member


Date Joined Jun 2010
Total Posts : 336
   Posted 3/5/2011 10:08 PM (GMT -7)   
@drleac - I'm not sure where in DE you are from. But the best I can suggest is trying the residency program at Christiana Hospital. Some programs have limited coverage for emergencies and it may help cover part of the extractions. Though I'm sure the cost of the residency programs are a lower cost then a private dentist. If not, Penn and Temple both have a dental school in Philly that have extremely low cost care. They also could concievably make dentures as well. They're students, but the quality of care is good.

I'd also look into your Medicare plans. Is there any chance that you are eligible for a dental plan with part of your medicare package. If not, I'd recommend looking into other plans that have equivalent coverage with a dental plan.

Hope that helps.
Diagnosed 2002 at 18. Remission for about 7 years. Getting back into the swing of things at 26.

75mg Imuran, 750mg Balsalazide 3x day,Entocort 9mg/day, loading doses of Remicade.

Maybe this flare is going away?!

drleac
New Member


Date Joined Mar 2011
Total Posts : 5
   Posted 3/5/2011 10:54 PM (GMT -7)   
thx tooth-but i think i looked into program--wait list is long!--i need pretty immediate attention, since at least 1 of the teeth are ready to come out, and i think i may have infection in it--i just do not know where to turn--i wish you continued success with your remission--thanks again
diagnosed 1997-crohn's disease-not in remission at all!-conventional meds. were no help--too sensitive to alot of the meds.(asacol, pentasa, flagyl, entocort, prednisone)
currently on no meds. for crohn's-have c.o.p.d., parkinson's disease,degen. disc disease, bad nerves--currently take: zoloft, lipitor, multi-vit., ativan, neurontin, sinemet, requip, vitamin-e, cipro twice a week, diflucan(when not on cipro), cranberry softgels, bronkaid, symbicort, pro-air, albuterol nebulizer, and oxygen

cindywchrones
Veteran Member


Date Joined Mar 2005
Total Posts : 1064
   Posted 3/6/2011 10:11 PM (GMT -7)   
I do feel for you..I have had several extractions and have maxed my dental benefit for the last five years running..Abcess and tooth pain can be painful. I know there are low cost clinics..Some will not do molar extractions. I know root canals and crowns are out of the question.

Cindy

OlderThanDirt
Regular Member


Date Joined Oct 2010
Total Posts : 192
   Posted 3/6/2011 10:29 PM (GMT -7)   
I don't know about Delaware, but here in New Hampshire, our county health department handles medicaid, fuel assistance, and also has a low cost dental clinic on site. If you can show that your income goes to paying other medical bills, and have a certain amount left for living expenses, you may be able to requalify income wise for dental assistance. PS My name is Older than Dirt - not Dumber than dirt.
OlderThanDirt
Misdiagnosed 25 years w IBS. Crohn's dx 8/10.
Gallbladder out '97. Taking Lialda, Prednisone, B12 shots, Vit. D, Prevacid
"Thank God for fellow crohnies. They know the words to the song in your heart when you've forgotten how they go."

tooth
Regular Member


Date Joined Jun 2010
Total Posts : 336
   Posted 3/7/2011 2:49 PM (GMT -7)   
Hey OTD - how are you feeling after those extraction? Did you dentist do anything special for you before/after?

OlderThanDirt
Regular Member


Date Joined Oct 2010
Total Posts : 192
   Posted 3/7/2011 4:42 PM (GMT -7)   
@ tooth

Thank you for asking, Tooth. The surgery went very well. I had an oral surgeon who really is an artist when it comes to sutures, etc. However, I ended up in the ER on Saturday due to an adverse reaction to my pain meds. I had told him I couldn't take NSAIDS because of Crohn's and I knew that anything with codeine gave me nausea. So he prescribed tramadol to try. Just another pain med to add to my ever-growing list. Not only did it give me nausea, I couldn't take my prednisone as it came up so fast it didn't have time to dissolve, but it gave me tremors like Parkinson's disease. I had to go have an IV for dehydration, plus I got my steroid for Saturday via IV plus I got an IV anti-nausea and some more meds to bring home

The good news is he has had me taking a slightly higher dose of the pred for a few days, I have been able to go without any pain meds at all since Friday night, and no dry sockets or signs of infection yet. I am eating well for not having anything but liquid or soft food and I see the surgeon on Friday re the sutures.

Thank you again for your comments pre-op as it gave me the confidence to get it over with.
OlderThanDirt
Misdiagnosed 25 years w IBS. Crohn's dx 8/10.
Gallbladder out '97. Taking Lialda, Prednisone, B12 shots, Vit. D, Prevacid
"Thank God for fellow crohnies. They know the words to the song in your heart when you've forgotten how they go."

drleac
New Member


Date Joined Mar 2011
Total Posts : 5
   Posted 3/7/2011 5:54 PM (GMT -7)   
hi otd,
sorry for stating that you were d---er than dirt!!--please forgive?--clearly, an oversight by me.--i hope you are continuing to do well after your surgery!--sorry that you are going through so much:(.--i am still holding up on the dentist thing, i simply do not have the bucks to fork out--hoping on a wing and a prayer that the 1 tooth will eventually fall out on its own--i am not eligible for any medicaid here, of course; that is the way of the u.s. of a. today!--continue to get well, and stay in touch!

Lasardo
Regular Member


Date Joined Jan 2011
Total Posts : 361
   Posted 3/7/2011 6:12 PM (GMT -7)   
hello otd..I have had the same thing happen with prednisone, 3 extractions so far and my front tooth is dangling..every time I take prednisone! it is really unfair, Do you ever have nightmares about it like I do?

Crohns,pelvic floor tension,pelvic adhesions,recent hystorectomy,depresion..etc etc

OlderThanDirt
Regular Member


Date Joined Oct 2010
Total Posts : 192
   Posted 3/7/2011 9:32 PM (GMT -7)   
@ljb
I have nightmares about most meds used to treat this DD. I have to choose between 6mp and remicade in a few weeks, and am having a very hard time choosing. My GI has kept me on pred at 20 mg for 8 weeks since my last hospital stay until I could get these teeth out and go on to my next tier of medicine. The only good thing I can say about the pred is it has kept me out of the hospital again and I am not one of those who get diabetic on it. I have the moon face, the bad skin, osteopenia, swollen ankles, have gained about 5 pounds on it this time, and find myself so anxious at times that I am hyperventilating. Also, very bad insomnia. Otherwise not too bad LOL!
@ drleac
Thank you for your kind words. Have you called your local United Way and asked if any private dentists volunteer their time?
OlderThanDirt
Misdiagnosed 25 years w IBS. Crohn's dx 8/10.
Gallbladder out '97. Taking Lialda, Prednisone, B12 shots, Vit. D, Prevacid
"Thank God for fellow crohnies. They know the words to the song in your heart when you've forgotten how they go."

Lasardo
Regular Member


Date Joined Jan 2011
Total Posts : 361
   Posted 3/7/2011 9:44 PM (GMT -7)   
OTD, no have nt called United Way, but will for sure do that, thankyou! So you have to chose between 6mp or Remicade, have had both, One thing about the Remicade is I had never felt so good in my life! OTD, even colors were sharper! I had energy, felt amazsing unfortunalty on my third infusion I developed antibodies to Remicade, I begged the dr to continue infusion but he warned if he did that I could die..Sorry if I scared you, that is why you get infusion in hospital, they watch you closely, and it is rare to develope antibodies. I agree prednisone has kept me out of hospital many times and I have had all the wonderful symptoms you have..it stinks! lol But what do you do? If my flair is not to bad they give me Emtocort which has worked sometimes and sometimes not, just the thought of prednisone brings me to anxiety..good luck to ya, let us know how you are doing..

Crohns Disease, Pelvic Floor Tension,Pelvic adhesions,recent hystorectomy, several reconstructive surgeries after childbirth,colostomy bag, depression and anxiety, chronic pain. bad teeth

drleac
New Member


Date Joined Mar 2011
Total Posts : 5
   Posted 3/7/2011 9:51 PM (GMT -7)   
@ older than dirt
You are welcome, and thanks for forgiving?--Will call United Way and give them a shot--all they can say is no, right?--i'm used to that anyway, lol, not really lol!--by the way, what is lialda?

OlderThanDirt
Regular Member


Date Joined Oct 2010
Total Posts : 192
   Posted 3/8/2011 9:50 AM (GMT -7)   
@drleac

Lialda is in the same family of drugs as Asacol or Pentasa. It just has a different breakdown time so it affects a slightly different part of the intestinal tract.
OlderThanDirt
Misdiagnosed 25 years w IBS. Crohn's dx 8/10.
Gallbladder out '97. Taking Lialda, Prednisone, B12 shots, Vit. D, Prevacid
"Thank God for fellow crohnies. They know the words to the song in your heart when you've forgotten how they go."
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