Root Canal / 6 MP and Tacrolimus

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NDBC
Regular Member


Date Joined Mar 2010
Total Posts : 49
   Posted 10/15/2011 5:14 PM (GMT -6)   
Hello, I read a thread posted back in September about root canals for us Crohni'es who are immune suppressed. I had a root canal yesterday. The tooth was already infected. The dentist said I did not need pre-med and my GI had said (in the past) that I did not need to be premedicated (but we did not know about the infection till they went in yesteday). I am also sick for the past 10 days with a really bad cold / cough and was just tested for pneumonia, but I assume I don't have that since the GP didn't call me back (nor did he return any of my 3 phone calls of Friday RRRRR). His assistant did say he had the xray report, so I assume he would have called but STILL!!

Anyway, that's what has been going on. What is going on today is major PAIN. It's in my whole jaw, from the root canaled tooth back to my jawbone. Hot, throbbing. I have erythromicyn from the GP doctor prescribed for my chest / head cold, so I've taken that 3 x today (500M). But, of course all docs and dentists are closed. It's gotten worse since this morning. I know anti biotics can take 24 hours.. not sure what to do. I have phoned the GI on call to ask him what to do. Now I'm waiting. I'm so worn out with all this, and in pain, even the oxycodon can't touch this pain. Sigh. Would you wait till Monday or go to the ER?? Usually the ER does not help and I think they might not get it, regarding the tacrolimus and 6 mp stuff. I'm not sure if this is normal after a root canal, but I think not.

NDBC
6MP Tacrolimus Gabapentin and for Crohn's, peripheral neuropathy, arthritis.

nawlinscate
Veteran Member


Date Joined Jan 2007
Total Posts : 656
   Posted 10/15/2011 8:02 PM (GMT -6)   
I'm actually going through something a little bit similar. I had a rear molar extracted on Wednesday, September 21. It wasn't infected, but it had a large, very old cavity that was going to be so hard to deal with that it made more sense to pull the tooth. My dentist knows all about the fact that I'm on 6MP--and that therefore my immune system is suppressed. But he told me that I did not need antibiotics.

The extraction went well, and the three sutures were removed this past Monday. Supposedly, the extraction site is healing well. But I'm experiencing what seems like an unusual amount of tenderness and discomfort. I've decided that I'll have to call him if it's still feeling this bad by next Wednesday, four weeks after the extraction.

He did suggest that I rinse with warm salt water several times a day, which I haven't done. Maybe I need to start that.

At any rate, even though the pain isn't as bad as yours, I'm confused, too, and a little concerned.

NDBC
Regular Member


Date Joined Mar 2010
Total Posts : 49
   Posted 10/15/2011 9:20 PM (GMT -6)   
Hi Nwalins Cate, I'm sorry you are going thru this too. My doctor never called back (I mean the GI on call doctor). I am so upset, no doctors ever call back. I don't really over-react, but I am starting to get the impression that this must be ME. Or that I need to exaggerate when I call - say that I'm screaming and writhing in pain or something. The GP didn't call back about the xray result, the GI on call doesn't call back to answer my question as to how serious this tooth is - whether I should go to ER or not. Obviously now I'm not going its 10:15 at night and I am wiped out. But I am FURIOUS. I took another oxycodone pill at 6, and it took the edge off but still in pain. Will take another one now and resume trying to get answers tomorrow if this is still getting worse. What about the blankety blank hippocratic oath! Neither dentist, nor GP,not GI seem to really listen or care. I am so very upset. This has been a really bad week, and the pain is now in my mouth - jaw. I think they used to not "seal" root canals, but the dentist told me that now they do it all in one step. I hope he did the right thing for someone in my condition. I will NEVER do anything medical on a Friday again and go thru weekend with nothing but the ER. I'm ready for the funny farm now, for sure.

But, to your issue, I had a molar out last spring, while I was on the same immunosuppresant regime, and it knocked me for a loop, missed a day of work next day, vomiting, feverish, sick & weak. Dunno why, I didn't have general anesthesia. But, the tooth site was not especially painful, it just seemed to knock my system out in general for 2 days, then I was ok. The tooth site was not especially painful and it healed well. I hope you find out - 4 weeks is a long time. Thanks for replying, this week has been so bad and I feel so very alone with these troubles, especially without even doctors....

cindywchrones
Veteran Member


Date Joined Mar 2005
Total Posts : 1051
   Posted 10/15/2011 9:50 PM (GMT -6)   
I have problems with my teeth and have had two root canals under immune sup. drugs. I was given antibiotics before and after. I don't take pain medication well, but I know how bad teeth pain can be! I do not heal well so I take any kind of procedure seriously..It took me two months to get over my last ingrown toe nail surgery..Pain medication making me sick was an issue..I had to take phenegren with in to hold it down!
Cindy

NDBC
Regular Member


Date Joined Mar 2010
Total Posts : 49
   Posted 10/16/2011 6:07 AM (GMT -6)   
Today my whole left side of my face is fat and swollen. At the moment, the pounding pain has stopped, but since half my face is swollen, (which it was only slightly swollen yesterday) I guess it is infected. WHich is why I want to talk to my GI doctor, this can't be a good thing for me overall. I will continue to take the erythromycin but I am very upset that the GI did not call me back. Maybe erythryo is not strong enough ??? My Hospital keeps GIs on call round the clock, but this one did not call me back. If I can get to the point where it doesn't hurt to talk maybe I call him, or maybe just wait for the dentist to open tomorrow. Either way, this sucks so bad. And meanwhile I just have to wait and see what this infection is doing to me... and then see the dentist tomorrow I really hope. If they will listen to me and squeeze me in.

No one ever takes my complaints seriously, honestly, I saw this tombstone (for real, not a joke) and it said "I told you I was sick" and then had the person's name and date. That's what I will get when it's my time. I'm not writing to ask for advice at this point, just to vent. Sigh ..hang in there till tomorrow. When it is time to go back to work.... sigh. This sucks so bad. At least I did sleep.

Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14994
   Posted 10/16/2011 8:52 AM (GMT -6)   
I think you need to contact your dentists emergency line and tell him whats going on with your tooth and the pain. Since he is the one who did the dental work, I would try calling him first. Hugs!
Gail*Nanners* Co-Moderator for Crohns Disease
Crohn's Disease for over 35 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Percoset prn for pain, Zofran, Phenergan, Probiotics, Calcium, Vit D, Folic Acid and Xanax prn. Resections in 2002 & 2005. Also diagnosed w/ Fibromyalgia, Osteoarthritis, & Anxiety. Currently my Crohns is in remission, but my joints are going crazy!

NDBC
Regular Member


Date Joined Mar 2010
Total Posts : 49
   Posted 10/16/2011 3:36 PM (GMT -6)   
Dentist does not have any on call or emergency line. No way to get him. I called back my gi emergency line and told them no one got back to me last night then my own gastro Dr called me back. He said what Nanners said - call the dentist. But I am flat out sick haven't left my bed. Throwing up and d. I just have to keep the erythroo down. I can call the dentist tomorrow at 8am so just have to hang in till then. At least give said the erytromycin is OK.

nawlinscate
Veteran Member


Date Joined Jan 2007
Total Posts : 656
   Posted 10/16/2011 9:31 PM (GMT -6)   
Oh, man, you really really have to call the dentist in the morning. I don't see how all that swelling can be anything but a raging infection. My heart breaks for you, going through this.

Turns out I was counting from the wrong dentist's appointment--and tomorrow will be only two weeks from my extraction, not four. Which makes me feel a lot better, although the extraction site still hurts like crazy.

I'm so sorry for you tonight. I hope that your dentist reacts appropriately to your miserable situation and takes care of your problem immediately. Just know that all of us here have you in our thoughts.

Dagger
Veteran Member


Date Joined Apr 2008
Total Posts : 1522
   Posted 10/16/2011 10:23 PM (GMT -6)   
You need to go to the ER. Erthromycin is not the correct antibiotic for an infection in the tooth or jaw. An infection like this can be very serious.

My daughter just went through something similar and she is healthy with a strong immune system. They did a CT scan to track the infection and kept her overnight in the hospital on IV antibiotics. She was released the next morning and sent directly to her dentist who went in and removed the infected tissue. Afterwards she was on a combination of oral antibiotics for 10 days.

NDBC
Regular Member


Date Joined Mar 2010
Total Posts : 49
   Posted 10/17/2011 8:21 PM (GMT -6)   
Dagger, you are so right, I got a special antibiotic, a z-pack. I guess it is stronger. It's not making me as nauseous as the erythro. I feel better today, slowly starting to eat some food and drink. But I'm exhausted, stayed home from work, called dentist at 8 am and at 8:15 am, he called me back (or had his secty call) and they called this z-pack rx in and said "it's not uncommon" for such an infection to develop. I'm angry! If it's not uncommon, why did he make me suffer all weekend, after I TOLD him Friday (and it's also in my chart, I've told them repeatedly) that I'm on tacrolimus & 6mp and thus have a compromised immune system and can't risk infection!!! Why why why, didn't he listen to me. Wahh. I think I will change dentists. I'm still feeling like crap but actually sat up for a few hours this morning... Thanks all for your help. I guess i will slowly come along, definitely won't make work tomorrow unless I have a miracle happen. But I think I'm on the road to getting well (or as close to well as we can get)

Dagger
Veteran Member


Date Joined Apr 2008
Total Posts : 1522
   Posted 10/17/2011 10:50 PM (GMT -6)   
If you decide to change dentists, ask about their after-hours emergency policy right up front. My dentist has an answering service and will get back to you quickly, even on weekends. He met us at the office once on a Sunday when the wire on my daughter's braces snapped and he fixed it for free. After her problem with the infection, he gave us his cell number in case she had any trouble that evening so we could call him directly.


(My poor daughter has inherited my awful teeth. My son was luckier!)
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