A matter of Teeth!
Posted 07 June 2011 - 05:10 PM
Please could anyone help me out?
Im in a mixed state of mind of what is going to be the best course of action with one of my back teeth.
Last week I started with a sensitive tooth; not painful as such, just uncomfortable. Initially thought I was getting a mouth ulcer, it was that kind of pain. 72hrs later, my whole neck and jaw ached and were stiff. I had made an appointment with my dentist and when I saw him it was really very sore and felt as if I had been punched in the face! It took 4 hours to numb me up!! When he did an xray, it was found that the tooth was dying, so he emptied the tooth of the pus pulp and nerve and dressed it; it has all come out now, so I have an open shell of a tooth! I'm on erythromyocin antibiotics to kill off any infection; I'm not in pain now, nor have any swelling. I rang them to see if I should return for him to dress it again, but it was decided that as long as I was pain-free, I should be ok until I return on the 14th june.
My question is: I have a choice... to head down root canal filling, or to extract the tooth and be done with it. This option is in my mind, as the tooth is dead and it isn't going to affect me cosmetically. I'm probably going to be better off if my mouth shrinks or if I have other issues later.
If I go down the extraction route is there any precautions I should be aware of to tell the dentist? Have any of you had teeth extracted? I am on prednisolone 7mgs a day and a lot of others. It's not something we do all the time and I attend my 6mthly checks,but I've read somewhere that we have to be careful with this sort of issue because of infection and slow healing of the cavity and possible damage to our jaw bone.
If any of you can assist me on this or experience of tooth extraction with scleroderma I would be everso grateful.
Thanks in advance
Warm hugs to all
Posted 07 June 2011 - 05:59 PM
As you k now, I'm not a dr, but I DO have experience with extractions since I've had Scleroderma, along with my other chronic illnesses.
Your dentist should have your medical history, along with a list of all your medications. If you aren't sure, check with him.
I know of many folks who are given an antibiotic several days prior to a precedure of this nature, (in order to avoid infection, as you suggested).
I've had a total of 5 teeth extracted and have had good results.
Of course, this is something you and your dentist may want to visit about, as I've never had a "tooth die"!
Posted 07 June 2011 - 09:52 PM
I have had quite a few dental problems and I think my first question would be "what caused the tooth to die?". It seems if the tooth is dead a root canal would not be of much help now but I am not a dentist. Did you ask what the benefit of a root canal would be over having the tooth extracted? If not, I would discuss the pro's and con's of each with him/her and base my decision on that. Keep us posted!
Good Luck to You!!
Posted 07 June 2011 - 10:46 PM
Sorry about your tooth. I too have had teeth 'die'. I usually opt for a root filling and restoration because every tooth I can hold on to is a benefit in the future. These days the philosophy usually is to keep your teeth because when we are old and decrepit care givers will throw away your dentures and feed you mush!!! Well, I don't really know about that but I don't want to risk it.
Sometimes I have had to have an extraction and I have even had two implants with no ill effects. I have Sjogrens too which makes dental health more tricky but I seem to be managing so far.
I have Rheumatic Heart disease as well and that usually brings up a red light with the dentist and still I am doing fine there too. The only other caution I know about is FOSAMAX which is a bone re-building treatment. I was 'lucky'? enough to have early menopause which means now that I have a certain amount of Osteoporosis. In spite of all that my dental health is as good as it can be. Not particularly marvellous, I might add, but as good as I can expect, all things considered.
The next thing that comes into it is cost!! We have no universal dental care in this country after age 18 and unless we take insurance it is a case of paying the going rate. I am fortunate that we can afford to pay and I am thankful for that too otherwise I suspect I might be in the category of "toothless old crone" by now and in my book, that is something else to avoid. We have enough to put up with having been blessed with this interesting disease called Sclero..... without anything else being loaded on us.
Hoping you can make the right decision for you.
Warm Hugs from NZ
Posted 08 June 2011 - 02:10 AM
I do sympathise; toothache is really miserable! I've experienced dreadful toothache in the past and would have considered amputation at the neck to alleviate the pain!!
As Judy has rightly mentioned, some medications can upset tooth extractions. My dentist recoiled in horror when I told her I was taking Alendronic Acid (Fosamax) as apparently this can cause the bone to crumple after tooth extraction and also she suggested I might have to up my dose of steroids following tooth removal to deal with the trauma? It really grieved my previous dentist to remove any teeth; he seemed to take it personally if he couldn't save the tooth; having said that I have (in the past) had quite a few extracted. However, as I don't want to be eating pureed food for the rest of my life, I now tend to go the root canal filling route.
I'm glad to hear that your dentist has managed to get your toothache under control; I would probably suggest on your next visit you explain all about the medications you're on and ask him for his advice. Let us know how you get on with your appointment on 14th June, won't you?
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Posted 08 June 2011 - 06:52 AM
I have had issues with my teeth for years, but mine was due to grinding. I tend to clench my jaw when I concentrate and end up cracking or breaking teeth. The first tooth that broke I had them remove it, as it was the cheapest and easiest so I thought. After removal my teeth started to shift and I now have a cap in between my front teeth. The tooth next to the removed tooth has become super sensitve to hot and cold, and often times I bruise the gums around that area when I eat anything cruchie. Due to these issues when I broke another tooth I went down the root canal route, and I am much happier that I did that. If it happens again I will probably do the root canal thing as there is less chance for infection, and as others have said I want to hold on to my teeth as long as possible.
Best of luck that it all goes well, and you are pain free with a super smile soon!
Posted 08 June 2011 - 12:01 PM
I'm really sorry to hear this. I have Sjogrens, which is getting worse, and losing my teeth is my biggest fear. If I were in your shoes, my choice would be to have a root canal, crown or whatever it took to repair the tooth, but that's just me. Good luck in whatever you choose to do!
Posted 08 June 2011 - 04:40 PM
However, as it has been said cost is a big factor, in England dental work is very expensive. A simple root filling with a crown can set us back around £200 and its a lot of money to find, especially in the financial climate we are all in! if it had been a front tooth then I would have begged, borrowed or stole to find the cash! If it is not going to cost a fortune to repair it then as said I'll try to save it, if not then out it will have to come!.
I'll let you know how I go. My dentist does have all my meds and diagnosis on his system. I will mention about the upping of the steroids afterwards, Jo. So as they say onwards and upwards!
Hugs and thanks,
Posted 09 June 2011 - 01:58 PM
I rather think you might have already chosen the direction of saving your tooth, or else they would have just pulled it in the first place. I've lost teeth, had them pulled, and saved teeth all depending on the circumstances; I have many crowns and a partial. You can't count on scleroderma affecting your mouth though (it doesn't affect everyone that way, in fact I think it's a rather small percentage). The thing to consider about losing teeth is that you will probably, sooner or later, look at replacing the tooth with either a crown or a bridge or an implant or partials. So it doesn't really necessarily save money just to pull them.
Take the time to discuss everything, including finances, with your dentist, and don't just assume that pulling the tooth will be the cheapest route, long term. It may be perfectly fine to just pull it and be done with it and never replace it, but you deserve the opportunity to make a fully informed decision.
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Posted 09 June 2011 - 07:00 PM
Many thanks for the advice I know exactly where you are coming from, my worry is that my dentist of 17years has noted over the last year or so how much my mouth opening has shrunk,. I just cannot seem to "open wide" any more, I have always had a small mouth "delicate and petite" as he says haha, as I am small in height too, I am just 5ft 4 at a push and I struggle now to keep my mouth open even with a brace to support the jaw while he does the work.
But, as you rightly say I will take it seriously and not do anything rashly, if I can afford to do this I will but if the expense is high then sadly I will not have a choice but to extract it, as all my money is been used for supplementing my sons university fees. I cannot let that suffer, I would rather go without my old battered tooth!
So fingers crossed the dentist and I will do the right thing for me at the time. Maybe its too far gone, its very discoloured now. They could not take it out at the time due to infection and a lot of gum swelling he did not want to risk traumatising and hurting me and causing more trouble but to let things settle down for a week or two before proceeding further. So we will await events and see.
Hugs and thanks as always,