Clementine

Oral Surgery

28 posts in this topic

Aww thanks Erin. It's going to be OK. I spoke to my rheumatologist about it

today and does not think my initial dental problems are sclero related. He also said he wasn't so sure he'd blame Cellcept for the fact that it's not healing, but it was possible. He said that because I don't have skin involvement I shouldn't have the typical gum issues that come with Scleroderma. I am not sure I agree with him that you have to have skin involvement to have teeth issues.

 

What do you all think?

xo,

Jen

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Jen, can't remember if you have been on prednisone, but that will cause a lot of dental problems. I haven't had near the problems since I got off pred. (well, down to 5 mg a day instead of 20) and started taking cellecpt. Just make sure you are taking plenty of antibiotics, that is very important.

Good luck.

~whirlway

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whirlway,

how does prednisone cause dental probelms?

 

peanut


You can deprive the body but the soul needs chocolate

my HMO makes me wear a helmet...

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Hi Jen, I definately think you should go for the implant if you can afford it. My husband is going through this as we speek. He broke his front tooth which already was a root canal tooth. They extracted the root, and they placed the implant right after the extraction. He had to wait about 6 weeks before they could put the temporary in, which cost $300.00. Now he will wait until December to have the permanent crown put on. The total cost is around $3000.00. As far as pain the first couple of days he was uncomfortable, but the pain medication took care of any pain he was having. Now he is fine no pain whats so ever. He is glad he went through it all. He didn't want to deal with a flipper partial. I hope things work out for you, I know if it isn't one thing it's another.

 

Jackie S.

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Jennifer,

 

I've been reading the different opinions about your implant, and wondered if I should also say something. I have been very poorly of recent weeks, (which I may do a later post about), but I decided I'd like to tell you my experience with a tooth implant I had recently, and which failed.

 

I can't help wondering if some of the problems I had with it all, stress in particular, messed around with my sclero, but whatever......... At the beginning of this year I had 3 teeth together being affected by cervical root resorption, caused of course by the sclero. These are not the first teeth this has happened to either. The dentist did all sorts of things to save them, but to no avail. One was the top canine on the right side, and the other two went back from there. First of all one was pulled, then another, and lastly he had to pull the canine!

 

The first two teeth which went he said had the possibility of having "mini-implants", with shorter posts which go into the jaw. These are generally used where the jaw bone is minimal, in that if you put in a large implant it goes into the sinus. So we decided to do this. Unfortunately, by the time they'd healed the usual amount of time, about 2-3 months, the jawbone had resorbed so much there wasn't enough for even a mini implant!

 

So then the canine had to come out....... in several bits I might add! The plan for this was to try for a full implant as I had a large amount of jawbone above it, and the dentist said he wouldn't leave it as long this time, so hopefully there'd be enough bone left. At least I wouldn't have a gap so near the front.

 

It was allowed to heal for a month, and then the implant post went in. It was about 15mm long, and went up into "virgin" bone. The actual procedure was OK and under a local. The dentist said I'd be fine now. Not so......... the pain after the anesthetic wore off was VERY bad! It took several days to stop, and even then not totally. I had a very temporary plastic crown, placed so that I couldn't bite on the implant.

 

I went back in about 10 days and the dentist was very pleased with the implant, which was rock solid. Three days later not so! I woke to find it wobbling and loose! Went back to dentist, and he very regretfully, pulled it out with his fingers! When he had it out he remarked he'd never seen that before. "That" turned out to be bone which had so far osseointegrated with the implant as it does, all came out stuck to the implant post! He had his nurse put it into a tube to take to a conference he was going to, as he wanted to see what they made of it.

 

He is a very decent dentist and gives me lots of discounts etc. The implant was $1500, and he offered to do another one free! But to my way of thinking who is to know whether the same thing will happen again or not?! I have had/ and still have, sinus trouble where the implant was close to the sinus (not in it, as I saw the Xray). But I feel now that I will eventually get a partial plate, not that I love the thought! But neither do I want to go back the way I came! As of now I chew on the gums! LOL! And if I smile and someone looks closely they'll see my gaps. But then the sclero has made my mouth so much smaller that it's hardly noticeable. Any more time in the dentist chair would knock me out just now I think, so I will wait.........!!!

 

I think implants are great for healthy people, and before I went ahead with mine I made a lot of enquiries from doctors etc. I also have renal disease with dialysis, which affects the bones as can sclero. Everyone said go for it. But you live and learn!

 

Warm hugs,

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Hi,

 

I also had an implant, which was partially successful. The whole process has been going on for about a year. After the tooth was removed I had to have a bone graft, which took longer to take then expected. We then waited and waited and waited for the gum to build up and look good. So far my dentist is still unhappy about the amount of vasculature in the gum.

 

Anyway he tried to do a gum graft using tissue from the top of my mouth, however this failed. He was going to do a second one with cadaver gum, but we both decided to hold off on this as I was diagnosed with CREST in the mean time. At that point it seemed best to wait until I stabilized and my immune system was a little less active.

 

If you can do it, having a real tooth is nice, but make sure your disease is under control at the time. In any case get the tooth out as soon as you can so you don't lose too much jaw bone, which is what will happen if you have an infection down there and you leave the tooth in.

 

Good luck


keep on smiling

 

crawler

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Peanut, sorry it has taken me so long to get back to you. I had been taking large amounts of prednisone for about 20 years. When a person takes 20+mg per day, it will suck the calcium right out of your system. I wasn't made aware of this and as a result have osteoporosis and have had one compression fracture in my spine, plus I have had three teeth practically disintegrate, but the dentist was able to salvage enough of them so now I have three beautiful gold crowns. Luckily they are in the back and don't show too much.

When I first started seeing my rheumatologist, he ordered a bone density test and found the osteoporosis. Now I take a calcium supplement (1800mg per day), fosamax once a week, and didronel every three months. The osteoporosis will never go away, but from the intense treatment it hasn't gotten any worse.

So, as a warning to all of you who do take prednisone, please talk to your doctor about the drug and the side-effects and about taking calcium supplements. Also, ask for a bone density test, and not the one where they just stick your foot in a boot. It doesn't hurt, or take very long, and could be a big help in the long run to keep you from getting osteoporosis, which is a big, huge pain. (Seriously, I would rather have a baby than another compression fracture, they are very painful. I was in the hospital for 4 days on a pain medication drip)

Also, when you have any dental work done, the dentist should be giving you antibiotics before any proceedure, even cleaning your teeth, due to all the bacteria in your mouth.

~whirlway

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whirlway,

thanks! yeah I'm worried about prednisone which is why I'm actively weaning my way off of it. Unfortunately my numbers dropped so I might have to stop at 9 mg for a while. I'm taking Boniva and calcium everyday so hopefully my bones will be okay.

 

I looked up the side effects of calcium suppliments: nausea, vomiting, loss of appetite, constipation, stomach pain, thirst, dry mouth, increased urination. I'm on a lot of meds and most of them have the same side effects as calcium (listed above). So I'm not sure how I would know if my morning nausea is from calcium or another med? Hum...

 

I went to the dentist for the first time in 2 years a few months back. The x-rays did show the beginning of bone loss which is frightening to me. I'm very anal about my teeth. I take very good care of them. I'm not ready for them to fall out.

 

peanut


You can deprive the body but the soul needs chocolate

my HMO makes me wear a helmet...

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Hi, peanut. Let me jump in here on the calcium issues. Here is a link to an excellent article from the Office of Dietary Supplements at the NIH:

 

Dietary Supplement Fact Sheet: Calcium. One note from the page says:

 

"Some common complaints of calcium supplement use are gas, bloating and constipation. If you have such symptoms, you may want to spread the calcium dose out throughout the day, change supplement brands, take the supplement with meals and/or check with your pharmacist or health care provider."

 

It is also important to make sure you have adequate amounts of vitamin D to aid proper of absorption of the calcium.


Warm wishes,

Jefa

 

Carrie Maddoux

(Retired)ISN Sclero Forums Support Specialist

(Retired)ISN Sclero Forums UK Chat Host

International Scleroderma Network (ISN)

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Peanut,

I take 3 500 mgs of calcium with D throughout the day. It makes me sick when I take it with nothing on my stomach. I am constantly urinating. I wonder if that is from the calcium. It sure does effect my sleep pattern.

 

Jen

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Nearly off-topic, but a little note for those of us who take calcium and who are also hypothyroid: A general guide is, do not take any calcium supplements 4 hours before or 4 hours after taking thyroid medication.

 

Also, take thyroid meds on an entirely empty stomach, with no other medications or food, and do not eat for 1 hour afterwards.

 

Calcium (in particular) and food (in general) affects the absorption of thyroid meds.

 

Also, something I just recently learned, is not to take thyroid meds for at least 6 hours before a blood test to measure thyroid levels.


Warm Hugs,

 

Shelley Ensz

Founder and President

International Scleroderma Network (ISN)

Hotline and Donations: 1-800-564-7099

 

The most important thing in the world to know about scleroderma is sclero.org.

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Shelly, thanks for clarifying the thyroid issue. I knew I wasn't supposed to take the calcium withmy am meds, but couldn't remember which med it was. :rolleyes:

I have am 1 meds, no food, am 2 meds withfood, and pm meds. My hubby doesn't understand how I keep them all straight. I found a small plastic three drawer container and keep my meds in it according to the time I am supposed to take them. It works pretty well for me, hopefully I don't need to add any more drawers! Last month most of my meds had to be re-filled at the same time. I don't know many people who get their meds in a large paper bag. WOW, is this off the subject or what. But that is how it is, one thing can just lead to another in the many chapters of our lives.

Here's to a better day for all of us.

~whirlway

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