Should I have concerns about possible dental surgery?

[ArlaMo]

I have a tooth that needs either extraction and an implant, or crown lengthening and a root canal. I need to make an appointment with the periodontist, but I'm wondering if there are issues with someone on Cytoxan and pred having dental work done???

Just what I needed All my other teeth are perfect and the dentist wasn't sure why this one was so bad.

[Psyborg]

I've had two root canals in the last 2 months. It's not listed as a side effect that I've seen, but all my problems started when I was on CTX. Certainly not scientific, but I suspect it was hard on my teeth. I didn't have any issues with the root canal, but I am on MTX now, not CTX so I'm not sure that really answers your question. You definitely will want to take pre-procedure antibiotics I'd think.

[drz]

I was told not to do this when on Cytoxan. Now on Azathioprine (generic Imuran) they told me to hold that med for three days if i need a root canal.
Ask your dentist and treating rheumatologist since they would know your situation best and have current lab results.

[ArlaMo]

Good to know, drz! After my visit with Dr. Langford, it looks like we will be switching to Rituximab so I'm going to have to check this all out thoroughly. Hoping my tooth doesn't get worse in the meantime.

[drz]

Good to know, drz! After my visit with Dr. Langford, it looks like we will be switching to Rituximab so I'm going to have to check this all out thoroughly. Hoping my tooth doesn't get worse in the meantime.

I think Rituxan is safer for dental work than Cytoxan but your doctors will know this along with your situational needs. Hope you don't have to deal with tooth pain too. Getting good dental care was emphasized as important in my over all care for Wegener's disease.

[Palmyra]

I have a tooth that needs either extraction and an implant, or crown lengthening and a root canal. I need to make an appointment with the periodontist, but I'm wondering if there are issues with someone on Cytoxan and pred having dental work done???

Just what I needed All my other teeth are perfect and the dentist wasn't sure why this one was so bad.

Teeth are fickle...they don't respond like other 'soft' tissues in the body, even if one is systemically healthy.

I agree with Drz...best to consult with your rheumy before any treatment. Better yet, have your periodontist consult with your rheumy.

I am in the field (periodontics/oral medicine) and your periodontist should consult with your docs as to the particulars. It would be advisable to consult with the periodontist for an evaluation, and then let the docs decide on a schedule regarding needs. Normally, endo/crown lengthening is not a major proceedure thougth would take more than one visit, and the outcome is unpredictable (meaning it could succeed or it could fail).

A dental implant is more predictable, but would involve an extraction, possible bone augmentation / healing and then implant placement after an appropriate time. How deep the existing decay extends would lead to a better opinion on the matter, and your dental team should be able to help you with these decisions.

Respectfully yours,
Palmyra, mom of Alison (Crohn's'99, WG'06) 25+ years in perio/oral med

[ArlaMo]

Thank you, Palmyra, for all the great info!!

[Palmyra]

PS....AriaMo....
I think it is unlikely that Cytox or pred had anything to do with your current dental needs other than it may have thrown you 'off schedule' for preventive check ups. Do be aware if your mouth is dry, as that can make one much more suseptable to decay. Topical fluoride and a reduction in any sugar intake would be advised.
Hugs,
Palmyra

[ArlaMo]

I use Biotene mouth wash, recommended by a few of the people here, for my dry mouth. Also the spray. I did try the toothpaste, too, but it made my mouth taste even more metallic.

And yes, I think the tooth problem preceded my diagnosis - I had a filling (tooth 29) years ago on the side/front of this tooth and it has been a bit tender ever since. I never really think about it, but just had the once-every-5-years panorama x-rays done this week when it was discovered.

Probably should heed the sugar intake advice - it would probably help with the weight gain issues as well, lol.

[Palmyra]

We like tooth #29 , but the good news is it is not nearly as important as the one behind it (#30). Glad you are on the biotene...great product. Good luck with your care. It sounds like you are right on top of everything.