Root Canal

[Psyborg]

Well...just had a root canal. Apparently I had a bad enough tooth infection that it killed the nerve. I'm guessing that the Prednisone must have masked the effects of the infection. On Friday I had a little tiny serving of Ice Cream and it was followed by throbbing through my sinuses and to my right ear for 4 hours :P

Anyway...I'm hoping I won't have any further infection here, I know I had several people suggest just having it pulled, but the tooth is visible when I smile so I followed the Dentist's wish for the first attempt at least.

Man the smell when they drilled into it was putrid...not sure how something can be that wrong but be otherwise not remarkable lol.

[Sangye]

Eech, I wonder how much it's been affecting your recovery. I hope you heal up soon.

[elephant]

Glad you got that taken care of. Hope you start to feel better and on your way to recovery!

[drz]

Well...just had a root canal. Apparently I had a bad enough tooth infection that it killed the nerve. I'm guessing that the Prednisone must have masked the effects of the infection. On Friday I had a little tiny serving of Ice Cream and it was followed by throbbing through my sinuses and to my right ear for 4 hours :P

Anyway...I'm hoping I won't have any further infection here, I know I had several people suggest just having it pulled, but the tooth is visible when I smile so I followed the Dentist's wish for the first attempt at least.

Man the smell when they drilled into it was putrid...not sure how something can be that wrong but be otherwise not remarkable lol.

Are you on Cytoxan now? I was told not to even have a tooth pulled while on Cytoxan but what can you do when you get an infection that is painful? I need some deep filling in front teeth but every time I get work on that area I end up needing a root canal in a a few weeks. I was hoping to wait a couple months till off the Cytoxan.

[Psyborg]

Nope, moved to MTX about 1 month ago now. I'm hoping the dumb thing heals properly. Hurts more now than it did earlier too :)

[jola57]

You are more brave than I, I need to have possibly two root canals and one for sure but being the dentist chicken that I am I keep stalling. I keep promising myself the moon if I go but its the same as yours its in a visible part and I will need implants and don't know it I can have one. So ther isn't that a good excuse?

[Psyborg]

I totally understand. Honestly I was really worried about it, as I'd heard so much bad about root canals, but to be honest it wasn't any worse than getting a filling. It did hurt more later yesterday, but I feel pretty normal this morning. My right eye (above the tooth) feels a bit dry for whatever reason.

One thought I had...I wonder if this infected tooth was the cause of all my weird eye/sinus pressure I had a few months ago. They never found anything on CT scans or vision checks, and the pressure eventually wore down. Since the tooth was clearly dead I kind of wonder if I was having a massive infection that I missed due to the Prednisone covering up some of the symptoms.

It also makes me wonder on one other thing...I had a tooth filled right before my initial flare. It left my mouth in pain longer than I ever remember a filling doing so. Makes me suspect that it might have been involved.

[Psyborg]

I called my dentist, that tooth was filled on 4/21, about a week before my flare started. I even had called them at the time as I suspected maybe I was allergic to something in the filling. I think I finally figured out what my onset infection was after all this time wondering. Strange how things work. I left a message for my Doctor, but not sure if they track this kind of thing or not.

[Sangye]

What did they use to fill the tooth?

[Psyborg]

I'm not 100% sure, it's whatever the "standard" filling is, as I had to pay extra for the white fillings and it was not in a visible area of the tooth. I honestly thought I was having an allergy to the filling, but I'm wondering if it didn't stay sterile when they were doing the filing.

[drz]

I totally understand. Honestly I was really worried about it, as I'd heard so much bad about root canals, but to be honest it wasn't any worse than getting a filling. It did hurt more later yesterday, but I feel pretty normal this morning. My right eye (above the tooth) feels a bit dry for whatever reason.

One thought I had...I wonder if this infected tooth was the cause of all my weird eye/sinus pressure I had a few months ago. They never found anything on CT scans or vision checks, and the pressure eventually wore down. Since the tooth was clearly dead I kind of wonder if I was having a massive infection that I missed due to the Prednisone covering up some of the symptoms.

It also makes me wonder on one other thing...I had a tooth filled right before my initial flare. It left my mouth in pain longer than I ever remember a filling doing so. Makes me suspect that it might have been involved.

All my root canals have followed fillings. It is very common for drilling to affect the nerve and it gets infected from the dental work. The smaller teeth area and deeper down the fillings go, the more likely they are to hit or damage a nerve.

[Sangye]

Bob, regular fillings are amalgam and contain mercury. Not only is the patient unprotected from inhaling mercury during the filling procedure, but the mercury filling continues to expose you to the toxin as long as you have it. I wonder if, instead of the infected tooth causing your Wegs flare, it was the mercury filling.

A month before I was dx'ed I broke a molar containing a large, old mercury filling. In order to cap it the dentist had to drill it out. I had a severe dental phobia and he took hours to do it, working with my absolute hysteria. I was already seriously ill and had severe shortness of breath. (My lungs were hemorrhaging but I didn't know it.) Because of my hysteria I inhaled those mercury vapors for several hours. Things went downhill quickly after that and I was dx'ed within a month. I have a lot of mercury fillings and wonder how much they've contributed to the onset of Wegs.

[pberggren1]

I have 10 mercury fillings. It has always concerned me.

[elephant]

I have several mercury fillings too. I spent a lot time at the denist.

[Psyborg]

I've got a bunch of Mercury fillings too. A few are the newer fillings, but those cost more so I generally didn't get them.

[Palmyra]

Hey Psyborg...I am in dentistry in the US. It is pretty unlikely that the original filling had anything to do with a flare, but the following level of inflammation associated with the abcess surely wasn't good for you. The nerve canals of teeth can spontaniously avulse (go dead,) or it might have been that the proceedure to do the original filling irritated the pulp to the extent it eventually failed. I am glad you had the root canal, as if they are done properly, and the damage was not to extreme, they can save a tooth (and even simple replacement otherwise is expensive). The pain you've experience due to the exposure of the nerve and supporting gum is due to a bacterial infection, so you had an infection before the pain actually started. Did they place you on an antibiotic to help speed healing?

Tee hee, we sometimes treat persistant inflammation with a short course of prednisone :-) I am sure you would love that! Nerve inflammation or contagon is not uncommon after any type of dental preparation. Remember, the original filling was a mechanical means of teating an area of infection (decay).

Best of luck to you, and feel free to post if you continue to have problems. Hope not!

[Psyborg]

I had them give me Penicillin. They asked if I'd like to take the precaution before hand, and I said I'd likely develop an infection if I didn't due to the immune suppression. The timing of the original filling and my flare (not to mention the pain in the area after the filling) seems too related to be pure coincidence. On top of everything else the filling was one of the first a newly certified assistant did rather than my normal Dentist.

[Palmyra]

I think I miscommunicated some of my previous information in my post. The preparation for the original filling, no matter the material used to fill it, very well could have been a causitive factor in the eventual demise of the nerve, especially if you continued to have pain after that initial proceedure. the original prep could have been placed 'high' so you percused on it every time you closed your teeth together.....or..... The preparation for the filling could have come so close to the nerve chamber, out of necessity, heating it up (nerves don't like trauma :-), and it can occsionally take awhile for a nerve to die. And even a good dentist can have that happen, if the original decay is already close to the nerve. Hopefully the root canal with be successful, and resolve the problem. If you continue to have pain, especially if you have swelling, you need to consult your practitioner right away.

I hope you have the pain and inflammation under control, because continued inflammation is not good for you, not to mention uncomfortable.

Cheers and best wishes Psyborg!

[Psyborg]

Oh, everything seems to be in good order now. Very little pain, my only concern is that the prednisone might mask what would otherwise swell. I'm hoping not.

[drz]

Palmyra;3117...or..... The preparation for the filling could have come so close to the nerve chamber, out of necessity, heating it up (nerves don't like trauma :-), and it can occsionally take awhile for a nerve to die. And even a good dentist can have that happen, if the original decay is already close to the nerve. Hopefully the root canal with be successful, and resolve the problem. If you continue to have pain, I hope you have the pain and inflammation under control, because continued inflammation is not good for you, not to mention uncomfortable.

Cheers and best wishes Psyborg![/QUOTE]

I have had this happen three times. I think my dentist is good but he says there is no way to avoid it. They have remove all the decay and the decay is next to the nerve so then I end up with a root canal in a few weeks. Maybe I should have the root canal same time as the filling and skip the pain but they say there is no guarantee I will need the root canal and usually I haven't.

Is there any risk to having this type of dental work done while on Cytoxan and low WBC?

[Sangye]

Palmyra, we are so lucky to have you in this group. This is very helpful info. :thumbsup:

[Psyborg]

I'm now pretty positive that the infection was what caused the pressure in my sinuses and the eye problems last summer. I think the prednisone masked a ton of what would be normal symptoms of a tooth ache. It's weird but I've felt slightly better in general since the root canal. I think the infection was slowing things down perhaps.

Then again it might all be in my head :)

[Sangye]

I think it was all in your head. Literally. :wink1:

[elephant]

Sangye you are too funny. Always thinking, your synapses go way to fast!

[Psyborg]

Sangye you are too funny. Always thinking, your synapses go way to fast!

Ain't that the tooth....

:flapper:

[LisaMarie]

I had all my metal fillings removed 3 years ago and white ones put in ...they are not as cold sensitive....but since my last hospitalization and round on many drugs alll my teeth are cold sensitive ...it sucks but it could be worse...i am still waitng on permission for my teeth to be cleaned and a tooth checked to be fixed ...wishe me luck...hope you continue to do well with your root canal healing process:biggrin1:

[BrianR]

I hope Marta won't mind me adding something completely immaterial to this; that being that she had a root canal when she was eight years old and living in Bulgaria. The entire procedure was done with no freezing or anesthetic whatsoever. And...most of her fillings were done the same way - with no freezing. I am sure this is part of the reason she is a tough as she is today (sorry Marta but its a good story!)

[Sangye]

Eeech! Poor kid. Can you imagine?

Novocaine inexplicably stopped working for me in my early 20's. I had two fillings replaced and one tooth capped without it. This is the reason for my severe dental phobia.

The dentist who capped a broken molar just before Wegs dx got the tooth totally numb. I couldn't relax during it, though, waiting for the pain.

[Minneapolismark]

I had a tooth filled a few weeks back and found that the Novocaine did not work as well with all the drugs I'm on. They were still able to numb me up but it took a bit more work. I am VERY glad things worked out well for you.

[marta]

I hope Marta won't mind me adding something completely immaterial to this; that being that she had a root canal when she was eight years old and living in Bulgaria. The entire procedure was done with no freezing or anesthetic whatsoever. And...most of her fillings were done the same way - with no freezing. I am sure this is part of the reason she is a tough as she is today (sorry Marta but its a good story!)

I don't know if I'd go as far as 'tough' but definitely feisty when it comes to dentists. I did have a root canal with no freezing, three nurses holding down my head and two arms and the dentist pulling out my nerve and dangling it in front of my face just in case I wanted to see what a nerve looks like. I think it was priming me for my future as a Weggie.

Glad to hear things are looking up Psyborg. I've just been made aware of the masking abilities of pred. My dad's on it as well, and had a car accident a few weeks back with no apparent injuries. He's weaning off the pred and is now (as of this week) down to 10mg and all of the sudden is getting ridiculous pain in his head and neck. We both just had a thought that he might have injured himself in the crash and now that the pred is down to normal human levels and is not acting as an antiinflamatory he is starting to feel his injury. He's just started to use T3's to try and get sleep from the pain.

I digress -
:back on topic: I've been wanting to use Putin'TRRUNK for a while now.

[pberggren1]

I'm sorry to hear about your dad Marta. I hope he can get this pain sorted out soon, like seeing not only his docs but maybe a PT or Chiropractor.

[pberggren1]

Oh, and by the way, I love the Putin.

[Sangye]

Marta, your dad should definitely see a chiropractor. Even when (if) the pain goes away, the misalignments and soft tissue imbalances persist unless corrected and cause lots of problems.

[jola57]

One of my molars cracked and 1/4 of it fell out. Surprisingly it didn't hurt at all. I had a dentist do an emergency fill and he did it without freezing. Now why can't my root canal be the same?

[Psyborg]

Ouch...sorry to hear about your tooth cracking. Are brittle teeth a result of some of our drugs? My teeth definitely seem more sensitive than they used to be.

[Palmyra]

Hey Bob,
I hope that tooth is feeling better. Lots of experience in dentistry here (25+years), and I am just now catching up on your post. Allergy is very rare with dental materials, but it can happen. When it does, it only affects adjacent 'soft' tissue, like the gum tissue or side of the cheek directly in contact with the material.

The 'white' filling material is typically a glass ionomer composite....meaning it is basically glass with high end composite resin materials to make it 'flow'.

Endodontic problems(death of the pulp/nerve in the tooth), are very common with teeth, and are usually associated with decay (bacteria,) or trauma. If the infection of the pulp chamber goes beyond the root tip and into the bone, it can be quite a mess (abcess) and is characterized by swelling, pain and inflammation. Some root canal therapy may need additional help with antibiotics to treat the infection, or even a little steroid (yes, unfortunately) to help relieve inflammation. Good luck, and I think you made the right move with having the root canal. Very difficult to replace missing teeth!

[Palmyra]

Oh, and yes to you all.....dental infection absolutely causes inflammation, and Weggies need to avoid inflammation right! Get your teeth cleaned regularly, and get decay out of there.
Floss often and have a Happy Holiday:biggrin1:

[drz]

Oh, and yes to you all.....dental infection absolutely causes inflammation, and Weggies need to avoid inflammation right! Get your teeth cleaned regularly, and get decay out of there.
Floss often and have a Happy Holiday:biggrin1:

My inflammation markers are both up today with CRP of 1.6 and SED rate of 74 but I was just diagnosed with aphthous ulcers and my gums are very sore. Would that cause markers to go up? They also stopped Cytoxan due to low WBC of 1.6 and plan to start me on Imuran when WBC recovers. I have been tapering prednisone and am currently at 11 1/4 mg day and will be at 10 in two days.

I need some lower front teeth filled deep down on teeth but think I best wait till mouth heals up. I usually end up needing a root canal when they work on those teeth since the trauma of getting the fillings in those narrow teeth damages the nerves.

[Palmyra]

Sounds like the Ctx got a little toxic, and probably affected your mouth as well. Have no idea what would make those inflammatory markers go up...many possibilities.

Not a bad plan to wait on restorative dentistry until you are more "settled". Try the baking soda rinse for your mouth...you will feel the difference immediately. Bleeding gums can be a hygiene issue. You can ask your DDS about a script for chlorhexidine gluconate solution (if you live in the States it requires an Rx, if in the UK I believe it is over the counter). Regular, gentle cleanings are especially important if on chemo (every 6 months). Floss gently, but get it under the gum line. Same with brushing. Bleedng will indicate mild infection (gingivitis), but if you don't clean under the gum line, it just gets worse. The bleeding should subside within a very short period of time (that magic 10 days).

If you are an adult, and still getting decay, it is a bacterial infection that feeds on simple sugars....there is a sourse of sugar in your diet (liquid sugars like sodas, even gatoraide or energy drinks, and hard candies/mints are the worst).

[Sangye]

drz, It may be that ctx is overly toxic to your bone marrow and you can't tolerate a therapeutic dose without tanking your WBCs. That's what happened to me. If that's the case, you can't take ctx again. My first (lousy) rheumy kept me on ctx for 7-8 months, ignoring that it was so damaging to me. No wonder I got sicker and sicker with treatment!

Palmyra, you are a gem. I'm learning so much from you! :thumbsup:

[Palmyra]

Thanks Sangye. I haven't been working much lately, so at least I can put some of my skills to work here. Will be talking to my old boss at the local dental school/hospital where I used to teach. I miss it!

Just as an FYI....the daughter (she is the one with Weg..) just hopped on her connecting flight, with her hubby in hand, to spend Christmas with his family in Vina del Mar, Chile. This will be the first time she has met the entire family....and her Mayo Doc, Ulrich Specks, has a former intern that lives near, so all bases covered!

[Sangye]

Whew! :wink1:

[pberggren1]

Hey Palmyra,

I have not been to the dentist in about 3 1\2 years. I know I should probably go but I have this darn lung infection and my good days are maybe one or 2 a week and even at that sometimes I start coughing and can't stop for a while. So I am thinking I should wait another year until this lung infection is cleared up so I can actually sit back in the chair without asking to swallow water every 20 seconds.

[jola57]

Nice for your daughter to have a doc close by but I am sure she will have a wonderful time and will not need one. Palmyra thank you for sharing your knowledge about teeth with us. It is definitely one topic we were lacking expertise in. Between you, Sangye and our resident nurses, we have all the bases covered now. LOL

[drz]

drz, It may be that ctx is overly toxic to your bone marrow and you can't tolerate a therapeutic dose without tanking your WBCs. That's what happened to me. If that's the case, you can't take ctx again. My first (lousy) rheumy kept me on ctx for 7-8 months, ignoring that it was so damaging to me. No wonder I got sicker and sicker with treatment!

Palmyra, you are a gem. I'm learning so much from you! :thumbsup:

that is why they decided to give up on Cytoxan and switch to Imuran if I can tolerate it. I have had to stop the Cytoxan three times when my WBC gets too low but it was effective even at lower dosages in reducing the inflammation markers and ANCA scores but now they have decided to try something else and see how that works.

My sores in my mouth and bleeding gums seem to be healing so I am hopeful it will be much better in a week or two.

[drz]

Hey Palmyra,

I have not been to the dentist in about 3 1\2 years. I know I should probably go but I have this darn lung infection and my good days are maybe one or 2 a week and even at that sometimes I start coughing and can't stop for a while. So I am thinking I should wait another year until this lung infection is cleared up so I can actually sit back in the chair without asking to swallow water every 20 seconds.

I couldn't do that long of wait. When I spent several months in hospital earlier this year I missed my seasonal teeth cleaning and my gums got sore and started bleeding when I brushed. This was due to plaque build up and the bleeding went away as soon as I was able to get my teeth cleaned. I suggest you talk with a dentist or dental hygienist to find out how you can get some dental services. They can do shorter sessions or schedule longer ones and take breaks and work around what ever limitations you have in being able to sit still for long periods. Many of their patients have similar limitations and need dental work. At least getting a checkup would let you know the state of dental health. Those can be real quick. Just some X-rays and poking around a couple minutes in your mouth.

[Psyborg]

Geez, I had root canal number two in less than a month yesterday. While they aren't as bad as I would have though from what people say, but not exactly pleasant either :p I'm guessing my teeth don't like one of the meds maybe? Dunno

[Meredith]

I had a tooth pulled in december while on cytoxan. Before that i had two root canals on the same tooth trying to save it - still on cytoxan all the time. Did not have any trouble while all this was going on. Only thing they would not do was an implant to replace the tooth. Had to have a bridge.

[drz]

I had a tooth pulled in december while on cytoxan. Before that i had two root canals on the same tooth trying to save it - still on cytoxan all the time. Did not have any trouble while all this was going on. Only thing they would not do was an implant to replace the tooth. Had to have a bridge.

I was told to avoid such procedures while on Cytoxan. Now I am on azathioprine and if I have a root canal I should hold that med for three days and also get an antibiotic during procedure.

[Palmyra]

Its a shame to have to worry about normal "maintenance" of body parts while on such drugs, but its reality. Lots to keep up with when nedi-potting sinuses and pumping in all kinds of chemicals. My daughter has to think about all things hygiene, not just teeth :biggrin1: I admire each and every one of you for your diligence and effort. Some smart peeps here on this site!

[Cindy M]

Hi, just read about your absessed tooth. I had to have two teeth pulled that were part of a bridge because of the same problem. I was put on antibiotics to clear up the infection before pulling the teeth but then I ended up with the flu for a week. Didn't take the antibiotics because they upset my stomach more. I had the two teeth pulled on Dec 22nd with the infection still there. I was a little scared because I could not feel the needles with all the infection so I wasn't sure if the freezing would take but it did because I didn't even feel him pull out the teeth. The dentist did a great job and got alot of the infection out, I now have a partial which I absolutely hate but its better than before.

[drz]

Hey Palmyra,

I have not been to the dentist in about 3 1\2 years. I know I should probably go but I have this darn lung infection and my good days are maybe one or 2 a week and even at that sometimes I start coughing and can't stop for a while. So I am thinking I should wait another year until this lung infection is cleared up so I can actually sit back in the chair without asking to swallow water every 20 seconds.

Phil, have you made any dental appointment yet? You will probably get on some body's nag list if you don't. :biggrin1:

[pberggren1]

Phil, have you made any dental appointment yet? You will probably get on some body's nag list if you don't. :biggrin1:

I'm puting off phoning the Dentist right now because of my horrible cough and fatigue.