Dentist Advice

[Dirty Don]

Hey DD the right call for the lowers. So glad I still have (some) of mine. I sure could not afford a "full set" of implants, maybe like a Jack o lantern? By the way DD I can still eat corn on the cob, just a little differently. Oh, are you used to change?
Dale

I just told the dentist that I didn't want to look like George Washington! Change is not an issue usually for me...well, unless my feet aren't on the ground...

[drz]

Dear drz.
it takes time to heal from root cananl, prob more then your doc said. mine took a week even before I had WG.
for us especiialy, healing is more slowly.
don't worry. but if you do, call your dentist and ask him.
try to make the area cold. rest. dont eat "hard" foods.
lots of hugs and prayer heading to you
please update us.

A week later the tooth area seems to feel better, just a bit more numb on the adjoining tooth but no pain from eating so I guess it worked out OK. The tooth next to it might die now and need work. A friend had an implant for a front tooth and it cost him over $3000 so maybe partial bridge is way to go if one needs several teeth replaced. I never used to need any dental work beside a cleaning or check up once a year so it is frustrating to now need 10 visits a year or so depending upon what happens with my teeth.

[ingemlb]

Last century I had major abscesses behind all my upper teeth. Doc wanted to crown all of them but I could not afford it at the time. Eighteen Thou for crowns or Fourteen hundred for upper plate. I got the plate and I really believe that was the beginning of my WG. Any way, been almost fifteen years now and I am wondering if a weggie would be a candidate for dental implants. I have no idea how much they cost or if I could afford it, but just thinking out loud I guess.
Dale

Hi Renidrag. I thought I would add my experience. Has been very informative reading this entire thread .

Several years ago I decided to see an Orthodontist to ask if my partial upper plate could be replaced with implants. My doctor did a medical health care plan ( in those days our government allowed people with illness to get a substantial amount of dental work paid for by medicare) and this medical health care plan spelled out years of autoimmune disease. The Orthodontist took one look at my report and said even though he makes his money from doing implants given my immune system he wouldn't touch me with a barge pole And in those days I was not on immunosuppressive drugs or steroids.

So he simply built me a new upper plate which I hate and would much rather have the implants but they cost a fortune. The issue he said was they would likely not take or heal and I end up in a mess. I never had a 2nd opinion.

I need to see a dentist soon but think now I will wait to see if I can get at least off the Pred before I start any dental treatment. Am thinking of investing in one of those waterpik machines for the teeth as my gums are retreating exposing top of roots in some cases. Also have a gap between 2 back teeth where food for ever gets stuck and it's hard to get out even with flossing. I asked the Orthodontist at the time if anything could be done to fix this but he claimed no and that he had the same problem himself !!

What I am not clear about after reading all these posts is a) is it the Wegener's that is making our teeth worse ? or b) is the the drugs we are on? c) Is Prednisolone particularly bad for teeth?

Michelle I am a huge chicken when it comes to dentists. I had one stretch of 25 years where I never went. After having a tooth knocked out where the root had grown sideways under my other teeth and the tooth (wisdom) came out in bits and pieces I was totally put off. One day I read an advert in the paper from a dental clinic "We specialise in cowards". By that stage after 25 years of avoidance I figured my mouth must look like a sewer and the longer I waited the harder it got but I picked up the phone and rang this clinic. Said "I am a major coward and need an appointment".

The joke was after 25 years of agonising around about the state of my shockingly decaying teeth I ended up needing 3 fillings and my husband who had been going regularly needed half a dozen at least LOL.

So all that agony and stress I could have avoided by regular attendance.

Anyway I guess if I were to return to this Orthodontist now he would freak out even more when I have to mention the Wegener's diagnosis But I best get them checked. I will wait a couple of months and see how much Pred I am on then. Wonder what the MTX does or the Bactrim. Will do some research

[MikeG-2012]

... Am thinking of investing in one of those waterpik machines for the teeth as my gums are retreating exposing top of roots in some cases. Also have a gap between 2 back teeth where food for ever gets stuck and it's hard to get out even with flossing. ...

You just bought one off of the internet Inge--your sinus rinse machine! It's basically a water pulsing device. Just find an appropriate tip from the Waterpik brand of flossers and you should be all set.

[ingemlb]

Thanks Mike lol never occurred to me to use the same machine I still need to sterilise mine so the pleasure of using it is all ahead of me Buying some bleach today.

[debhaz22]

Never thought of the Dentist and WG. Do you need to see a special dentist? Or just hope your excisting one is familiar with WG??
Thanks
Deb H

[annekat]

Never thought of the Dentist and WG. Do you need to see a special dentist? Or just hope your excisting one is familiar with WG??
Thanks
Deb H

There seem to be different viewpoints about how much dental work should be done while having WG. I shouldn't think xrays and cleaning would be a problem with whatever dentist you are already comfortable with. Then I would mention the WG and see how comfortable he is with it, whether he's ever even heard of it, or whether he just blows it off as nothing significant (which wouldn't be good). In my case, I'm lucky enough to have already had a dentist, recommended by a friend, who teaches at the University of Washington Dental School, and is fully aware of what WG is. I was able to have all needed procedures done as usual, but my WG was fairly well stabilized at the time. That's just my experience, others may have very different ones. Some Weggies have more trouble with their teeth than others. You might ask your WG doc, next time you see him, what his opinion is on this and if he knows of any dentists who are especially suitable for treating WG patients.

[renidrag]

I saw a Dentist that had no idea what WG was and had no problem. He knew I could not fight infection, and on top of that he had to work around Warfarin. It all worked out OK. New uppers and fillings in the lowers, and one pulled. PCP did put me on antibiotics for a few days before work was done. Wanted INR at 2.2 told him it was. Actually 2.6 but what is a couple of tenths between friends. You should clear your dental appt's with PCP or Rheumy.
Dale

[Alysia]

Elsevier
“Strawberry like” gingivitis being the first sign of Wegener's granulomatosis

[Rose]

Probably few dentist have ever heard of WG (many doctors have not) but they have heard of prednisone and immune suppressants and the problems they pose for the dentist. I had to have a tooth removed a few years ago and the dentist referred me to a Maxillofacial Surgeon as not only was he concerned about infection, he was also worried about the tooth disintegrating in the socket whilst in the process of being removed because of long term pred use. They may not know the signs and symptoms that WG may present in the oral cavity but they do know what is normal and what is not.

Always inform them of your condition and the drugs you are on and you shouldn't run into problems with any dentist for routine work.

Oh...and I also asked about an implant when I had that tooth removed and was told that it was not advised whilst on prednisone as could run into trouble with the implant not remaining firm in the bone. Ended up having a plate and I am happy with that. Glad now that I never had it done...it would have been just another thing that could give me problems down the line.

Rose