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Prednisone and Tooth pain

Does anyone know if prednisone can cause tooth pain or other tooth problems? I've been having some tooth sensitivity and my dentist says she thinks it's the prednisone causing it.

It's very upsetting because she is saying I need to get off prednisone...I tried to explain that it's the only medication that can help manage this disease and without it, I'd might as well be bedridden.  Cry I found that out when I got down to 5.5 mg and had pain 24/7/365. We're really in a Catch-22 situation with this disease and drug.

I don't expect anyone outside the "club" here to understand this disease--if I didn't have it, I wouldn't have a clue, either.  And I still don't really understand it! 

freesia



freesia2011-03-13 12:34:31One of the ladies on the Patient Experience UK site has had a lot of problems with thinning enamel and breaking teeth that have meant a lot of dental work (crowns) and I'm fairly sure steroids have been given the blame. If you are still at the sensitivity stage have you tried the special toothpastes for sensitive teeth? I have had sensitivity problems for years and finally gave in and started using Sensodyne - always hated the taste before but now I wouldn't use any other. I say that particular brand because the others just don't work as well for me - I have tried a few. I think there is also stuff to paint on that is meant to help replenish the minerals in the enamel. You should also use a very soft toothbrush if you have those sorts of problems. There are special ones available - at a price. Don't know if these are the same names in the US but I'm sure Google can help!
 
However - if I were faced with the choice of PMR with no steroids or dentures, somehow I think the dentures might just win!
 
MrsE
i have teeth pain, but i'm not sure if its from the PMR or the GCA, though GCA does list tooth and jaw pain as a symptom. .. i had tooth pain before i started pred. Winnie--I'm so glad to see you are back and hope that means you are feeling better. I hope you are getting the medical help you need (or anyway it sure sounded like your doctors needed to step up!).  It is very frustrating. Before I started pred, I only had tooth pain when there was something wrong with a tooth--or in certain cases, with very cold food or cold air on certain teeth.

MrsE, yes, Sensodyne is available here in the States, and I am going to go buy some today. I am also going to look into that enamel-replenishing stuff. Would love to have that! I've had major problems with teeth fracturing over the years. But I agree with you, I have to keep going and need prednisone to do that, so if I have to get dentures eventually....so be it!!

I just wonder why they don't list tooth problems in the prednisone side effects list. Or maybe they consider it part of bone loss?

Thanks for your help!
freesia
freesia2011-03-13 14:06:26Hi Freesia
 
Yes, I believe I'm the one MrsE has referred to on the Patients Experience UK forum who has been having seemingly endless problems with fracturing tooth enamel for the last 2 years necessitating 4 new crowns, and my rheumatologist is blaming Prednisolone!  I switched from Sensodyne about a year ago to an enamel care toothpaste by Arm & Hammer in the hope that this would eventually offer some protection.  I have just switched to a new dentist, have had X-rays and she is going to try and save the latest fractured tooth, believing it is important to save the tooth where there is a certain amount of enamel still in existence.  She is hoping to remove the filling and replace with a big one!
 
The sensitivity you refer to may perhaps be due to the bones thinning(steroids again!)which is slightly exposing the nerves - perhaps your dentist could check this out.
Hi Winnie - So glad to see you posting as I've been feeling concerned about you.  I do hope you are feeling at least a little better.Freesia - I rather rushed my post to you to watch a tv programme (pathetic I know!) and just checked back on it - I meant to say "bones thinning and gums receeding" in the penultimate line.  One bit of good news I did have from my new dentist was that at least my gums are in fantastic condition (shame about the teeth though!!!).  To be fair, I was probably predisposed to Prednisolone adversely affecting my teeth as a few of them were filled as a child due to another health problem which was eventually resolved by the removal of a kidney.  As I'm only on 1mg now I'm hoping not to lose any more enamel, not least because it's costing a small fortune and the new dentist is going to be even dearer than my last one - if she does a better job that he did, then it will be money well spent!Celtic, now I remember in previous posts, you did say you had a kidney removed as a child and thought that might have predisposed you to enamel loss. Thanks so much for all your input on this matter! I hope your upcoming dental work saves your teeth. Keep us posted on that! I dread having a lot of dental work because it is soooooo expensive and dental insurance doesn't even come close to helping--it's a joke (so I don't have insurance). 

There are some tv shows that I don't like to miss, so I don't fault you for that. It's cute, not pathetic! I hate to miss Project Runway when it is on--you probably don't have that one across the pond.

I found some Sensodyne toothpaste with an enamel protector in it today, so I will try that.  I noticed that Colgate and possibly Crest also have sensitive tooth toothpaste. Maybe they have better flavors than Sensodyne? I'm going to check Arm and Hammer as well.  That's a good thought about nerve exposure--I must mention that possibility to my dentist.

It seems like such a huge challenge making all my health care providers understand that I can't go without pred for now, and I also can't quit taking it cold turkey!!! Also, supposedly 7.5 mg per day is a small dose, according to my primary care doctor. 

Thanks again and take care!!
freesia
I use Crest Sensitivity and the taste is not bad, but maybe it does not do as good a job as some of the other brands/types mentioned. Nanatjjj, Crest is such a highly recommended toothpaste, it seems like it would do a fine job. Unless maybe there is some financial reason why dentists seem to think Crest is better...maybe it funds dental schools? Seriously though--my dentist does say that patients do better with Crest than Colgate, for example.

freesia
Hi all - as I said they are all a bit different in the way they work I think so it's a case of finding the one that stops your teeth hurting! They all taste disgusting if you ask me!
 
Celtic - I hope the TV programme was worth it - I can't remember there ever being anything that good but if you think the UK is bad you should see Austrian TV (I won't even consider Berlusconi TV - all tits and bums if you'll excuse the phrase!).
MrsE
Like my hairdresses, who recommends you never buy the same bottle, switch everytime. Toothpaste is in the same category, switch. I just saw the prosthodontist (he made my nightguard) and he says, yes, switch brands to get all the benefits of each brand.

The Sensodyne with enamel strengthener has a pretty good minty taste until you get that medicinal aftertaste. Arghhhh!!
It grows on you - honestly! Wink In six weeks your taste buds will all be new ones and they'll like it - then you'll be rotten to them and change brand LOL so they'll have to get used to it all over again!LOL!!!LOL my pain levels are up today and so are my teeth .. nerve pain from either fibro or poly.
i got in to the rhuemy 5 days earlier, going on the 31 march now so thats good. must ask him about teeth pain and prednisone and see if it is related.
hi all, i have just been to see rheumy tonight still very frustrated by what he is telling me i to am suffering from tooth pain have only been on steroids for 3 weeks and have been quickly reduced from 15mg to 10mg after 2 weeks i am not feeling to good at all he has told me to start taking diclofenac again and see how i go for another week when i mentioned the tooth pain he said he has never heard this before. Dont seem to be having a lot of other side effects from the prednisone. Still says he thinks i am very young to have pmr do wonder if this disease has been swept under the carpet a bit because it is said to be an old peoples disease. He did say jokingly that i was old before my time. I wish he could have seen me at my 50th dancing the night away what a terrible disease we are coping with.
I am already using sensitive toothpaste and have been for some years any other suggestions do mouth washes help anyone.
 
kinest regards to all lynn
 
 
I think I would have risen to the "old before my time" quip - how rude! If you have PMR, reducing from 15 to 10 after 2 weeks is not correct. Show him the diagnosis and treatment guidelines from the British Association of Rheumatologists (download from the PMR-GCA UK northeast support group website. It is not an old peoples disease exclusively and the official line has recently been changed to should be considered in patients with the clinical picture OVER THE AGE OF 50! I was also in my early 50s when it started and you have had your 50th so - we fit!
 
Can't remember - did your symptoms improve dramatically with the steroids? If you have bilateral stiffness especially in shoulders and hips and that and other symptoms improve by 70%-ish within 24-48 hours of starting to take steroids it is thought by many experts to be pretty much confirmatory of PMR. Where do you live? Sounds like the rheumatologist I saw. Luckily the GP was better clued up about it - unfortunately I hadn't seen her before or I wouldn't have been sent to the consultant. However - you need to be on 15mg for a bit more than 2 weeks and the reductions should not be 5mg at a time. It should preferably be by not more than 10% of the current dose although often 15 to 12.5 works OK. Below 10mg the reductions should be 1mg at a time. What your rheumy has done is the same mine did without listening to me at all about how the symptoms had gone at 15, came back a bit at 10, more at 5 and were back with a wallop within 2 days of stopping the steroids - I was worse than before. It has been more difficult getting the dose down since then. It is quite possible that the tooth pain is a sign of GCA - hopefully not - but if I were you I would try the GP, armed with the Guidelines and ask for a sensible discussion. Do you have more than one doctor in your practice? Maybe one has experience of PMR - ask them all!
 
As for mouthwashes helping the pain - no, unless the pain is from something totally different.
 
good luck,
MrsE
oh i meant to tell you that our dentist says you need to use a soft bristle toothbrush if you use toothpaste for sensitive teeth as the other types just rubs it off.

Hi all Hi mrs e you are so right about my rheumy being rude he is very arrogant as well just doesnt want to listen at all. I did tell him what it says in the guidelines and that i thought it was perhaps to much to soon to reduce but he just sort of shrugged it off.Will try what he says for now i am going back to my gp next week but i am thinking that i may have to take things in my own hands and do what i think feels right. Still got the stiffnes in my shoulders although when i first started taking the steroids did get great relief but then i think i overdid it which coincided with me dropping the steroids and cant seem to get back on the right track since. By the way mrs e i live ner manchester. The rheumy i have been seeing is through a private practise because i have insurance through work couldnt get an appointment through the nhs for 3 months.

 

So not only is he rude and arrogant - and ignorant - but you are paying for the privilege. He needs telling that the days of people thinking doctors with poor patient relationship skills are the really good doctors are long gone.

 

I wouldn't wait to go back to the GP until next week - your yo-yo action with the steroid dose won't have helped but what you probably need as a couple of weeks back at 15mg to get the inflammation under control and then start to drop very slowly, testing the water with each drop to make sure you are not going to return to the pain situation. And to do that you need to have your GP on your side as he/she will have to write the prescriptions. Ask them for their help and support, show them the guidelines, get the DVD from the PMR-GCA northeast support site - and show it them. Other people have given their doctor a copy and they have also learnt from it. Remind him/her that you benefited a lot from steroids initially which suggests the PMR concept is probably correct. If the GP will play ball - mine did and has never argued with providing the steroids - and you can get stable, DON'T GO DOING THE GARDENING  next time  !

 

This is a longhaul flight you are on - the garden will still be there next year and you will probably be able to do a lot more. If you visit the Patient Experience UK site you will see that Pauline has got back to playing golf, which this time last year she would never have believed. Other ladies are now doing things that were impossible in the first few months as well. More haste less speed - and your rheumatologist seems to be rather hasty in his actions. There is no absolute need to have a rheumy on board if your GP is confident and you would be better off without this one. On the other hand - if you can go privately there are PMR experts who do private practice, the president (?, can't remember his proper position) of the PMR-GCA national charity works in Southend and does private work - if he isn't an expert I don't know who is! There is also a chap in Middlesborough (who is involved in the northeast group) which is a bit easier to get at from Manchester! I'd travel a couple of hours to see a good doctor who wouldn't dismiss me like your consultant did.

 

all the best, MrsE [QUOTE=Winnie15]my pain levels are up today and so are my teeth .. nerve pain from either fibro or poly.
i got in to the rhuemy 5 days earlier, going on the 31 march now so thats good. must ask him about teeth pain and prednisone and see if it is related.
[/QUOTE]

Winnie, Sorry that your pain levels are up. Ouch I'm glad you are getting in to the rheumy sooner, and I really look forward to hearing what your rheumy says about the tooth pain, since I am having tooth pain, too. It's more or less vague, like a feeling of pressure at least in the front top teeth.  It would be good to know if it is caused by prednisone, or by disease.

Take care and good luck with the doctor.

freesia
freesia2011-03-18 14:29:59hi freesia.....before i was diagnosed i had terrible problems with my teeth and sensitivity.had many trips to dentist,had one tooth removed which i now think could have been saved.since on pres(12.5 at present) still get jaw ache but no sensitivity.drove me mad and agree no one understands outside this.dont know what advice to give you except we are all in it together,keep smiling.xSmilelinnie, Sorry to hear about your tooth and jaw troubles. That in itself can drive a person nuts, never mind the body aches and pains! I've lost a lot of teeth, too, and it's awful when you start thinking one might have been saved rather than pulled.  I've been there.

The highest dose of prednisone I've been on was 15mg for 3 days--that was when I had a flare at the beginning of February this year.  I have been taking pred for 14 months today (hey, it is my anniversary!) Currently at 7.5mg daily. I wonder if there is some cumulative build-up and that's why the tooth sensitivity only just started lately?

thanks for the good cheer, linnie. It is important to try to keep smiling despite this "beast" PMR !!!

freesia
i've had terrible probs with my teeth over the years, had 3 root canals that weren't successful and had to have them pulled out .. then had to remove remaining upper teeth as my teeth couldn't support the partial denture, very gutting for someone who always looked after her teeth.
I didn't know i had fibro back then!
 Having investigated last year, we can now say that my recent root canals on my lower jaw have been successful but it's the fibro or PMR that keeps them sensitive and sore as it's a nerve problem.Had i known that years ago i would have kept my teeth and learnt to live with the pain.
I have had most of my lower molar teeth crowned .. i'm keeping this lot!
 

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