Dental question on meds | Arthritis Information

I need to get a few teeth pulled and my rheumy is out of town. I am wondering if i need to take any precautions. Or what should I take if any antibiotic before or after.
I am on enbrel and 10mg of methotrexate. I really need to get this done.
If you had any teeth pulled when on meds what were you told to do?
Thanks
Hi, I would get a prescription from my gp or dentist. Lynda

I had a tooth pulled while on mtx....can't remember if I got an antibiotic from the dentist before the the extraction though. All I remember (this was 4 years ago) was that being on the mtx was fine and I had no problems afterwards.

Give your dentist a call and let him/her know and see if they can advise you on what needs to be done before an extraction while on those meds.

Good luck!

< =text/>_popupControl(); As far as I can understand about the whole dental thing...we have to have an antibiotic before any dental procedure to preent any infetions since we are immune suppressed from the ra meds. Some docs recommend getting off the ra meds likefor a week or two before and after a dental procedure and some don't recommend that. Guess it depends on the particular RD. So...give your RD call and see what they say about it.

Good luck with your dental procedure. Let us know how you are doing.

For dental work it's usually amoxicillan.

Have you considered seeing a Biologic dentist? They uses the Huggins (Higgens? Hodgkens? I can never remember) protocol which uses dental dams and high powered suction to make sure we don't get any sicker.

Pip

yes please alert your dentist, because for a heart murmur you have to take antibiotics. not a regular does, you have to take a large dose of antibiotic first to prevent blood piosoning. So give them time to call the pharmacy and ask them how many hours or when to take the medicine. it needs to be in your system before you go to the dentist. and then you take another dose after. Like i said thats for a heart murmmur. I would think it would be similar.

Unless you have another qualifying reason (such as high infection rate) antibiotics aren't prescribed simply because you are immunosuppressed. Anti biotics are recommended 2 years post joint replacement and for certain heart conditions. The heart condition list has been dramitically cut down recently. You have to have an artificial valve or shunt, infectious cardimyapathy or heart transplant to automatically receive one. COndtions such as heart murmur, mitral valve prolapse, rheumatic heart disease etc the antibiotic requirement has been removed. or are reviewed on a case by case basis

Check with your dentist for your particular case

Oh, and the dose is 2000 mg of amoxicillan 1 hr prior to invasive dental work. I happen to have a bottle. I'm NEVER past the 2 year limit for joint replacements

< =text/>_popupControl(); Ah...thanks for the info buckeye. Last time I had to have dental stuffs done the dentist said because I was immune suppressed I needed them. Sheeesh times change.

Yeah, and the dentist recently told me I need them because of the heart murmer.

Pip

P.S. Grandma - what's up with the popControl insert in all your posts? Missed you!

the ada recommendation changes are very recent...updated in June of this yearI have no heart murmers. I am fine. This is my first time needing dental work since I have RA. Also I am on low dose MTX only 10 MG. I think I will revert back to my original question and ask . When having dental work what were you told to do ? Also, how was the outcome on healing?

I had a wisdom tooth out last Christmas and didn't have any problems at all. I think I did a week of antibiotics afterward but nothing before. I also stopped my celebrex for a few days because it makes me bleed.

Good luck When I had my wisdom tooth extracted 4 years ago while taking mtx, I had no problems with healing...didn't take long at all to heal.I'm glad to hear that because I want to get a partial completly done by Thanksgiving and I will need to heal as fast as possible. The day after I go to Sanibel Island for vacation.

Holistic dentistry does not prevent bacteria from entering the blood stream. The point to premedication prior to dental procedures is to prevent a bacteremia, or infection in the blood stream, from the natural bacteria that occurs in our mouths, specifically streptococci. With an active infection, the rate of strep mutans increases.

The drug of choice should be Clindamycin. Amoxicillin is still used, but Clin. is much better on the stomach. It is wise for your DDS to not play MD and have an email/phone consult first. Ideally the meds would be stopped for extractions, but the ONLY person to determine this would be your Rheumy.

This is my very first post to the forum. I literally was diagnosed today. I'm a dental hygienist who had to stop practicing in July. Over 18 years seeing patients, and now my career is OVER! I'm a bit upset today. However, it does feel good to actually KNOW something about this crazy disease that I know nothing about, except from a dental perspective.

Good luck! Hope your extraction(s) go well.

Lisa

Hi Lisa,

welcome to the board..I'm sorry to hear about your diagnosis. Did you quit work because of RA symptoms? Hopefully now that you have been diagnosed and will be beginning treatment your symptoms will improve so that you can return to work. I hate to see anyone making permanent life decisions when they haven't been treated. The differences between treated and untreated diesease can be night and day

My hands were going down the tube for about 6 months prior to my leaving. The straw for me, besides knowing that I wasn't giving 100%, was when I was going to inject a patient (I'm licensed to admin. anesthesia) and I lost feeling in my hand and put the needle thru his lip. Done. Fortunately, a really nice guy, no lawsuit, no lasting damage, but still, I had to stop. I can't see myself going back to working with such fine motor skills again. And, I can't see myself ever being in the position to injure someone, not knowing if a "flare up" is about to occur. That said, time will tell, right?

Thanks for the welcome. I've many questions to ask, and hope to learn from all of you.

Lisa

Lisa,

Thanks for jumping in and giving us information from a dental hygenist point of view. It is very helpful. I really appreciate it since you are probably still in shock from your diagnosis!

Just a point -

I was not referring to bacteria - I was referring to pieces of amalgams and mercury. Of course you would still need a antibiotic. Thanks for the tip on Clindy - not one of my dentists have ever suggested that.

Thanks,

Pip
P.S. As an aside - my last new doc before I moved suggested I get my heart murmer (diagnosed at 18) reevaluated as there were a TON of people misdiagnosed in the good old days. There are a lot of people being treated for heart murmers when they don't have one. Haven't looked into it yet.

Pip, it's timely that you would post about heart murmurs being misdiagnosed. I was told that I had a heart murmur and a mild mitral valve prolapse years ago. I've always taken antibi. prior to dental work and also had cardiac workups routinely. This year prior to knee replacement I had a cardiac workup and because of a new found intermittent bundle branch block I had a heart cath and every cardiac test known to man/woman. I don't have a heart murmur!! No mitral valve prolapse detected. Anyway, just thought I'd let you know that your new doc was right. Lindy

And amazingly - supposedly I have mitral valve prolapse.

Better look into that.

:-)

Pip

Funny, too. I was diagnosed with a heart murmur and MVP at 25. I"m now 40. 1 1/2 years ago, had another full cardiac workup and not only no MVP, no murmur, either.

Lisa