MTX & Cold Sore | Arthritis Information

 

Lucky me got a cold sore yesterday. I remember my RD said next time you get one call me right away for a prescription. I didn't want to bother him on Father's Day. I have always used Campho-Phenique with good result. I just apply it frequently.

I've had plenty of cold sores over the years and have never stopped taking mtx. I have anti-virals on hand to take at the first sign of a cold sore. I have never stopped taking MTX because of mouth sores and/or cold sores, but have on occasion had the dosage reduced temporarily.

If you are experiencing outbreaks of HSV1 call your physician, get the prescription and break the latent/active cycle of the virus.

Best wishes, Shug
I'd get a prescription to have on hand, but I think you have to take it at first sign in order to be fully effective.  Might be too late by the time you get it.  But maybe it's still good, just not as good.He called in Valtrex with a refill for next time.  He did say I should take it ASAP. 2 now and 2 in 12 hrs. He did not talk MTX at all. Hurray!FWIW, one prescription broke the cycle of me. However, I keep the anti-viral close to hand just in case.

Good luck, and good for you!
That's good news Shug- thanks![QUOTE=Spelunker]FWIW, one prescription broke the cycle of me. However, I keep the anti-viral close to hand just in case.

Good luck, and good for you!
[/QUOTE] My message would undoutedly have been more effective if I could but type and spell at the same time, or at least adequately proofread...of course, I meant one prescription broke the cycle FOR me.

Here's another question...

They wear gloves so I bet it won't be a problem.  I'd call and tell them though, just to make sure.

GO! to the appointment, simply advice the dental tech and the physician that you are being treated.

GO!
I'm going- I think it was an omen that I got the cancelled appointment. I'll let you all know when I get home tonight.Sorry about the cold sore... hope the meds help take it away. MAN~I've had some horrible cold sores....and man do they hurt! I got a prescription for valtrex and take it at the first tingle of one and I really haven't had a horrible one since (knowck on wood) I never had to stop my MTX either. Well I'm back.  I didn't know that nerves could get infected.  That could explain your high wbc though, right?  It sounds awfully painful.  Can you get a second opinion?  Would insurance cover it if you did?  Well it's not really too painful right now- that's what bothers me about it all. When I touch the bump with my tongue it just causes the tooth above it to feel tender.
This kind of is my 2nd opinion- my dentist sent me to this periodontist. It just seems strange that between December and now my WBC was never elevated. Suddenly it just became very high. I can't see that I would have an infection anywhere else though....

edited for typo
wanttobeRAfree2009-06-22 19:09:22

Great- this is what I am supposed to have and this says it can CAUSE infection!

Gingival Flap Surgery

What Is It?
Gingival flap surgery is a procedure in which the gums are separated from the teeth and folded back temporarily to allow a dentist to reach the root of the tooth and the bone.

What It's Used For
Gingival flap surgery is used to treat gum disease (periodontitis). It may be recommended for people with moderate or advanced periodontitis, especially if the initial, non-surgical treatment (scaling and root planing) has not eliminated the gum infection. It may also be done in conjunction with another procedure known as osseous (bone) surgery.

Preparation
Your periodontist or your dental hygienist will first remove all plaque and tartar (calculus) from around your teeth and make sure that your oral hygiene is good. Before flap surgery, your periodontist will determine whether your general health or your current medications allow for a surgical procedure to be carried out.

How It's Done
After numbing the area with a local anesthetic, the periodontist will use a scalpel to separate the gums from the teeth and then lift or fold them back in the form of a flap. This gives the periodontist direct access to the roots and bone supporting the teeth. Inflamed tissue is removed from between the teeth and from any holes (defects) in the bone. The periodontist will then do a procedure called scaling and root planing to clean plaque and tartar. If you have bone defects, your periodontist may eliminate them with a procedure called osseous recontouring, which smoothes the edges of the bone using files or rotating burs.

After these procedures are completed, the gums will be placed back against the teeth and anchored in place using stitches. Some periodontists use stitches that dissolve on their own, while others use stitches that have to be removed a week to 10 days after the surgery. Your periodontist may also cover the surgical site with an intraoral bandage known as a periodontal pack or dressing.

Follow-Up
You will have mild to moderate discomfort after the procedure, but the periodontist can prescribe pain medication to control it. Many people are comfortable with just an over-the-counter pain reliever.

It is very important for you to keep your mouth as clean as possible while the surgical site is healing. This means you should brush and floss the rest of your mouth normally. If the surgical site is not covered by a periodontal pack, you can use a toothbrush to gently remove plaque from the teeth. Antimicrobial mouth rinses containing chlorhexidine are commonly prescribed following periodontal surgery. Although these rinses do not remove plaque from the teeth, they kill bacteria and help your mouth to heal.

You may have some swelling, and this can be minimized by applying an ice pack to the outside of your face in the treated area. In some situations, antibiotics may be prescribed to prevent an infection, and these should be taken as instructed. Your periodontist will want to reexamine the area in 7 to 10 days.

Risks
After the surgery, you may have some bleeding and swelling. There is a risk that you could develop an infection.

Your gums in the area that was treated are more likely to recede over time. The teeth that were treated may become more sensitive to hot and cold. The teeth also are more likely to develop cavities in the roots.

When To Call A Professional
It is normal to feel some discomfort or pain and experience some minor bleeding during the first 48 hours after the procedure. These symptoms usually subside after a couple of days. Call your periodontist if bleeding continues or if the symptoms deteriorate after the first three days. This can be caused by an infection that has to be taken care of promptly.

Well, the bump has to be something, right?  It seems like an infected nerve would hurt a ton just because it's a nerve.  But it's not like I know about these things.  Do you trust your dentist?  If yes, that's a good sign that he's sent you to someone he thinks is good.  Yes I do trust my dentist I've been going to him since 1989. This person was not his first choice- his first choice did not participate with my insurance....
However maybe I will call him tomorrow. The periodontist said he would be sending him a letter.
OMGosh.I just read your article and all I can say is......RUN AWAY!!!   Just kidding.  Doesn't sound like a day at the beach though.   Any kind of surgery risks infection.  I think they'll give you an antibiotic to help ward one off.  Of course you would talk to your RD before doing anything and I'm sure the periodontist (sp) would insist on that before doing anything.I really don't want to have to go off my MTX! I think I will have to and last time I flared. Not only did I flare but I did not return to the same level of comfort I had before even on a higher dose of prednisone.... Yeah, I know.  I don't blame you, I wouldn't want to either.  But if you have an infection you can't just let it fester.Especially one under your gum line.  If it spreads it could mess up your teeth and effect your overall health.  Then you'd still have to go off the mtx, but maybe stay off it longer plus you'd have a really big mess in your mouth to contend with as well.  I think it's better to nip it in the bud before it becomes something a lot worse. Linncn2009-06-22 19:37:26I wish I just really believed I have an infection there...
See how it all started was I squeezed a lemon with my teeth. That tooth became really tender like I injured it from the pressure. I went to the dentist and he numbed it all up because the tender tooth was triggering that all over throbbing teeth pain I used to complain about. So in order for me to be comfortable during the exam he numbed me. He couldn't find anything wrong.
So a day or two later this bump appeared. I thought it was at an injection site but couldn't be sure it wasn't an abcess. So I went in again and he called it cellulitis. he put me on an antibiotic for 10 days and...the rest is history.
I just find it hard to believe that since December I have this infection just lying there but not getting horribly worse... Especially being on the immune suppressant drugs
Hmm.  Well, I can see why you aren't convinced.  What are you going to do?Talk about being caught between that proverbial rock and a hard place!

WTBRAF, I am so sorry you are caught in this dilemma. It must be agonizing to know what to do. I send you my very best wishes for resolution, no matter what you decide.
I am agonizing over this. I did leave messages for both my RD and my regular dentist. Maybe I will feel better after I talk to both of them. Sno- you bring up a good point- I never asked is there an alternative? I don't find him very approachable. Not that I didn't approach him on other issues- billing for one! I was told by my dental ins. to have him code it as a consultation and it would be covered 100% the one snafu was he could do no work on the day of the consult. Well he billed it as an exam and when I asked that it be changed he tried to tell me that if he billed it as a consult any work he did there after would not be covered. When I insisted I was told different he got a book out and said let me read you the definiition of a consultation is to an insurance company. Which he did and then I think he said -well that's exactly what you are saying but I have had experience where the insurance companies refuse to pay for work afterwards. He agreed to bill it as consult and I said I would call my insurance company again to verify. Which I did and I got the same answer as the first time. It's official...my luck has rubbed off on everyone that I talk to here.   Oh Bob- my luck has always been this way- please don't blame yourself LOL! Thanks for your well wishes! My RA is a little more bothersome than I would like but I always try to remember the onset and then nothing seems too bad anymore.
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