Hi all. Today I faced a major phobia of mine and had my broken wisdom tooth pulled without being put to sleep. I know… I’m a big baby! Been thru back surgery, have a rod in my leg, 2 c sections… But the dentist scares the hell out of me.
Anyway, in January I had a root canal n 2 crowns done. I went into such a flare for about a month.so now I’m just curious if the same thing is going to happen again. I know my TMJ will be severely painful again obviously. Does this happen to anyone else?
Actually no. Originally when I started going there they were unsure about that. They had me premedicating as a precaution. My rheumy said I didn’t need to though.
Your dentist can prescribe antibiotics, too, if your rheumy is being a pain (don’t get me started on how I feel about 99% of rheumatologists… >_< ) My dentist has almost always premedicated me if there was any risk of infection present (which there always seems to be with me - I’ve had one abcess after another for years now.) I would think if you tell your dentist you have lupus (which he needs to know anyway,) & that any major work causes you to have a flare, that he should be willing to give you antibiotics either before (if you already have infection present) or after (to prevent any post-procedure infection.) Alternately, you could also talk to your GP about it… I have just found so few rheumies that are truly approachable and willing to deal with things like this, matters that seem to THEM like a minor detail & a bother. (If anyone is aware of a rheumie in eastern VA who’s not like that, please let me know! lol)
I also have TMJ, and dental stuff can definitely set it off, but I’ve learned a few tricks to minimize it. First, I make sure that anyone working on my mouth KNOWS I have TMJ (of course the loud pops & clicks from my jaw every time I open my mouth usually tip them off!) Both my dentist & oral surgeon make a point of not keeping me with my jaw wide open for huge periods of time: they’ll stop periodically and ask if I’m ok, and give me a short break if I need one - it helps a lot. The other thing I do to help the TMJ is I’ll take an extra muscle relaxer, and - if it’s a procedure I’m anxious about (like recently when I had 4 teeth pulled & bone graft work) I’ll take one of the low-dose xanax (my neuro gives me a few a month for anxiety, & this is one of the perfect times to use them!) Having a muscle relaxer helps my jaw and the Xanax helps both the jaw (I’m not so nervous, so I’m not clenching my muscles so badly) and it helps reduce the overall pain and anxiety. This especially helpful for me, since when they give me nitrous oxide for the more serious procedures, I can’t feel much affect from it at all!
Oh! And I absolutely back Ann A. up as far as probiotics any time you take antibiotics. They are really, really important. In fact, I take a good probiotic capsule, AND get as much yogurt and kefir into me as I can. Not replacing those good beasties in your gut can not only leave you vulnerable to yeast infections (and who needs that?), but to much worse things like c.difficile - at least that’s what my GP told me last winter when she was treating me for pneumonia. Scared me enough that I took her seriously - c.diff. is nasty stuff, especially for us lupies!
Good luck! I hope between the info people have shared here, and talking to your doctors, you can somehow work things out so that getting your dental work done isn’t so problematic!
Wow thank you! The oral surgeon did give me antibiotics for the next week. Funny about the Xanax because I had to take one just to calm me down for the procedure n I was still shaking like a leaf. Imagine if I hadn’t taken it… Jeez!
Jend719 said:
Wow thank you! The oral surgeon did give me antibiotics for the next week. Funny about the Xanax because I had to take one just to calm me down for the procedure n I was still shaking like a leaf. Imagine if I hadn't taken it.. Jeez!
Maybe you need to take two next time! 
Hey All! Thanks for all the detailed replies, you confirmed many things I need to know for an upcoming dental visit! You Rock! Be Well! K
Reading all of your postings, I was wondering how an antibiotic helps with flares? I understand if you are getting teeth pulled or something like that but just going for any dental work you should take antibiotics? I had bonding done on my front teeth a few years ago and I ended up with a little cut on my lip from the work he was doing. That then turned into a swollen lip and a big sore. I also was very fatigued. I do seem to get fatigued even from getting a filling done. I'm not afraid of the dentist at all either (like some of you babies....kidding). I worked for a dentist all of my life until I had to stop working 17 yrs ago. We had about 2,000 patients and only one with Lupus. She never had to go on antibiotics, so this is new to me.
Alley :)
I had a root canal in March,some plaining done and abrace put behind my lower front teeth,I’ve been in a bad flair,it happens every time I go to the dentist,I’m also terrified of the dentist and always take anxiety meds before I go,or I won’t go at all…I also had cancer surgery after my Hawaii vaycay,I’m just not feeling like doing a thing…
Ann, thanks for the info, it makes a lot of sense to me. I'm learning more each day.
God Bless, Alley
I’ve had 8 teeth pulled so far. I have a broken canine right now and am devastated because I might have to have it pulled if I can’t afford a root canal. I really have taken care of my teeth but between lupus and meds, my teeth have so many issues and it’s very sad to go through. I can deal with hair falling out but teeth are permanent. There is a medicine that helps with dry mouth but they didn’t start me on it until two years ago and it couldn’t help the previous damage caused by dry mouth. The medicine is called pilocarpine and works great. I wish i had dental insurance.
Hi Jen....I had a flare after an infected, cracked tooth was pulled. AFTER CONSULTING WITH MY RHEUMATOLOGIST, I asked him to order an antibiotic[amoxicillin] and a prednisone taper[ Medrol Dose Pack] to begin before the extraction.
Sandy,Nurse Practitioner
Hi Jen! Yes. Yes. Yes!! I’ve had the same thing. I’ve had 3 teeth worked on/pulled this year and each time I ended up flaring. Rhuemy tells me ANY trauma to your body may or may not cause a flare. He always says be prepared for a flare if you can … and i know now that i will flare after dental work. Guaranteed. I flared severely after all three procedures. Now if I need dental work done, I call him for a medrol dose pak first. Lupus us so inconsistant …for me dental work is a given! Good luck!!
Thank you for all of your responses. It’s always good to know I’m not just imaging it. Lol. Isn’t going to the dentist bad enough without having to flare afterwards!?! I hate the dentist.
I don't get antibiotics for dental stuff. but I do take a sedative because I've had so many bad dental experiences. If you are getting fillings with mercury in them (any metal filling has at least 50% mercury), then you are introducing a toxic substance into your system. I only get composites. I had all my metal fillings removed in 1994.
Alley said:
Reading all of your postings, I was wondering how an antibiotic helps with flares? I understand if you are getting teeth pulled or something like that but just going for any dental work you should take antibiotics? I had bonding done on my front teeth a few years ago and I ended up with a little cut on my lip from the work he was doing. That then turned into a swollen lip and a big sore. I also was very fatigued. I do seem to get fatigued even from getting a filling done. I'm not afraid of the dentist at all either (like some of you babies....kidding). I worked for a dentist all of my life until I had to stop working 17 yrs ago. We had about 2,000 patients and only one with Lupus. She never had to go on antibiotics, so this is new to me.
Alley :)
I am a dental hygienist and see about 8 patients a day and have been working for 8 years. We have a few patients who have Lupus but not many (who report it). Anyway, anytime I get fillings done on myself, I always get a massive painful infection in the area the work was done. The first time, it manifested as extreme pain on the side the fillings were done and my PCP said it looked like I had an ear infection on that side (never had an ear infection as an adult in 29 years of living). Then, when I had the other side done, the SAME thing happened, fluid in the ear with extreme pain. Neither doctor (dentist) I work for has ever seen or heard of this. I was prescribed Sulfa antibiotic for the first infection which worked but then I had a massive allergic reaction to it (Steven-Johnson Sydrome). The second time it happened, I took a Z-Pack. Anyway, these posts are very interesting to me because it is not something we have ever seen. But obviously the "ear infections" were correlated to the dental work. I agree with the idea that the body is sending auto-antibodies near the site of trauma or "infection" ten-fold and although it is not the standard, you can bet your dollar that I will be taking prophylactic antibiotics before I have any dental work done in the future.
if i had your history, Alex, I would *DEFINITELY* get antibiotics before dental work.
I have reacted to so many antibiotics, and it's so hard to keep my digestion working properly, that I have to err on the side of taking as few antibiotics as possible.
Definitely one of those things that we can't make a blanket statement about- what is right for one person may not be for another. But once you find out what works for you, you stick to it!
I had 10 dentist appointments last year. between the exam, the fillings, the cleanings, the temporary then permanent crown, a nightguard... oy vey! I found I do not need antibiotics but I definitely need a sedative.
I'm thinking of having something controversial done by my dentist. Going back in where one of my wisdom teeth was cut out and filling in the cavitation with a piece of cow bone, which my real bone will then grow around. It's surgery, so I'm going to wait until I feel really sure that it's the right decision, talk to others who have had it done, and make sure I have plenty of time to rest afterwards, if I do it- and enough sedatives :D
Alex said:
I am a dental hygienist and see about 8 patients a day and have been working for 8 years. We have a few patients who have Lupus but not many (who report it). Anyway, anytime I get fillings done on myself, I always get a massive painful infection in the area the work was done. The first time, it manifested as extreme pain on the side the fillings were done and my PCP said it looked like I had an ear infection on that side (never had an ear infection as an adult in 29 years of living). Then, when I had the other side done, the SAME thing happened, fluid in the ear with extreme pain. Neither doctor (dentist) I work for has ever seen or heard of this. I was prescribed Sulfa antibiotic for the first infection which worked but then I had a massive allergic reaction to it (Steven-Johnson Sydrome). The second time it happened, I took a Z-Pack. Anyway, these posts are very interesting to me because it is not something we have ever seen. But obviously the "ear infections" were correlated to the dental work. I agree with the idea that the body is sending auto-antibodies near the site of trauma or "infection" ten-fold and although it is not the standard, you can bet your dollar that I will be taking prophylactic antibiotics before I have any dental work done in the future.