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Has anyone else lost molars since getting PMR/GCA?
I began PMR/GCA in Oct of last year, was started on 80mg a day of prednisone, and just had my second dental extraction 4 days ago. My GCA symptoms have been jaw claudication on the left side and I have lost both left rear most molars (upper and lower). I have always had healthy teeth, get cleanings done, no problem with gum health, etc. Google says it happens with GCA. The problem as well is that I now have to wait to get the infusion for Osteoporosis until "healed" from this extraction which can be a month or two and I have already had 2 spinal fractures, still on prednisone (5mg), have hyperparathyroidism, and may have to increase the prednisone because the extraction has restarted the jaw spasms. Yikes.
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I'm at the very beginning of this journey. I've been diagnosed by Rheum for PMR and suspicion of GCR. I started on 60 mg. Prednisone in January and quickly reduced to 40 mg. I've begun tapering. A few weeks ago I was leaning on my cheek with the palm of my hand when I felt something shift and move around in my mouth. It was an old ill-fitted crown which had cracked off at the gum line along with the tooth. I now need an extraction.
While my situation is not as complex as yours, my dentist will only extract if I get a bone graft as well to preserve the ridge line. Why?
Well...first, Prednisone increases our risk of infection. Second, I now take Eliquis for AFib which is a blood thinner and could potentially make it harder to stop the bleeding and third, I've been on monthly Boniva by mouth for a couple of years. That concerns the dentist the most. And I think that may be because of the rare event of jaw necrosis which seems to be a greater risk with infusion. Is that possibly the issue with you rather than PCR/GCA being the cause?
By the way, as an aside I had a parathyroidectomy 20 yrs. ago. When I started having PMR symptoms it was very reminiscent of the way I felt when I developed hyperparathyroidism. I also have idiopathic small fiber neuropathy which never caused me more than numbness and tingling. That now borders on pain.
None of this really confirms anything other than I'm fearful of losing more teeth.
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I’m with you on the thought of the osteoporosis meds causing tooth and jaw bone issues. I’m hoping I can quit taking them as my sister in law just had bone fragments come through her gums. She is not currently on the meds but had been on Fosamax in the past.
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2 ReactionsSomewhat related to topic: 8 months w/GCA, on 60mg Prednisone when I reached out to my Rheumatologist about possible (single tooth) dental implant. Can't say my dental problem is due to GCA...my teeth have never been great. Anyway, this is what she wrote in response: "Cleaning, root canal and crowns are ok to proceed. If you are undergoing a heavier procedure that requires more healing time such as an extraction, implant, or jaw surgery, it is contraindicated until you are titrated (weaned off) to a lower dose of prednisone." "... you can run the risk of the dental implant failing because the prednisone had suppressed your healing. You also run the risk of developing osteonecrosis of the jaw."
My molars are chipping. I wasn’t sure if it was my habit of snacking on ice cubes, but the left side where the jaw pain occurs has needed more dental care. I’m two years diagnosed with both PMR and GCV, which began in a country ER with a doctor still in training. Five days in the hospital with a diagnosis, 60 mg prednisone tapered to Actemrya injections weekly. Now it’s suggested to benign tapering these injections to every other week. Not sure what to expect…