Broken filling!

Wobblylegs

Hi Guys,

Just another quick question from the newbie! I'm now 8 weeks post TKR and I've broken a filling!

What's the latest on dental work, TKR and antibiotics, it's got me running scared again!

Wobbly

Wobblylegs

Sorry guys panicking - should have said any experiences or knowledge welcome.
Thank you x

theresak

Hi,

I'm sorry, I can't remember if you have RA or OA. I'm on a biologic drug -humira - for my RA, and I lost part of a filling the week before last. I'm due to have the tooth out on the 18th, and my rheumy's instructions are to miss my last humira injection before the extraction, & the injection due afterwards.

I'm also given an antibiotic after any invasive treatment. Not all rheumys have this policy, but mine does.

Hope this helps.

Wobblylegs

Thanks Theresak

I have OA and this is my first TKR which is why I haven't got a clue. I don't know how you guys with RA cope at all. It's only a small filling and wouldn't need a tooth out just a repair.

It's just that the research I've done is confusing some say you always need to take antibiotics and some says only for very invasive treatment!

I think I'm panicking because it's still early days since mine.

I have MS too but that doesn't affect any dental treatment.

Thanks so much for sharing yours.

xx

Helenbothknees

HI,

I had a bilateral TKR nearly four years ago. I was told antibiotic cover was needed for any invasive procedures, eg extractions. I think routine fillings are fine. However I can't be certain, and I'd be guided by what your dentist says. If it's any help, I've had loads of dental work since then, with no problems whatsoever.

Wobblylegs

Thank you Helenbothknees,

that's really good to know. My hubbie told me not to worry but I seem to panic over everything since having this done! I think it's because it's only 8 weeks I keep worrying!

:cheers:

dreamdaisy

Those of us who take the immuno-suppressant meds have to be careful and you are wise to be cautious even though you do not. The best person to ask is your dentist, ring the surgery for advice and I hope they will be able to answer your questions. Good luck! DD

Wobblylegs

Thanks DD, as always sensible advice.

xx

GraceB

Hi,

I have a TKR thanks to OA. The instructions I had from my consultant - and re-affirmed via email when I queried it after a year or so - was that any dental treatment which breaches the gum line means I have to have antibiotic cover. That effectively means root canals and extractions. Also of course any dental abscesses.

I have had to stand my ground on a couple of occasions with my dentist about this and had to wave the printed-out email at my dentist. I'm sure I may well have to do the same again in the future.

Hope this helps.

GraceB

Wobblylegs

That's useful GraceB, i may well have to ask my surgeon to do the same. It's something I should have asked post op. But I'm not panicking so much now as this is only a small filling.

Thanks to all who shared.
xxx

stickywicket

Just to complicate matters - As the proud owner of two THRs and two TKRs, not to mention being on immuno-suppressants, I don't recall ever being given such advice re dentistry (or even surgery) and I've never had precautionary anti-bios afterwards even after an extraction. So far, so good

Wobblylegs

Thanks stickywicket that's really good to know, I don't know how you've coped with so much surgery :? I'm not sure I could.

Well I'm all sorted now thanks guys.

I spoke to my surgeon who said you will only need antibiotics for anything invasive. I quote from him "the research tells us that taking prophylactic antibiotics does not stop infection, but having said that when we do surgery on infected knees and send to the lab they usually find bacteria that can only be found in the mouth". But he did say you will need to take some for anything invasive for the rest of your life.

My dentist said you don't need antibiotics unless it's for something invasive and then only for the first two years after your op!

So take your pick on those eh? So glad you've been fine sticky as that gives me confidence

When I visited it was such a small filling she didn't even need to numb it lol which shows just how easily I'm panicking at the moment. I don't know if that's because this is my first major op ever! Or just the after effects of something like this. But it's coupled with the fact that I'm a huge reactor to drugs including antibiotics.

But either way I'm calmer now and my mouth is okay for now. The bad news was if it breaks again I'll need a bridge. So I'd better get on to reseraching what antibiotics I will need and what I can tolerate! Am I paranoid - too true after the experiences I've had with western drugs.

Thanks again. Have a great day. It's pouring down here!

tkachev

I wonder why it is only first 2 years after an op? My THR consultant says any risk of infection needs to be treated if you've got a joint replacement. I got told off for not treating something (might have been cuts on my legs from excessive itching).

Elizabeth x

Wobblylegs

I agree Elizabeth, now I've looked into it more.

Thankfully the risk of infection is treated seriously as I have MS because it cause a relapse.

My surgeon wants to see me for a follow up after a year so I'll check again at that point and get a letter from him re: dentist and infections!

Although if you see stickywickets post she's done well without!

Thanks for chipping in xx

stickywicket

I should add that my dentist and I have a good relationship. She always details what I must do at the first hint of a problem and how to contact them even at weekends.

Wobblylegs

I'm still confused though sticky as so many sites and surgeons and dentists differ. You see I don't have a depressed immune system. With MS you have a heightened immune system which attacks you if it raises its head. So an infection would risk a relapse.

Is that the same with RA or not?

I guess I'll just have to go with whatever my dentist will do along with advice from the surgeon. I too have a good relationship with mine so we will see.

Wobblylegs

Okay, so here we go again! After the dentists parting shot of let's hope that lasts a while as next time that tooth will need a bridge! The filling she put in Monday has come back out!

So I'm trying not to panic and reading your post sticky lol

stickywicket

Yup, it's the same with RA and other autoimmune forms of arthritis. We take meds to suppress our overactive immune systems.

When I first had a hip replacement while on immuno-suppressants my surgeon advised me to lay off the meds for about 5 weeks prior to the op to give my immune system chance to fire up. By the time the same surgeon did my knee revision – a bigger op – about 6 years ago, he said just to lay off them the week before and a week after as it doesn't seem to make any real difference.

I've done the same, after discussing things with my dentist, before a tooth extraction but for regular inspections and having the hygienist scrape away at me I just carry on as normal.

I do think it all depends on the surgeon and dentist and there are no hard and fast rules (though I do seem to be in the minority here). My surgeon is one of the best at our teaching hospital and I trust him implicitly. He's done both my hips and the knee revision.

As for the filling - get thee back to the dentist. Mine replaces them free of charge if they don't last 6 months.

Wobblylegs

I thought that would be the case Sticky, I don't take anything for my MS. I figured if it had taken them so long to diagnose it I could manage without until I'm desperate!

Yes, I will be on the phone in the morning, I'm just concerned now because she said it would need a bridge. Hopefully she'll just fill it again! Otherwise I'll be on the antibiotics and like so many other meds I'm allergic to lots of them. Hey ho it's all good fun!

xx

dreamdaisy

Hello, we're a couple of days on now, how are things going? I reckon you are on the auto-immune spectrum but I do not know how MS is treated (or not). Isn't life complicated at times? And stupidly so? Most irksome. DD

Wobblylegs

Hi DD,

Yes they do consider MS to be autoimmune, but it attacks the Central Nervous System rather than joints directly. So everyone of us will experience different symptoms at different times that's why it's so difficult to diagnose.

There are a number of immune-suppressant treatments but I don't take any and just have symptoms treated as and when needed. My main issues have always been my eyes, legs, some cognitive issues and the fatigue.

My dentist filled the tooth again with what she called a 'stronger bonding' filling and said keep your fingers crossed. It cones to mind "Why not do that in the first place!" But I didn't say it out loud lol.

If it goes again, she can try taking out all the fillings in that tooth and building it up, after that it would be a crown. She was still not convinced about the antibiotics and said if we need to do that we will have to talk to your surgeon. But my surgeons beliefs are clearly stated on his web site I've since discovered. If I need to go back to her I think I'll print them out.

Thanks for asking DD, how's it going for you?
Wobbly X

dreamdaisy

How's it going for me? Well, it could be better but I am pleased it's not worse. I'm nearly back to moderately grotty which is my usual state

We had a thrilling morning at the opticians, Mr DD was due an eye test and then of course frames had to be chosen. I also bought an outrageously expensive pair of sunglasses but reckon I deserve them. And I do.

I knew that MS attacked the CNS, and that it can be the very devil to diagnose; does it also go into spontaneous remission? It can be so hard to decide what to do, can't it? The meds suit some and not others, one man's can't-do-without is another's utter poison. I hope the tooth now behaves and yes, treat it with caution for at least forty-eight hours. DD

Wobblylegs

It can and does go into remission and I have the relapsing /remitting form which is the most common. I figured that if most of my relapses were small and every day is a gamble as to how I will feel but major relapses have been one every three of four years in the past then I would cope without the gross chemicals that do not cure it! Especially with my record of taking drugs.

It took them 18 years to diagnose me and I held down a job as a principal lecturer, brought up fours kids and completed a PhD with that. So what would be the point now?

Having said that I saw the ENT yesterday for a chronic cough I've had six years and he's tried everything to help me. But It seems the MS may have affected the nerve to my larynx making it super sensitive. So I'm back to trying Pregabalin to see if that can quieten it. And so it goes on, all part of the fun.

I'm so glad you bought some great sunglasses, it's amazing to spoil ourselves every now and then and if they make you feel good why not. I can't think who it was that once said that with a great pair of sunglasses and a red lipstick no one would ever know how grotty you look or feel underneath lol.

Enjoy the rest of the weekend, it's been lovely here today just right for the glasses.
:cheers:

barbara12

Hello wobblylegs
Sorry I have missed this, but I find it very interesting, has you might know I am 8 week post THR and have never been given any advice about visiting the dentist..nor did I with my first one..but suppose it does no harm to be on the safe side..apparently infection from the teeth can go all over the show..hope it all goes well..

Wobblylegs

Thanks Barbara, how's your recovery going?

Wobbly x

barbara12

Hi
My recovery's going well thankyou, I just need to get this back sorted if its possible..hows that new knee doing x