Dental treatment near to THR surgery date.

Nocturne

Hi, I'd be grateful if anyone has information or opinion on this - my TLR date is provisionally February, one year after assessment, waiting for exact date. At dental check up xray last week was advised of cavity under tooth, which could become infected. Dentist is unable to tell if cavity is infected from an xray and I currently have no pain so it may not be. NHS advice is any invasive dental procedures should be done and healed at least 6 weeks before surgery date, and if after surgery, not for 3 months (to prevent any infection travelling to surgery site). I've waited so long, in pain but being patient as I know many of us are suffering too, that the thought of delaying my surgery further is very depressing. It seems to be a gamble - delay dental treatment till after surgery and risk gum infection developing which would impair healing, or delay surgery for several more months (obviously have to queue several weeks for dental appointment) and ask for stronger pain relief as pain is 24/7, wrecking sleep and making all the daily demands we have extremely difficult. I know there's no easy answer to this but would be grateful for anyone else's take on it. Thanks for reading.

PeterJ

Hello @Nocturne a difficult dilemma. Have you discussed this with your consultant for the hip surgery? It would be a shame to end up going back on to a waiting list when you are so close.

Janlyn

@Nocturne I agree with @PeterJ regarding speaking to your consultant. It would be such a shame to go back on the waiting list but also you really don't want an infection.

If it's any use at all I had a similar problem with a dental cavity during lockdown and I wasn't able to get it treated for a good number of months. I actually used salt rinses a couple of times a day and was amazed how clean and comfortable I managed to keep it until I could have treatment. Maybe useful as a precautionary measure but definitely get proper advice.

distantshores

Hi I had an impacted wisdom tooth taken out on 31 October (there was infection around it) - not an easy extraction. I had THR on 26 November. I didn't think to mention it to the hospital/surgeon or at pre-assessment as I didn't realise it would have any bearing on the op. I just didn't want it flaring up after the operation. But if you are concerned it is probably better to speak to the consultant. Good luck

Nocturne

Thank you Peter, Janlyn and "Distant Shores" for your kind support. It would be clearer if I was in pain from a definite infection of the pocket, but I have no symptoms and wouldn't even have known about it if I hadn't gone for my 6 monthly checkup. It seems Janlyn that yours wasn't assessed as urgent as otherwise treatment would have been available even during lockdown, so that's useful to know, also about the salt rinses which are easy to do. I'm still thinking about it all.

Bryony

I'd be interested in the answer to this. I have a cracked tooth - known because of the type of pain, but isn't visible on x-rays (cracks often aren't). The dentist said that it would involve destructive investigation to try to locate the crack, and they still might not find it, but end up destroying much of my tooth. I've been waiting 2 years for knee replacements and don't want my tooth to jeopardise any appointment. The dentist said that antibiotics should be sufficient.

Apparently c 50% of older adults have some degree of peridontal disease, and usually are unaware of it until it is advanced. so many must be in the same position as you. I think prophylaxis antibiotic regimen is standard for hip and knee surgery in the NHS.

Nocturne

Hi everyone, just reading all our comments shows it's a dilemma with no one answer. I've been worried over last week and not getting response from dentist as to when I could be fitted in, so rang another one who agreed to see me next week for assessment and could do any treatment fairly soon. So I'll know more next week, but at the moment am of the opinion that it's too much of a gamble to leave dental work several months. If an infection flares up before surgery I won't be able to have it, if after surgery it would jeopardise healing. Also am bearing in mind that the physical, mental and emotional preparation for surgery could lower my resistance and accelerate the infection (I have ME so am somewhat compromised). I'll post again after seeing dentist next week.

frogmorton

In your shoes I'd want the dental treatment done and dusted.

When my friend was diagnosed with breast cancer (I know it's not the same obviously) she was told to get a dental appointment and treatment done before she started her chemo.

I'd be like you wanting to avoid anything post op when I'm struggling. The risk of getting an infection too.

Good luck I'll be interested to hear how you get on

Toni

Nocturne

thanks Bryony and Frogmorton for your input. I'm really hoping to have a decision made by next week and an end to the uncertainty although I'll then have the uncomfortable job of ringing the consultant's secretary . . .

Nocturne

Hi everyone, an update on my dilemma. The second dentist was much more helpful, the same diagnosis but can fit me in next week for work on the relevant teeth which presents a different picture to the vision I had of having to wait weeks for treatment. He also offered to speak to my consultant to check out any concerns! I think there was really no choice but to have dental work done first. Thank you all for your input and support, it's much appreciated and I hope my experience will help someone else.

frogmorton

https://community.versusarthritis.org/discussion/comment/730935#Comment_730935

Brilliant! Well done you @Nocturne hope the treatment goes well and you are all ready for your surgery feeling as healthy as possible.😊

Toni x

Janlyn

@Nocturne that's such good news, and a massive relief for you. Thank you for letting us know.

Wobblylegs

So glad you got that sorted, I had exactly the same problem last year. 2 small cavities discovered just below the gum line at a routine check up just 2 weeks before my surgery day. My surgeon said it needed to be done dusted and healed 3 months before surgery. So I was labelled unfit for surgery and here I am now with my date looming in 11th Feb that's 11 months extra waiting. So well done that you've been able to sort it out

Nocturne

Thank you everyone for your support. So sorry to hear Wobblylegs that you had to go so far back down the queue and wishing you well for your op next week.

Bryony

Thanks Wobblylegs for your info. 11 months is a long time to wait because of your teeth.

As I mentioned higher up in this thread, I do appear to have a cracked tooth, though it can't be seen on X-ray. Oops, just pushed on it to see if it still hurts under pressure and it has broken off! No pain from it. Will be ringing the dentist tomorrow! Now I know where the crack was! I hope it is one that can be repaired and I'm not left with a gap where a tooth was, which is what I have on the other side. That one couldn't be repaired, and then the one above was unopposed and dropped down, and when the filling fell out was deemed better to remove and leave another gap.

Nocturne

Another update: the 2 teeth showing largish cavities on x-ray have been sorted today. Apparently there was a lot of stuff down there and that's despite me being a careful flosser! So thank goodness I decided to get it done even if it delayed hip surgery. As it happened, I was fitted in quickly and with the third one being done next week then all being well I won't have lost any time as still not been given a surgery date anyway. Interesting re Bryony's figures in her post, I certainly had no idea there was a problem, no symptoms or pain. So panic over, but I'm now well aware that before any future operations an x-ray is the only certain way to know if there might be a problem affecting the surgery, so I hope my and others' posts will help other arthritis patients. Thanks again for your support and contributions.

Bryony

Hope your surgery date comes through soon, now that your teeth are nearly sorted! Yes it has been a very helpful thread.

Dentist appointment next Tuesday, in Sheffield. 95 miles drive each way, at least no snow forecast. I'm still with my old NHS dental practice as nothing in my area - it is an NHS dentist desert here, and I've been here for 15 years. One neighbour goes to Bolton, another to Wakefield, and they also been doing so for 15 years.

Nocturne

I hope your tooth is now sorted Bryony though you still don't have a surgery date. We are all waiting a long time and of course so are millions of others for most types of surgery. Hopefully we can keep each other's spirits up as we wait, certainly for me hearing how much better people feel after the op is very encouraging. Onward and upward!