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#128006 - 11/09/08 12:43 AM My teeth hurt!
postal2 Offline
Registered Visitor

Registered: 04/17/05
Posts: 777
Loc: Kennewick, Washington
I know I have read other posts on here about dental problems while on biologics. I just had two crowns put on and now some other teeth are hurting. I've never had many problems with my teeth, but now all of a sudden it seems to be on going. Anyone have any answers to this? Is it because of the enbrel?

Gail
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Somedays, it just doesn't pay to gnaw through the leather straps

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#128009 - 11/09/08 06:57 AM Re: My teeth hurt! [Re: postal2]
sequoia
Unregistered


i can't tell you if it is associated with enbrel, gail, but the whole bottom row of my teeth have hurt for about a week. the actual teeeth!! i do regular gum and cleaning onlyhbecuse of the meds i take and have taken so it cant be that, i just don't even know what it meanns. yours likely has a conncection, but i just have the hurtiing teeth.

i adore your quote, it is SOOOOOOO true.

prayers and peace. sequoia,


someone else will answer i am sure if it is a tnf thing. good luck

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#128038 - 11/09/08 07:50 AM Re: My teeth hurt! [Re: ]
Cosmololo Offline
Registered Visitor

Registered: 06/19/08
Posts: 1028
Loc: Georgia
I have jaw and tooth pain every couple months. It is HORRIBLE pain that comes for about a week and then is gone. Mine started with about six months back before I was on any TNF's. I was only on methotrexate at that time. I have had one episode since starting the Arava and Enbrel but that was at the very beginning. I am hoping it doesn't happen again.

I have not heard of the relation of this to TNF's but maybe an infection is the issue at hand? I sometimes wonder about the source of my jaw/tooth pain.

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#128046 - 11/09/08 08:04 AM Re: My teeth hurt! [Re: Cosmololo]
Merlin Offline
Registered Visitor

Registered: 01/24/07
Posts: 2612
Loc: Florida
I also have had to have teeth crowned and one crown replaced due to bone erosion under the crown. I don't know if it is due to remicade or just normal aging. I haven't heard of anything on the TNFs websites that indicates it is a side effect.
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Lisa K.
"Attitude is everything"

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#128069 - 11/09/08 10:06 AM Re: My teeth hurt! [Re: Merlin]
mariposa Offline
Registered Visitor

Registered: 11/08/05
Posts: 1906
You might be clenching your teeth without realizing it, especially at night.

The AS causes pain and tightness in my jaw, which causes me to clench more. Even when there is no jaw pain, I find that I clench my teeth at night. During the day, I'll realize I'm clenching and I take time to massage my jaw and stretch it out. Often, I don't realize it until I'm in pain. If you put a finger between your upper and lower molars and then close your mouth, you can tell how hard you are biting down. Sometimes there is no significant pressure on my finger and sometimes there is so much pressure I find I'm really biting down without realizing it. I know this sounds gross, but it works for me.

You can wear a mouth guard at night (I find them too uncomfortable). They sell them at the drugstore. You put it in hot water to soften the plastic and then when you insert it, it molds to your mouth. This is cheaper than having the dentist make one for you (which costs about $300).

Wearing one for a week at night could tell you if clenching is your problem.

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#128136 - 11/09/08 06:17 PM Re: My teeth hurt! [Re: mariposa]
Cindy Lou Offline
Registered Visitor

Registered: 07/13/07
Posts: 581
Loc: Waynesboro, PA
Gail, thank you for starting this thread. I've been having tooth pain ever since I started the Enbrel(been on it two months), and wondered if it's a side affect of it. My pain is usually only the top teeth. I was thinking that maybe it could be from sinuses. I hope that someone can come along and give us an answer soon. I'm going to speak to my Rheumy about it at my next appointment, which is 11/21.

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#128138 - 11/09/08 06:31 PM Re: My teeth hurt! [Re: Cindy Lou]
toby Offline
Registered Visitor

Registered: 04/07/06
Posts: 557
Loc: WA
Hi Gail. I haven't experienced any tooth pain, but I did have a corner of a molar break off recently.

Ditto on AS causing jaw tightness. My jaw will violently spasm closed in my sleep, waking me up. I've had some nasty bites on my tongue, mostly inside my cheeks though. Ouch!!!

I suspect it's more of an AS thing, but who knows?

toby
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I remember when we used to sit in a government yard in Trenchtown...

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#128145 - 11/09/08 08:25 PM Re: My teeth hurt! [Re: toby]
Mark D Offline
Registered Visitor

Registered: 10/02/03
Posts: 1799
Loc: Austin, TX
You have to be very careful about periodontal (gum) disease, which can certainly be a source of pain felt around the teeth. Periodontal disease is caused by bacteria that thrive on improperly cleaned teeth and leads to inflamed gums, infection, bleeding, pain, and bone loss. I got it quite badly when I was still a young man and have been in zealous treatment ever since. Today my gums are healthy and disease is under control, but something I have had to watch even more closely since starting TNF therapy.

Most people who lose teeth have gum disease. The problem with Enbrel is that it suppresses your immune system and can allow bacteria that were mostly under control to start getting out of control and that definitely can lead to inflammation and thus pain in your gums. (Not saying that this is your problem, but it could be). If you do have gum disease it is important to see a periodontist or at least a careful dentist who can do deep cleanings to get rid of any plaque and evaluate whether you may also need to see a gum specialist.

Mild gum infection problems are the only problems I have really had on TNF blockers (other than fatigue). It feels like a sore tooth or gum/bone area around a tooth and can also be felt as a headache. My problem was there before I went on Enbrel, so Enbrel did not cause it per se, but I knew my risk of it getting worse was raised with immunosuppressive therapy. Therefore, on several occasions when I felt pain and inflammation around a tooth, I always go to the dentist immediately to have it checked and cleaned. In every case it has been the beginning of a small infection that went away after the cleaning. Sometimes I have needed antibiotics. Now that I have switched to Remicade, I ALWAYS schedule a cleaning immediately before or after my next infusion, so I can preempt any problems.

By the way, if you take NSAIDs that can also help to keep gum inflammation down. My first really bad case of gum infection actually occurred when I stopped taking NSAIDs for 1 month. Until then I had no idea that I even had gum disease, but it came on with a vengence. I developed pus filled pockets in several places around my teeth (which fortunately have never come back because I have been careful since). Yes, "trench mouth" is a very nasty condition, but preventable with dental floss. Those of us with autoimmune disease and especially weakened immune systems are more at risk. And did you know they now have found a clear link between gum infections and heart attacks? I think it has something to do with CRP elevation.

Even if you do not have periodontal disease, it seems that the overgrowth of bacteria can also start eating your teeth and cause cavities. I have a friend on Enbrel who complained it ruined a lot of her teeth -- she got lots of cavities during her first 6 months of treatment. That has not happened to me (have not lost even 1 tooth yet, but have had numerous gum surgeries and bone grafts), but as I mentioned, I am religious about going to the dentist. The last thing I want is to loose any of my teeth to a gum infection, or to die from a whole jaw infection.


Edited by Mark D (11/09/08 08:27 PM)
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DXed with AS 30 years ago

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#128183 - 11/09/08 10:32 PM Re: My teeth hurt! [Re: Mark D]
postal2 Offline
Registered Visitor

Registered: 04/17/05
Posts: 777
Loc: Kennewick, Washington
Thanks for the replies! I have always had pretty healthy teeth and very healthy gums but I don't know what is going on now. I cracked a tooth when I bit into something hard in a sandwich a while back and ended up with a slight infection starting in the root. The dentist started me on antibiotics (and I had to stop Enbrel during this) but that has seemed to clear up. I am going to call my dentist (like I don't already owe a fortune for crowns) tomorrow and get an appt again. I will let you all know what I find out.

Gail
_________________________

Somedays, it just doesn't pay to gnaw through the leather straps

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#128189 - 11/10/08 04:51 AM Re: My teeth hurt! [Re: postal2]
Merlin Offline
Registered Visitor

Registered: 01/24/07
Posts: 2612
Loc: Florida
I just went to the dentist last week to have a crown replaced. I complained about a tooth that was crowned a year ago. Found out through xrays that the nerve in the tooth has now died. Have to have a root canal done in the next few weeks. I never had much of any teeth problems prior to being on TNFs. Seems the last three years has seen an increase in problems, but it could also be attributed to just aging.
_________________________
Lisa K.
"Attitude is everything"

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