Mysterious Tooth Pain

Bones, joints and muscles
1

I was diagnosed with PMR Dec 2014 and am in second round of course of Prednisone after symptoms returned upon completion of first.  Presently on DSNS method transitioning to 3 mg. and am feeling well over all. About 6 weeks ago developed an intermittent ache in last two upper molars but only upon biting down.  Both have old root canals.  My dentist, who I have made aware of my long term Prednisone use, took XRays and examined my mouth and can find nothing wrong.  His opinion is that my sinus cavity dips low near the roots and perhaps my sinuses are causing the pain.

it comes then goes away for a few days, then returns.   I am beginning to wonder if perhaps there is an upper jaw problem, caused by Prednisone, that may have not been apparent on the XRay.  Has anyone else had a similar experience?

2

Addendum to above..... The two molars are on the same upper left side of my mouth.

3

Firstly I really don't understand what you mean by "first" and "second" course of prednisone? It's not something you just take for a certain length of time and it all gets miraculously better. If you were only diagnosed in Dec 14 (incedentally, the same time as me) it's only been 18 months and your PMR almost certainly hasn't gone into remission, unless you are incredibly lucky!

One of the risks of not keeping the inflammation under control is the risk of developing GCA - the nasty big sister to PMR. One of it's symptoms is pain on chewing/biting and can send you blind very quickly once it develops, so I wouldn't be mucking about with it.

I'd be getting myself to a GP/Optometrist or hospital to get GCA ruled out ASAP.

4

Dear FlipDover,  In an attempt to abbreviate my history, I seem to have given an incorrect impression.   I was started on 20mg Pred in Dec 2014 and decreased per my rheumatologist's orders to 0 by July 2015.   After being pain free for two months, the symptoms returned and I was started back on Pred at 15 mg and am now at 3 mg.  I will take your advice seriously and seek further care.  Thank you.

 

5

Hi Bergrey, I have been having dry mouth resulting in dental problems for several years, no one knew what my problem was, but recently diagnosed with PMR and sjrograns , only been on press for 2 .5 weeks, so I know my problem isn't those, I had a dental 3D scan the other week, upper left area £125 and it shows I have no bone and my teeth are sitting and pressing into the open sinus space. Causing the problem. X-rays cannot show this as well. This is only my experience, it might or might not be related to your problem but thought it might help you rule things out. 

6

I had a similar issue way before PMR: after a root canal I kept getting sinus pain on that side. After much investigation and constant sinus pain it was found I had a cracked root which allowed bacteria to enter sinus. That tooth was pulled and, after a sinus lift I got an implant. 

Interestingly, after being put on Fosamax that implant started to ache and my teeth shifted, That stopped when I stopped the Fosamax- after 3 weeks being on it.

7

Yes indeed that is interesting. I hope your tooth is fine now. I wonder how many here have root canal or other tooth problems before or after PMR.

8

Hi Bergey, like you I started with PMR in 2004 and after 8 months of prednisolone experienced similar issue with my upper back molars.Dentist noticed bone loss on X Ray and suggested I gave root canal treatment a try first and if that didn't work he'd take them out. I'm so glad I did as I've had no problem since and I have now been off prednisolone for 4+ months.

hope you get sorted

9

i had attempted root canal treatment, but dentist gave up and as it wasn't bothering me decided to leave well alone. PMR did not follow immediately after but then this wee dead tooth has been lurking there ever since. So I don't know....

10

You are right, it might be a problem with a dead tooth lurking in the background. My GCA came 6 weeks after my root canal procedure. I think I had PMR already but I wasn´t aware until the GCA arrived. I sure hope the special dentist is right that my PMR/GCA will be significant better maybe even go in remission after the extraction.

11

Hi I messaged you yesterday, but had a dental appointment today, I have had sjrograns diagnosed last week but had it around 8 years and PMR more recently. I am now at home in bed with 6 teeth extracted, embarking on a years worth if sinus lift bone graft and implants, all seemingly due to sjrograns/auto immune. So do get everything checked out 

 

12

dear lawd, that sounds painful and awful. you poor thing. Be kind to yourself.

13

Thank you for your support. Painful but necessary, I hope it all heals well now for the next stage which is sinus lift and bone implant. 

14

Thank you to all for your helpful comments and suggestions.  My rheumatologist has scheduled an MRI and I will let you know how things turn out.

15

how are you feeling Adette?

16

How nice of you to ask.

Not sure if you followed yesterday but got my appointment through for North Allerton PMR clinic.  Also I'm in the middle of reducing this will be my third dose of 22.5 so couldn't sleep last night neck and spine stiffening, nothing like without tablets, so got up took some paracetamol as I had headache too, and finally had 4.5 hours sleep.  I worked 7ish hours non stop as I had a part shift to work. I'm on nights Thursday and Friday full 12 hours so might try medication 4 am ish and see how that goes.

How are you? 

17

I also wondered if you meant after my dental procedure last week, well I'm ok the double prednisolone did mess me up systematically that I had to take the day of the procedure, but the procedure went ok, I go back tonight, for a review of last week's work and to get my date for sinus lift and bone graft, probably in 4-5 weeks.

I went to see family and friends in the Black Country area at the weekend and stayed in a lovely spa hotel, just what the doctor ordered, the pool was warm and did some painless swimming, first time for years.

18

Hi Adette,  I hope all of these procedures bring the relief you need!

 I had not yet replied to everyone regarding my " Mysterious Tooth Pain" because I was hoping to gather  a little more information from test results, first.

I had called my Rheumatologist, after being urged to do so by a member of

this forum, last week.  He was concerned that it could be necrosis of my jaw.

I have been on Alendronate for the same length of time as Prednisone, 18

months and was instructed last week to stop taking it.   I had the MRI last

Saturday, but my Rheumy is on vacation this week and he will not see it until next week. I decided to consult an Oral Surgeon in the meantime who took more extensive XRays than my dentist had and he believes that the last upper molar, which has an old root canal has a cracked root.  Sinuses are being affected and there is fluid build up at the root involved, but no

infection.  I will have the tooth extracted, but only after a lab test reveals the

bone is strong enough and my Rheumy gives OK.  Oral Surgeon thinks jaw

looks good.

I know that most in this forum are very much opposed to taking 

biophosphates.  In my case, however, I felt it was warranted.  A baseline DEXA 10 years ago showed osteopenia even though I had been enriching my diet with Calcium and Vit D and taking Supplements.   A repeat DEXA when I was diagnosed with PMR 18 months ago showed a slight increase in the Osteoporosis, still with a calcium and Vit D enriched diet.  So, I am off Alendronate and still trying to consume calcium enriched food and fortunately get a lot of sun year round.

if any changes, I will let the forum know....  In the meantime, best of luck and good health through your procedures!

19

yes, I was asking about your dental procedure.... but everything else is just as important! We are not just PMR!

20

Thank you for asking.

I went to. The dentist last night, he was happy with things after the first procedure and will so the sinus elevation and bone graft in about 4 weeks.

luckily my PMR appointment at Chapel Allerton Is the 25th August and that's before the next procedure so al fitting into place in a timely manor.

Thank you again for your support.