Hi

I really need help. I was diagnosed with RSD 10 years ago. I had a stellate block to confirm it. Although I wonder since most of pain is aching and stabbing.

This summer two of my teeth broke off at the gum line. Top front of course. One is my eye tooth.

My dentist wants me to have an implant but I'm concerned I'll have a big time flare up and the implant could fall out due to bone loss.

He says there are too many teeth to bridge because of the loss of the eye tooth.

My last choice is pulling them all (again risking permanent mouth pain) and get dentures which I'd rather not have.

Please help



Pam

Hi Coach,

Several things need to be considered before placing a dental implant in someone with RSD. I am a believer that the decision process should include the overall health of your mouth, your teeth and your physical well being. To help become better informed, it makes sense to look at the entire picture and not just the current tooth problem because patching things up with additional fillings or root canals or placing an implant here and there when you lose a tooth may not be in your best interest overall.

1) How healthy are your teeth and gums in general? Do you have cavities, mercury fillings, crowns, root canaled teeth, periodontal disease??

DECAYED TEETH, ROOT CANALED TEETH AND PERIODONTAL DISEASE ARE ALWAYS A SOURCE OF INFECTION. MERCURY FILLINGS ARE HIGHLY TOXIC AND OLD OR ILL FITTING CROWNS GENERALLY HAVE DECAY UNDERNEATH THEM. ALL OF THESE ISSUES COMPROMISE YOUR IMMUNE SYSTEM AND IN TURN AGGRAVATE THE INFLAMMATION/PAIN ASSOCIATED WITH RSD.

2) Do you get regular check ups and cleanings at your dentist? Are you physically capable of properly brushing and flossing your teeth on a daily basis?

THE ONLY WAY TO MONITOR YOUR ORAL HEALTH IS TO HAVE REGULAR DENTAL VISITS WHICH INCLUDE THOROUGH EXAMS, COMPREHENSIVE CLEANINGS AND TAKING XRAYS PERIODICALLY. IT IS SO EASY FOR A DENTAL PROBLEM TO CROP UP WITHOUT EVEN KNOWING IT AND BY THE TIME IT SHOWS SYMPTOMS, THE PROBLEM IS COMPLICATED. ALSO BEING ABLE TO PROPERLY CLEAN YOUR TEETH AND GUMS ON A DAILY BASIS IS ESSENTIAL IF YOU ARE GOING TO KEEP YOUR TEETH AND/OR DO IMPLANTS.

3) What meds are you on? Do they contribute to a decrease of saliva... do you feel like you have a dry mouth? Do you smoke?

MANY MEDICATIONS CAUSE A DECREASE IN SALIVARY FLOW WHICH CAUSES RAMPANT TOOTH DECAY AND BONE LOSS. MEDICATED LOLLIPOPS LIKE FENTANYL OR ACTIQ AS WELL AS SOME OTHER ONES CONTAIN HIGH AMOUNTS OF SUGAR AND SEVERELY ERODE THE TEETH. OUR MOUTHS NEED A HEALTHY SUPPLY OF SALIVA TO CONTINUALLY BATHE OUR TEETH TO HELP PREVENT TOOTH DECAY AND PERIODONTAL DISEASE. DEPENDING ON THE INDIVIDUALS ABILITY TO BRUSH AND FLOSS,THIS PROBLEM CAN BE A HUGE CHALLENGE TO DEAL WITH.

4) How healthy/nutritious is your diet?

JUST LIKE WITH MEDICATIONS, AN UNHEALTHY DIET CAN ALSO CAUSE DECREASED SALIVA DUE TO THE CHEMICAL ADDITIVES ULTIMATELY CAUSING RAMPANT TOOTH DECAY AND BONE LOSS. SO WILL DIETS CONTAINING SUGARY FOODS, DIET SODAS, ALL SOFT DRINKS, ALL FRUIT JUICES, ACIDIC FOODS, STARCHY FOODS, STICKY FOODS LIKE RAISINS, PRUNES, DRIED FRUITS......JUST TO NAME A FEW.

Answering the above questions will give you some insight into what is necessary to maintain a healthy mouth. If your teeth and gums are continually compromised due to a variety of the above reasons, then your dental implants will also be compromised. If you are not able to alter these things, then your immune system is also continually compromised and your more likely to have RSD flareups and worsened pain from the oral inflammation. It is only fair that your dentist review all of these things with you and help you come up with a dental treatment plan that suits your individual needs.

I hope this was helpful.... I wish you all the best ....please keep us posted.
Bryanna

I am faced with losing numerous teeth due to trauma from a car accident.
I need a tooth pulled, and the oral surgeon discussed using cadaver tissue to do build bone back up.
He said I could then do an implant after about 4 months. However, an oral maxillofacial surgeon that researched this with a top RSD doctor will not do implants on an RSD person.

So tomorrow I am having the tooth extracted, without any bone grafting.
The bone grafting was to build the bone for the implant.

I don't think ? It is critical to have the bone grafting otherwise ??

I have been trying to research this, but just don't know about the bone grafting..

If anyone knows about this please let me know. Thank you

Hi Pam,

Dealing with RSD can be a PITA. The complications of anything that causes irritation or trauma can be unpredictable.

I am getting the impression that your dental health is not so good and that you have other problems with other teeth. Is that correct?

If so, then it may be wise to look at the whole picture and not just patch up this and that because the inflammation from unhealthy teeth is aggravating the RSD on a continual basis.

I know you don't want a denture, but in looking at the big picture is this truly where you are headed in the future? If so, then it may behoove you to remove the bad teeth and go into a partial denture which can be adapted to accommodate additional teeth as they are removed down the road. In the meantime you would be adapting to wearing the partial denture so when the time came to go into a full denture it would not be so bad. Removing the teeth will lessen the inflammatory burden that is caused by the teeth. The oral surgery may cause a flare up or exacerbate the RSD symptoms. But it would most likely be temporary and in the long run lessen your overall inflammation.

This is not an easy decision. But it would be better to deal with this now before the health of the teeth deteriorates further.

I hope I have explained that okay. Would it be possible for your physicians to work up a medication protocol for you to undergo oral surgery? One that may perhaps lessen the severity of a flare up??

Bryanna

Now I am into day 3 after the extraction.
I see the oral surgeon next week. He will want to schedule me for the bone grafting, so on 3 or 4 months he can put an implant in there.

He showed me how thick an implant is, so they will have to drill through bone to get it in !! Yikes! With RSD really ?

Anyone know about this ???

Hi Tashi,

So at this point how are you feeling? Have you had any flare ups?

Why did he chose not to do the grafting at the time of the extraction? Did he mention anything about the health of the bone at that time?

Grafting is done to stimulate and encourage new growth of your own bone. Grafting does not replace what bone is missing. Your own new bone takes over the graft after several months of healing.

Without the graft to encourage bone growth, you may or may not naturally grow enough bone to hold an implant. Yes, a hole in drilled into the bone and the implant is threaded into the hole. The implant is meant to integrate with the bone similar to your natural tooth. This is why it is imperative for there to be adequate healthy bone to hold the implant.

There is really no way to know if a dental implant will negatively affect the RSD. If it does, it may show itself immediately or some time down the road. I wish there was a more definitive and positive answer to that :/

Bryanna

Thank you Bryanna for your input.
I am into day 5 and the extraction inflammation has finally come down. Now the spots where the injections were given hurt. Those should settle down soon too.

I chose not to have the bone graft done at the time of the extraction as I did not know whether an implant would work for me. I have had RSD for 30 years now, and I do not want to wake the RSD pain..

I see the surgeon in about a week. Then is when he will need an answer as to whether we are going ahead or not. I am thinking not.

If a long car ride 's vibration causes the RSD to flare, I can't imagine what drilling into the bone would do to me.
'If' my body would tolerate the implant, I would do the bone grafting...

From what I have read on some other websites, some people are in bad pain from their implant and are looking for help.

The surgeon is also going to talk with another oral surgeon that has had more experience with RSD people. The other surgeon has researched the issue, and won't do an implant on an RSD person.
So it will be interesting to see what my oral surgeon comes away with from consulting with him.

Hi Tashi,

I think the dental implant is a gamble for you. If it causes a flare there is no telling how severe or how long it would be. It's best to go with your intuition on this one.

Is is possible for you to wear a partial denture?

Bryanna