Dental work with RSD?
 

My girlfriend just got her braces off about 2 weeks ago, her tooth, second to the back is just falling apart. It looks like she will need a root canal. What is the best way to approach this? Pull it, try to save it with a root canal?

I'm afraid fixing the tooth might trigger something and then have pain in more than just her hand and arm. It is something that needs to be done. Can't just ignore a rotting tooth.

Anyone with suggestions? We are still "new" to this disease, condition, whatever it is. :(

Thanks,
Heffe

I wish I could tell you. I have the same kind of teeth problems, and am sooo afraid to go to the dentist.

So I will be watching this thread too :laptop:

Teeth problems freak me out anyway, now I have CRPS I am petrified.

My dentist remarked quite a while back (pre-CRPS) when I had problems with a molar (including a botched root canal - not by him), that even if he was able to do a successful root canal on the tooth, it might last as much as 10-15 years at best, and that in the end he would have to take it out anyway, and it was best to just get rid of it cleanly now rather than possibly end up doing several painful and ultimately unsuccessful procedures first to try and save it.

I've never forgotten that, and I've heard enough stories from friends and relatives to be extremely glad he did just take it out. I had sedation back then (told you I was petrified :rolleyes:) and although it wasn't pleasant for the next couple of days, it was still preferable to the alternative.

With CRPS, I don't think it is worth mucking about at all. The risks are too great. Take your dentist a print out on the main symptoms of CRPS, and a list of treatment protocols. Make sure he understands that the main aim is to cause as little tissue and nerve damage as possible, and for the procedure to take place as calmly as possible, with minimal pain. He will need to numb the area twice as much as he normally would, both before and after the extraction. I would strongly advise sedation, because anxiety can cause CRPS to worsen and there is more risk of spread. The risk of spread is what marks the risks to a CRPS patient out as different to someone with a heightened sensation of pain due to a nerve problem. My dentist had heard of that, but had not heard of CRPS - I had to explain the distinction.

The only other thing you can do is make sure she has some strong painkillers on hand for a week or more afterwards so that any post-extraction pain is kept under control. Might be worth a visit to her GP to discuss is he can give her something stronger than usual. Oh, and take 500mg vitamin C twice daily for at last a two weeks afterwards (with food), to help prevent spread.

Really good luck to her. Tell her to try not to panic - I've read quite a lot about this because I'm so scared of it, and I truly believe that if your dentist is prepared and the procedure is properly planned, everything should be ok.

Bram.

I just recently had some dental work done. They have done other teeth but this last one is still really sensitive. If she decides to have it fixed she needs to talk to her PM and Dentist. Also both of them need to coordinate between them the best coarse of action. I looked up dental work and CRPS recently and found out stuff I didn't know I needed to know. Next time I have anything done on my mouth I am going to talk to both of my people and have them coordinate between them and me on the right course for us to take. It sucks that the simplest thing like getting a tooth filled now can lead to spread of this darn monster.

What my dentist did for my teeth and and just for a cleaning and fillings he called my pain doctor to find out of how to treat me. He totally sedates me along with a ketamine drip, strong morphine before and after the prceedure. He also numbs the area before the filling and before I wake up so its numb longer. He is and anesthesia dentist and has like 4-5 different ways of sedating someone from just laughing gas to totallying puting you out where you use a breathing tube thats what I do. But my RSD is full body and internal and any slight injury could send me into the hospital. This is the same thing they do just for an MRI. Iam not sure if your dentist does sedation and keeps pain meds in hand but thats something that should be at least close to hand. Everyone is different in what they need or can tolorate to get through a proceedure.

I just wanted to share with you all something I learned from both my PM and dentist recently. Many of the medications we all take cause dry mouth apparently this is the main reason we end up having horrible tooth problems suddenly. My PM cautioned me more than once to make sure my mouth stays well hydrated even if that means sucking on lemon drops.. she said she has seen to many people lose multiple teeth due to this medication side effect.

Wishing you an uncomplicated solution.. sorry I don't have familiarity with root canals after CRPS.

Kindly,
Tessa

Hi Heffe.

I have had alot of dental work done since my diagnosis of RSD. I was afraid of the spread, but my pm dr, neurologist and dentist told me they didn't think it would be a problem. None of them know for sure, because there is not much known about this disease yet. I had a failed root canal had the tooth pulled. I had no choice. The pain was unbearable and it was also infected.

Had alot of dry sockets from it and it took forever to heal, but it did heal and I didn't see any spread of my RSD because of it. I"ve also had a crown put on another tooth recently, and it was very painful while in the process, so I started asking my dentist to numb the heck out of it first, and that seemed to help. I didn't have a spread with that so far either.

Since I am not a doctor, I would suggest she ask all her doctors what they think is the best approach, so that she can make an informed decision.

Hope I helped and I hope she feels better soon, and please tell her I said hi.

Dental work with RSD??
 

I have been having major problem's with my teeth!! Every time I go to my dentist,i first have to take 4 pill's of Amoxicillin 500mg 1 hour before I go. Then it seem's everytime I go there is another problem! Either with teeth cracking,bonding coming loose,etc!! I told him if he could find a treatment for paitent's with RSD he would never have to work again!! It all has to do with the nerve ending's below the teeth. If anyone know's what would make it better I would sure like to know!! :eek: I have now had full body RSD 1986 I think? The Dr's have told me that they were sure that I would be in a wheel chair by now!! I think you just have to keep moving the best that you can! Hang in there everyone it sure is a bumpy ride!! Breezy55~ :grouphug:

Yeah most of the meds give all of us dry mouth which causes dental problems. I also personally think something about rsd messes up our teeth. I'm not a Dr just a sufferer. I have had dental issues all my life but its been more pronounced since I got this darn disease. I have had fillings fall out crowns fall off or move, and even more cavities than isnormal for me. I suck on peppermints and brush 3 times a day but still have to get them filled. I have also found that the new white fillings hurt me more than the regular silver fillings. I don't know why but I have had 2 white fillings and they hurt so much to this day. The silver ones I have gotten don't hurt as much. I have also found my jaw is so sore I have to go on a liquid diet for about 2 to 3 weeks, even after a simple cleaning. But we are all different remember that.

I've broken about 6 teeth, mostly molars and had to have root canals on them since I got RSD. I was massively grinding my teeth at night and didn't know it and they started fracturing and pieces were breaking off. Unfortunately I had an idiot of a dentist back in the beginning RSD years. He would send me out for a Root Canal and never once suggested a Bite Guard. FOr the last 7 years or so I've worn that bite guard faithfully, even for a nap and it's helped immensely. I also have horrible dry mouth like everyone else here, so that has caused me a couple of cavities as well. I cant have epinephrine which is in the normal stuff most dentists use as local anesthesia. The substitutes that much longer to deaden the nerves and I often need several injections because the first one or two never work. I hate going to the dentist, massively hate it.

One I just had removed, rather than having the root canal. I have another one that my dentist just patched without putting me under. She was really careful in removing part of the old filling and patching it without touching areas that would send me though the roof. I had already decided if she suggested the root canal, that I would just have it removed. I found that less stressful. In all cases I knew I had to have the dental work done. My RSD spread to my head and face after those first few years so I don;'t know if that work contributed to the spread I experienced across the rest of my body or not, but I don't contribute it to the dental work. Maybe that's me just trying to cope with the dental work I needed. I don't know. I do know as long as it's a tooth that's not so visible I would choose to have the tooth removed now and If anyone has problems with tooth breaking, I would highly suggest a night guard.

I just wanted to also let you know I had my pm okay extra med meds from my dentist to take a few weeks after the procedures done. With RSD, there is an increased sensitivity to pain, and it helps to get through it by doing this. Also, I prefer to be have teeth pulled under anesthia. Not only because of fear feeling pain, but because of my stress level going up. Stress makes my RSD flare up more. Of course check with drs to make sure they are all okay with this. I hope your friend is doing okay. Soft hugs to you and her.

I've had to have a LOT of dental work done this year. I've had 7 teeth pulled and two permanent bridges put in. For all of this I've had them sedate me so I don't even remember anything.

I told my dentist root canals were not an option. I've read there is a risk of spread when it comes to root canals and it is better to just have the teeth pulled. I have also read up a lot on root canals and I don't like what I read. A root canal takes care of the pain (assuming there is no spread) but it doesn't kill the infection in the tooth. Over time this can result in a weakened tooth and possible spread of that infection (this is for everyone...not specific to patients with RSD). I read up a lot on this after (this year) a tooth I had a root canal in when I was a child (many many years pre-rsd) snapped off at the gum line. Last month the same thing happened to my mom where her two front teeth just snapped off at the gum line. Both of those teeth had had root canals.

So...I personally wouldn't recommend a root canal and I would recommend trying to find a sedation dentist to do the work. I feel much more comfortable going that route...if for no other reason than I am MUCH less stressed (and we all know how stress affects our RSD). I am by no means an expert on any of these things...just relating my experience and my thoughts on why I went the way I did regarding root canals and dental work.

It depends on your dentist. Mine puts an antibiotic ointment into the tooth before the rods and before he puts either a temp or permanent crown on. I have had a ton of root canals done. All my molars are crowned. The bad thing is with crps my jaw bone on the bottom is shifting some so my teeth arent aligned right anymore. I am almost to the point of telling them to sedate me and pull them. I haven't quite gotten there though. Plus I'm not sure if my dental coverage will cover it.

I just had the same tooth worked on in July. I had a crown prep done and ended up with my first root canal a few weeks later and then the crown put on. My pain pump does not cover head aches, tooth aches, or stomach aches. So I ended up taking over 300 pills of Advil plus some 800mg of ibuprofen that the dentist sent home with me. Amoxicillin 500mg was also needed and this helped the most even though I was only on it for 3 days as far as the pain leading to the root canal. Last month I had the molar behind it crowned too. They had to cut the old gold crown off. They did not know of the decay because X-rays cannot see thru a gold crown so like others were saying about CRPS people having dry mouth or their ph slightly changing, you really have to get in for cleanings 2-4 times a year if possible.

Now to answer the question about the pain spreading. For me the short answer is no but be prepared to be miserable until that tooth is fixed. If doing a crown and you have to do a root canal you might want to pay the extra charge of getting the crown back to the dentist faster. Normally you get a temporary put in for 3 weeks until the real crown is made and sent to your dentist's office. I did not know I could of done that and I sure wish someone would of told me. All those pills I took had my stomach hurting more than my CRPS pain at times. After the crown and root canal were done, it took about a week before the pain(tooth) was gone. The second crown went smoothly and did not require a root canal.

Look into MI paste on how it can help. I put it on and can feel the pain melting pretty fast. Oasis mouthwash is my favorite of the dry mouth washes on the market but it can be difficult to find in some stores. Remember to brush your tongue and if you are having a horrible pain day and the last thing you want to do is stand in front of a mirror for 2 minutes then at least dry brush quickly.

There are some pretty bad horror stories from CRPS people who lost the battle with their teeth.

Good luck