Tooth Decay and RA

Last updated: December 2023

I have had issues with my teeth ever since my RA diagnosis (circa 2010). I went from perfect pearly whites to hell in my mouth in the span of a few months. 

But, I learned this was one of the cute little comorbidities we get to handle as chronic illness patients, so I’ve tried to navigate this additional journey as best as I can. I have shared my journey with my teeth before, but it has been relatively quiet on this front for a little while. Today's tale started about a year ago, in November 2022.

A new, stinging pain in my mouth

I felt a sharp, acute pain in the top left quadrant of my mouth. It was a new, stinging pain I had not yet experienced. This acute pain wasn’t persistent, and it came and went over a few days.

I used a steroidal mouthwash for about a week. (Unrelated, those mouthwashes are NASTY. If you take oral steroids, you may have experienced that film after swallowing those pills. The steroidal mouthwash is that but 5 times worse!) The pain went away.

It was like a jackhammer on my nerve

Let us fast forward to June 2023: I was preparing for surgery (a hysterectomy) over my summer holidays (I am currently a student), and I woke up to a pain that was UNREAL. It came in like a wrecking ball; a persistent, angry Grond (I have waited FOREVER to use this reference!). I could feel it through my daily pain medications. It was like a jackhammer poking at my nerve.

I went to the dentist, and they found an advanced cavity. We were previously aware of this cavity, but at the time of my last appointment, a year prior, it was a little bitty thing we left alone. Fast forward 12 months, and the nerve was dying and was infected.

A referral to a surgeon

Unfortunately, due to some of the medications I am on, my general dentist wanted a dental surgeon who specialized in teeth removals to perform the extraction. Personally, I don’t know much on the subject, but if this was the safer option, I was all for it.

Now, this next part upsets me. Remember, I was in a massive amount of acute, stinging pain. It was persistent, and I was not sleeping. This is not an exaggeration. I was not sleeping. The only relief I felt was from swilling lukewarm water in my mouth every 3 seconds. The pain would come back full force immediately. I couldn’t lay down.

I called the surgeon the dentist recommended, and they said they couldn’t get me in for over 30 days, and I had to go in for a consult before returning for the procedure. I’m sorry, WHAT?! I had just said I hadn’t slept in over 36 hours because of the pain!

This or That

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The relief from the tooth extraction was instant

My general dentist recommended someone else and said that if I couldn’t get in within the next 2 days, he would perform the procedure. Thankfully, the second surgeon had me come in immediately, took one look, and said, "We’re taking this out now. The benefits far outweigh the risks."

I have never felt better. The relief was INSTANT. The surgeon prescribed narcotics, but I never picked them up. It was night and day. The pain from the dying nerve was so bad that an extraction felt like nothing.

I try to do everything right, but I still have teeth problems

When the euphoria of finally feeling well wore off, I became frustrated. I take care of my teeth! I use a prescription fluoride toothpaste, I floss twice a day, I chew xylitol gum. I try to do everything right, but somehow, my teeth literally fall out!

I very honestly asked my doctor, "Is it my hygiene? Am I doing something wrong?" He told me he didn’t have to do a full cleaning because my teeth were so clean. It wasn’t anything I was doing, but that’s somehow worse! I can't do anything about this?

Sometimes, it's not the RA by itself that gets me; it’s these silly comorbidities that wreak havoc on my system. What’s the point of trying if it’s just going to go one way, anyways? Though, that being said, I’m sure my teeth could be a lot worse if I didn’t do the aforementioned things.

How about you? Have you noticed an uptick in teeth issues since your RA diagnosis? Let me know in the comments!

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