Quick help - tooth pain/fracture

Hi, guys,

Sorry for the urgent need here. I have a back molar that has had a small fracture for a while. Typically my dentist has told me that will ultimately need a crown but to wait until the last possible time- painwise- to avoid unnecssary work.

This morning I bit into, of all things, a husk in my oatmeal and the pain was immense. Now it's very sensitive to cold which is new.

Anyway, I have a call in with my dentist and I suspect crown, root canal, or both.

The question: I'm on MTX, Enbrel and other meds. Any concerns with any of the above dental procedures given my meds?

As a side note, I have braces so we'll have to have that band removed as well. Front tooth broke off last year and the braces are there to move everything into better position for an implant eventually.


HI Pignali, I would let the dentist know well in advance about all your meds. I know about MTX and Enbrel with dental work. I'm interested for myself and will follow this discussion. (I'm sure tntlamb knows the answer, he knows everything :-)

Hope you feel better soon !


I'm afraid dentist doesn't fit into my vocabulary. I have a bit of anxiety.

I have gone twice in the last 20 years with my dentists blessing. apparently my picture is posted in every dentist in towns counter, so their never seems to be an opening. Although after a very unpleasant experience several year ago involving a nerve test (they spray something very cold on the tooth and if you react its a dying nerve) I now have a regular dentist he took me as a personal challenge. Anyway once they packed the dentists nose which was not broken (I told him anything that bled that much couldn't be broken) I am now pre-medicated with plenty of valium. (I take a wheel chair in) and am gassed immediately. After they clean my teeth and before I come to they do any other work necessary. Its actually a very pleasant afternoon and if I'm really really good instead of a toy from the treasure chest I get some extra valium to get through the night. Its hard to tell whether I like gas or valium best......

I once went with a temporary over a broken tooth for 9 years (I bought some extras from a dental lab) because I wouldn't do the root canal thing.

To the subject at hand..... Yes contact him I almost always get a pre/post round of antibiotics if there is going to be blood and if an extraction I have to stop any NSAIDS.

FWIW you might need the valium too for a back molar. Some of us have just enough disease effects, we can't open our mouth wide enough to please some of those guys without. I once had a bad spasm and had to have the bite block removed in the hospital ER (they had to put me out)

I have had many crowns and root canals over the past 10 years. There has been no trouble with being on biologics etc while getting dental work. Because of my health issues, and tendency to inflammation, I get my dental work done BEFORE it become unbearable. By the time it is unbearable I usually have out of control inflammation before the procedure, after, or both, and I can take much longer to heal.

I have a tendency to bleed easily, whether that is from 20 years of high dose NSAID's or a tendency that runs in my family, we'll never know. But I remind my dentist, hygienist, and endodontist before every procedure.

I had a crown in December and on the same meds and it was fine.

The only problem you may have is methotrexate and enbrel could weaken the immune system so watch for possible infection and if your dentist gives you pain meds, check and make sure there is no interaction. I have had so many weird reactions to different meds throughout the years, I am hesitant about making any changes in my treatments.