What about gums?

Something weird is happening in my mouth, and I wonder if anybody has any clues or similar experiences. A couple of months back, I had an extraction of an old molar which had had a root canal. I've never had any gum issues, but the dentist wasn't happy with the way I healed. It was puffy and spongy. He opened it up, and cleaned it out. It healed, and this time, only part of the site was puffy and spongy. So this time, he really cleaned it out, and sent a tissue sample to the lab.

This morning I was wondering whether this might have anything to do with the DMARDs. I've been on MTX since last September, 20 or 25 mg, oral until last month, then injectable. I've also been on leflunomide and sulfasalazine (now discontinued). Last month I took leflunomide onboard. But MTX has been the main med.

Does anybody out there have any experiences or knowledge of gum problems with MTX?

Yes Yes Yes did I mention Yes? Its a known side effect!!!!!! This May be your ticket to the biologicals!!!!!!!

I have been noticing that my gums have been tender and a bit puffy and bleeding a bit when I brush my teeth. This never happened before I was on Methotrexate......so lamb, am I to assume from your remarks that this would be the case for me as well, that this is likely from the MTX????

Could be....

http://www.livestrong.com/article/167654-side-effects-of-methotraxate/

may not be enough to warrant a change in drugs though... With seenie and several months with no effects it might help.

Unfortunately, this problem could go either way… disease or medication side effects. I’m currently dealing with dental issues myself and did a little research on it. Apparently, autoimmune diseases have been linked to many dental problems. However, medications we take for our problems can also be a cause dental problems and inhibit healing as well. Unfortunately, it’s a double edge sword when dealing with dental health in our situations.

Cantwell,

Welcome to the forum, and thanks for your reply. I think I need to do a bit more research too. What have your best sources been?

Take care! I'm sorry you've joined the PsA club, but I'm glad you're here.

Seenie

Hope this helps get you gal on the biologics! We want you both feeling well, you too cantwell, then we can change your name to amwell!

Seenie, is it possible that it's from the DISEASE? I've experienced weird stuff with my teeth over the past 5 years. Two broke while I bit into soft foods (a french fry, in one case,) another one chipped when I bit my nail. I've often thought that these are weird occurrences. Any possibility that mouth issues can be linked to our illnesses and not the meds?

Hi, Petunia

Yes, I'm thinking that the problem could well be as you suggest. I know that inflammation hampers healing, and I know mtx isn't doing me a whole lot of good. So perhaps it is the inflammation from the PsA itself. The dentist has sent a biopsy off, so we will see what transpires.

I'm really not liking this. Nor the PsA, of course.

Seenie

Yes it is very possible. Try googling autoimmune disease and peridontal disease and you can read numerous articles on the links between the two conditions. After discussions with my dentist though dry mouth seems to be the only side effect that I suffer from that could contribute to my dental health in a negative way at this time… however there is always the unknown that we are not seeing. It could be one or the other or both!? Geez… it is a never ending battle with this disease!

Thanks for putting me on a slightly different train of thought. Here's what I found at

http://www.umm.edu/patiented/articles/what_causes_periodontal_disease_000024_3.htm

The Autoimmune and Inflammatory Response

Evidence indicates that periodontal disease is an autoimmune disorder, in which immune factors in the body attack the person's own cells and tissue -- in this case, those in the gum. It appears to work like this:

  • The bacteria that form plaque and tartar release toxins that stimulate the immune system to overproduce powerful infection-fighting factors called cytokines.
  • Ordinarily, cytokines are important for healing. In excess, however, they can cause inflammation and severe damage.
  • In addition, white blood cells produced by the immune response to bacteria also release a family of enzymes called matrix metalloproteinases (MMPs), which break down connective tissue.

Studies suggest that this inflammatory response may have damaging effects not only in the gums but also in organs throughout the body, including the heart.

Read more: http://www.umm.edu/patiented/articles/what_causes_periodontal_disease_000024_3.htm#ixzz1yN89a4l7

So maybe this gum/healing issue is just another manifestation of the inflammation in my body. I have a family doc appointment tomorrow. I'll add that to my list!

NO NO NO, its the MTX and you need off of it immediaatly and on Enbrel....

Buy 'em books, send 'em to school and they still cant' cut and paste out of context from the internet sheesh!

LOL, Lamb knows what my heart desires!

tntlamb said:

NO NO NO, its the MTX and you need off of it immediaatly and on Enbrel....

Buy 'em books, send 'em to school and they still cant' cut and paste out of context from the internet sheesh!

Listen to the wise old lamb, Seenie! Enbrel could just have you back on the wine tasting circuit!

So heres what I think,

If seenie gets her Bio and off the MTX (push for enbrel 'cause its mono therapy and they don't often use mtx with it) We have first celabratory wine tasting.... We will have two wines a non alcholic Chardonay thats readily available for those still on DMRDS and a resaonably priced bottle of Seenies choosing. She will then guide us in first reurn tasting.....

She could do webinars, or even blog about pairings specializing in chardonays which of course are pelntiful relativley inexpensive AND low carb

If she prefers we can all go to facebook where she will do it by web cam or use the shout/chat box here if it goes well she could then become the first online sommlier (course she could fake it with grape juice then she doesn't have to spit the spat) she could set up a pay pal account to sell a password to her weekly tastings.

i don't blame you a bit. It's not cool when your gums are inflammed or infected and not healing properly. Maybe your doctor and your dentist need to have a conversation about this issue.

Seenie said:

Hi, Petunia

Yes, I'm thinking that the problem could well be as you suggest. I know that inflammation hampers healing, and I know mtx isn't doing me a whole lot of good. So perhaps it is the inflammation from the PsA itself. The dentist has sent a biopsy off, so we will see what transpires.

I'm really not liking this. Nor the PsA, of course.

Seenie

Ahhhhhhhhhhhhhh, I take it you want off MTX and on Enbrel. Well, like lamb said, here's a good opportunity.


Seenie said:

LOL, Lamb knows what my heart desires!

tntlamb said:

NO NO NO, its the MTX and you need off of it immediaatly and on Enbrel....

Buy 'em books, send 'em to school and they still cant' cut and paste out of context from the internet sheesh!

Lamb, you rogue, you've made my day! An on-line wine tasting -- a viticultural first! Online organoleptics!

Brilliant. Thanks for the smile.

Seenie


tntlamb said:

So heres what I think,

If seenie gets her Bio and off the MTX (push for enbrel 'cause its mono therapy and they don't often use mtx with it) We have first celabratory wine tasting.... We will have two wines a non alcholic Chardonay thats readily available for those still on DMRDS and a resaonably priced bottle of Seenies choosing. She will then guide us in first reurn tasting.....

She could do webinars, or even blog about pairings specializing in chardonays which of course are pelntiful relativley inexpensive AND low carb

If she prefers we can all go to facebook where she will do it by web cam or use the shout/chat box here if it goes well she could then become the first online sommlier (course she could fake it with grape juice then she doesn't have to spit the spat) she could set up a pay pal account to sell a password to her weekly tastings.

Sounds like lamb has big plans for you, Seenie!! Look out!!

tntlamb said:

So heres what I think,

If seenie gets her Bio and off the MTX (push for enbrel 'cause its mono therapy and they don't often use mtx with it) We have first celabratory wine tasting.... We will have two wines a non alcholic Chardonay thats readily available for those still on DMRDS and a resaonably priced bottle of Seenies choosing. She will then guide us in first reurn tasting.....

She could do webinars, or even blog about pairings specializing in chardonays which of course are pelntiful relativley inexpensive AND low carb

If she prefers we can all go to facebook where she will do it by web cam or use the shout/chat box here if it goes well she could then become the first online sommlier (course she could fake it with grape juice then she doesn't have to spit the spat) she could set up a pay pal account to sell a password to her weekly tastings.Soun

Yes, Petunia, that's the general idea. I've been on mtx since September, with various other DMARDs thrown in. No improvement. I am on this regime until September, and if nothing has improved, it's then a bio for me.

Long story short: I drink veeeeery moderately. Really, I'm not lyin'. In the good old days, I regularly enjoyed a glass of wine. I'm terrified of liver problems, though, so I've been on the wagon since starting mtx. The rheumy really put the fear into me when she added leflunomide last month. The heartbreak of sobriety is getting very very old.


Petunia Girl said:

Ahhhhhhhhhhhhhh, I take it you want off MTX and on Enbrel. Well, like lamb said, here's a good opportunity.


Seenie said:

LOL, Lamb knows what my heart desires!

tntlamb said:

NO NO NO, its the MTX and you need off of it immediaatly and on Enbrel....

Buy 'em books, send 'em to school and they still cant' cut and paste out of context from the internet sheesh!