Rheumatoid Arthritis Support Group

Rheumatoid arthritis is a chronic, inflammatory, multisystem, autoimmune disorder. It is a disabling and painful condition which can lead to substantial loss of mobility due to pain and joint destruction. The disease is also systemic in that it often also affects many extra-articular tissues throughout the body including the skin, blood vessels, heart, lungs, and...

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LynnRivers 08/19/2009

Well I only made it to the sixth week of Enbrel shots before I developed an infection. I didn't take my sixth shot because a gum infection in my right lower molar flared up. I had this type of absces about three years ago right before my first RA flare. Its caused by the errosion of the gum from gum disease (smoking) and they put me on antibiotics and I had several cleanings and everything seemed to be fine.

I guess it wasn't really fine, just my overactive immune system keeping the infection at bay. And now wham bam a couple of weeks of real immunosuppresion and its back, worse than ever. I guess it tells me the Enbrel is working, so thats good I guess. I'll probably miss three or even four shots before I get this resolved. I have quit smoking over a year ago, so I thought my gums were getting better.

I'm considering just having the back molar pulled and let that be the end of it. Its probably a referral to a periodontist who will recommend gum surgery that may or may not resolve the problem. I don't have any coverage for dental.

What do you think, pull the tooth? or see the periodontist and open my wallet?

KiddoGal 08/19/2009

Hello Lynn...I don't have an answer for you on this one, but was wondering how the Enbrel shots are working for you since we both went on them about the same time. I don't think I am having much luck with Enbrel. My knees are still swollen and three weeks ago my RA doctor put me on low dose Methotrexate. I tried to lower the prednisone dose by just a tiny bit but could tell that my swelling increased. I have had no side effects from Enbrel and no infections to date. Anyway is Enbrel working for you?

deleted_user 08/19/2009

I've been on the Enbrel for 6 months now and absolutely love it. THe down side, it does turn a regular infection to monster mutant infections. I've had to stop taking it a number of times. The first was an abscess molar (by the way, pulled it) the other was bronchitis turned pneumonia, then there was the UTI (that one was fun!) But all in all, if you can catch the infection when it starts, before it get's out of control, it won't get too bad.

I hate that your having problems with your teeth and hope it gets better soon. And if I were you, I would have it pulled, it's easier in the long run and you can always get a partial.

lycesq 08/20/2009

Lynn - I'm sorry you have to deal with the infection issue; it's hard enough finding the right drug. To pull or not to pull - I'm just torn. I had a tooth pulled (it was irreparably cracked) and wouldn't recommend that to anyone but is sounds like this could help. Have you talked to your rheumy about it?

Lynne

deleted_user 08/20/2009

My 10 year old son with JRA has had a lot of success with Enbrel, although he was hospitalized for what started as a common cold. He noticed real results after the seventh shot, when he woke up one morning and looked at me and said "Mommy, I don't feel ever so sick anymore!" I did not have the same results. I am very sorry to hear you only made it through five injections.

As far as your tooth, I don't know what to tell you. I would see the specialist, but I live in a country where I would pay minimal costs for the surgery. I am very sorry you are stuck in this situation.

Feel better

Cheers,

Aoife

wrenchead 08/20/2009

I would think if it was working that you would want to be on it. The tooth being pulled would be reflected by if you have others pulled, your age, what your research tells you about reoccurring issues. I dont know if I would be opening my wallet for " A " tooth, if it was a couple that were bad it might be a different story. Hope you get it sorted out.

deleted_user 08/20/2009

Lynn, this is a very interesting post to me. I am on Enbrel (my 2nd month) and have 2 infections in my back lower teeth. Had a root canal on one, have to see a specialist for the other. The dentist did not feel there was a connection, now I guess maybe. I also have been trying to decide whether to just pull them, but I think I will crown them both if the infection clears. Hopefully yours resolves soon.

As far as Enbrel, I have seen about 50 improvement in symptoms but still frustrated with my pain. The Rheumie says I will likely see improvement over the next 4 months. I sure hope so, this is my first medication for my disease.

Heather

deleted_user 08/20/2009

if you are able to afford it i would try and save the tooth.I have been on enbrel since jan 2003 and had great results after the 1st injection.but for the past year or so i think it is not working so well. actually right now my feet hurt so bad i can hardly walk.This morning I was just fine.anyways i have had no serious infections while on enbrel.got an infected finger after a manicure one time thats not on any other meds just ibuprofen when i need it; llike tonight!!

LynnRivers 08/21/2009

My RA symptoms have been fading on thier own since January of this year. I'm not expriencing an acute flare so its hard for me to judge if the Enbrel is helping. I'm more worried about stopping or possibly reversing the damage the RA has already done. Any pain I have now is from the damage to the joints not active inflamtion. However I just noticed the the RA nodule on my left wrist is gone. I saw that is was getting smaller last week but it is gone now so the
Enbrel must be working.

I want to stay on the Enbrel becuase the other DMARD's are not stopping the progression of the disease. I'll ask my dentist on Monday if he thinks pulling the tooth now will absolutely 100% fix the issue. If it will then that's what I think I should do. I think my RA treatment is more important that just one tooth even though I'm only 36.

Thank you all for sharing and your input.

LynnRivers 08/26/2009

Just another update on the tooth. I think the tooth is toast. The dentist said the prognosis is not good. I have a 9mm errosion of the bone under the tooth (that's the jaw bone that holds the tooth in). The tooth itself seems to be fine just practically nothing left to hold it. I've been on clindamycin for 8 days now and the irritated gum is still not healed. I may need to try another antibiotic and another whole week of pills. I seem to be healing really slow.

My dentist wants to wait until the gum is all healed before he pulls the tooth. There is apparently no way to regrow or restore the bone under the tooth.

Looks more like 6 weeks off the Enbrel before this will be resolved.

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