Here's Your Gold Watch - Rheutired: implants

Showing posts with label implants. Show all posts

Friday, 14 November 2014

RA, Sjogren's and Dental Implants

People with rheumatoid arthritis know, or ought to know, that it affects their bones. Of course the effects on the joints are the first thing you think of. I knew that but unfortunately it did not cause me to realize that all of my bones might be at risk. Osteoporosis came as a real surprise 15 years after my diagnosis, and now I take calcium and Vitamin D and exercise more.

But it gets worse. With a diagnosis of Sjogren's Syndrome you suddenly find that your teeth require a lot more attention. Sjogren's causes dryness of the eyes and mouth - those are the two most famous and obvious symptoms. That lack of saliva in the mouth is very bad for your teeth. I have at least one acquaintance who just gave up and had all of her remaining teeth removed and got dentures.

You would have thought that was a good solution but it turns out you need saliva to keep your dentures in place and to make them feel comfortable.

The next possible solution for the teeth problem is implants. I heard a very enthusiastic dentist say implants are great and will solve all of our problems. So far losing has not been an issue, but as I have been mulling this over, all the RA bone quality issues came into my mind. Now I am wondering if the quality of the bone in the jaw with RA is good enough to sustain implants. It probably varies from person to person.

This is a story from Julie in an online group where we are both members

"I just saw my dentist a few weeks ago and he again suggested a dental implant. On further examination of the X-rays - he changed his mind. He is also concerned about the RA and my age. Like Polly has said before - "I scare doctors".

I really don't know whether to try one or not. I don't want to get in a bigger mess - if you know what I mean. The Oral Surgeon that had a good look at the bone structure when he was extracting the tooth and the cyst was the person that said I didn't have enough bone. He said I would need a bone graft and that didn't sound pleasant at all. He didn't know if it would even work, plus it would take a year to heal."

That leaves all of us with RA and Sjogren's with some tough choices to consider in the future.

BrookburnPrimary.net

Comment from Jean Nov 16/14: I have had bone grafts 3 or 4 times, mostly related to implants. They have all worked. They grind up bones from cadavers, sterilized of course. It may take up for a year (I seem to remember 6 mths) for the bones to meld together so that you can complete the implant but that’s no big deal. I don’t even remember how they inserted the bone; possibly it was ground up enough that it happened through a needle and syringe, but obviously that wasn’t a problem since I don’t even remember

Saturday, 13 July 2013

Part 4. Immune System Gone Wild. Dr Carl Laskin and Dr Izchak Barzilay

Dr Carl Laskin was kind enough to fill in for a speaker who had to cancel because of family emergency. He is a reproductive endocrinologist, a wombatologist as he so colourfully described himself, and the head of the Lifequest Centre for Reproductive Medicine. He told us that autoimmune disease is not often a big problem in pregnancy.

The goal is to identify the effect of the underlying disease on pregnancy and pre-plan the pregnancy based on medications and the current disease activity as well as social situation (how you would be able to manage). Autoimmune is the gift that keeps on taking as we know.

He felt that you could conceive and carry a child while taking anti-TNF drugs but definitely not on methotrexate. We learned that ObGyns are on the alert for Ro and La. Sick Children's Hospital has a program where an ultrasound of the electrical systems of a baby's heart can be done at between 20 and 32 weeks. Pregnancy is seen less often with Sjogren's Syndrome because the majority of patients are post menopausal.

Next we heard from Dr Izchak Barzilay who is the Head of the Division of Prosthodontics and Restorative Dentistry at the University of Toronto. He told us that with Sjogren's Syndrome we could face problems with dental adhesives and dentures in general because you need saliva to be comfortable with dentures. With denture adhesive you often lose tissue when you remove the denture.

An example only

He gave us background on shapes and sizes of implants and told us that there is a 95% success rate in 10 years. This was seconded by Dr Papas who has a 97% success rate in 200 patients. The implant must be "kind" to soft tissue. Titanium is reliable, and you can count on it to work. The key to successful implants is healthy bone to support them and even grafted bone can be used.