Lupus + orthodontics

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#1 Post by **iamtheotherme** » Tue Jun 17, 2008 7:39 am

Long-time lurker, first-time poster. I've read this forum a long time to get up the nerve to go get an ortho consult, which I did recently. The ortho mentioned something that I hadn't considered and have not found discussed here: how my lupus (systemic lupus erythematosus) can affect tooth movement.

The ortho explained that tooth movement is essentially inflammation and that anti-inflammatories taken for lupus can slow the movement. I know Meryaten posted an article a while back about how NSAIDs can affect tooth movement, which was useful. Beyond that though, I haven't been able to find additional articles (that I have access to or in which I could decipher the jargon) nor anyone with the particular experience of having lupus and braces, so I thought I would inquire here for some additional insight. Thanks in advance!

#2 Post by **purpleteeth** » Tue Jun 17, 2008 2:22 pm

Many people with TMJ take anti-inflam drugs while in braces, myself being one of them --- I even go to the extent of using Aspirin (which works, however it does not amuse my dentist I use this...). I am supposed to take Advil 2/3 times a day regularly, alternating with Tynelol and or Aspirin because I have chronic inflam in my jaw... which limits movement, causes pain, etc...

Have you talked with your primary care about this?

#3 Post by ***melissa*** » Wed Jun 18, 2008 7:01 am

i have constant pain, doc thinks its fibromyalgia...i have to take Motrin everyday otherwise i wouldnt make it to work...anyways, that being said, my teeth have been moving quickly these past 3 months...

#4 Post by **iamtheotherme** » Wed Jun 18, 2008 10:14 am

Thanks for your responses. I see my rheumatologist next month and I'll discuss it with her then. She is wonderful, but hasn't been a great source of information on All Things Dental. Over the last few months, I've had a good deal of dental work. I consulted with her on many points, but she didn't have a lot to offer beyond the usual advice (keep up with the meds if I can, rest more as appropriate, etc.). It's entirely possible that the lupus may not be a big consideration in dental issues, but I like to know as much as I can.

The first ortho I saw seemed to think that the medication could slow things down considerably, to the tune of 30% longer treatment. I have an consultation with another ortho on Monday; I'll ask him about this now that the possibility of lupus affecting treatment is on my radar.

Melissa, I hope you find the source of the pain soon and find some relief. That your doc is willing to even suggest fibro (rather than "it's in your head") is a promising sign. Good luck.

#5 Post by ***melissa*** » Wed Jun 18, 2008 10:48 am

iamtheotherme, thanks for your kind thoughts. I have had a couple docs act like the pain was in my head... in fact, I have changed doctors about 3 times now because they act like there's nothing they can do for me except give me depression drugs.. I have Kaiser and most docs from Kaiser that I've seen all act the same way..like they don't believe me. I've taken soo many blood tests. About 4 have come back abnormal and yet, they still "don't know what to do for me"...its very frustrating to have doctors act like they don't believe you....

#6 Post by **rolo** » Wed Jun 18, 2008 11:11 am

Hi could you post me the details of Meryaten's article on NSAIDs, I'm a pharmacist and haven't come across this professionally before. I'm interested to know more. I did have a look on a couple of UK product lic for commonly used NSAIDs and couldn't find any mention of this. I would like to evaluate the evidence so I can warn patients if significant. If anyone knows of any actually cases of this happening to them could you post and let me know.
Thanks

#7 Post by **eggraid101** » Thu Jun 19, 2008 6:20 am

I think the association of NSAIDS slowing tooth movement is more theoretical than practical. The study that you guys cited from the pharmacologic journal analyzed other articles to look for an association, but it looks like these articles were looking at movement in animals. That is helpful, but I wouldn't call it a definitive conclusion. It would take a prospective study on humans to really prove that there is a cause/effect relationship. The abstracts cited also never really say how much it affects tooth movement. I do have several patients who have lupus and take 1800-2400 mg of ibuprofen every single day to manage it, and their teeth do move. Maybe if they were not taking the meds their teeth would move faster, but they've got to take them, and so we work with it. We have to make compromises every day in how we treat people: everyone is truly different, and we just work with what we're given and do the best we can!

So what it boils down to is that I'm confident your teeth will move; they may move a little more slowly than ideally they would, but it's hard to say for sure.

#8 Post by **iamtheotherme** » Thu Jun 19, 2008 6:31 am

Meryaten, thank you kindly for finding your post. It was taking more time to find it again than I could afford at work.

Dr. Mullen, thank you for sharing that experience with me. I too am confident that my teeth will move, but was seeking a bit more granularity on the details so I could ask more intelligent questions at my next ortho consult. You've given me some good insight that will help me be more prepared.

I am very lucky that my lupus is under control with very minimal medication, so I hope it won't be much of an issue at all. I'm happy to share whatever else I find out and my personal experience once I get the darned braces on.

Thank you all for indulging my nerdy, need-to-research-everything-to-death side.