For people with lupus, oral health is a top priority. In addition to dealing with lupus symptoms like joint pain and hair loss, many MyLupusTeam members must also contend with dental procedures like root canals or tooth extractions. “I have had a lot of trouble with my teeth. I have had root canals, crowns, and teeth pulled,” one member shared.

Are people with lupus more likely to experience dental problems that would require a tooth extraction or root canal? Are there special precautions you and your dentist must take for these procedures? Read on to learn more.

Lupus and Tooth Decay

Many MyLupusTeam members have discussed their experiences with their teeth and dental procedures. “I have had several problems with my teeth since I was diagnosed,” one member wrote. “I have had mouth sores. My gums would swell or become irritated just from me eating. I’ve also had a few of my teeth pulled due to cavities.”

Oral symptoms of lupus are extremely common. The prevalence of tooth decay is nearly 100 percent in those with active lupus disease. One theory is the dry mouth common to people with lupus can compromise tooth health.

Periodontal disease (gum disease) is also common in people with lupus. Gum disease can make your gums swollen and painful, and they may bleed easily. In some cases, it’s possible to lose teeth.

Treating Tooth Decay

Your dentist will recommend treatment options based on the severity of your tooth decay. Possible options include a standard cavity filling, a crown, a root canal, or a tooth extraction. If tooth decay is caught early, your dentist may try fluoride treatments instead of something more invasive.

Crowns, root canals, and extractions are reserved for more serious cases. A crown is a covering over a decayed tooth. A root canal is a procedure to save a tooth with infected pulp (tissue inside the tooth). In an extraction, your tooth is fully removed, and then possibly replaced with an implant.

Dental Considerations for People With Lupus

If you have lupus and are preparing to have a crown, root canal, or tooth extraction, talk to your rheumatologist and your dentist about how your lupus may affect your dental care. You may have an additional risk for infection, inflammation, and irritation. Here are some things to consider.

Mouth Sores

Mouth sores, also called mouth ulcers, are seen in about 40 percent of people with lupus. Dental procedures can increase your risk for these oral ulcers if your gums and mouth are irritated during the dental work. Speak to your dentist if you’re prone to mouth sores, so they can take precautions to prevent irritation and provide you with tips for aftercare.

Dry Mouth

Lupus puts you at increased risk for mouth problems such as xerostomia (dry mouth) and angular cheilitis (cracking and bleeding at the corners of the mouth). These symptoms can make it uncomfortable to keep your mouth open for a long dental procedure. Ask your dentist to see how they can keep you comfortable during your visit.

Neuropathy

People with lupus are already at risk for neuropathy (nerve damage), which may be increased in dental procedures. One member asked, “Has anyone else had painful neuropathy after a root canal?”

Although rare, neuropathy is a risk for anyone undergoing a dental procedure like a root canal, because the teeth hold nerve endings that may be disrupted during the procedure. Imaging before dental procedures usually shows the dentist what areas to avoid and what procedures are necessary to reduce long-term pain.

Infection Risk

Infection risk has been found to be higher in those with lupus after dental procedures. If you are taking an immunosuppressant drug for your autoimmune disease, such as azathioprine or methotrexate, your immune system may be weakened.

People with lupus have a higher risk of infection of the heart valves due to heart valve damage associated with the disease. For this reason, dentists may recommend using antibiotics before some dental procedures. Be sure your dentist is aware of your lupus diagnosis when you schedule any dental procedures, so they can prescribe antibiotics in advance if you need them.

Photosensitivity

The overhead lights in a dentist’s office may increase your risk for photosensitivity. Don’t be afraid to use sunglasses and full-coverage clothing when sitting under that bright dental lamp during your extraction, root canal treatment, or any regular dental checkup.

Medications

Depending on what medication you’re taking for your lupus or other conditions, you may have to alter your medication schedule before your dental procedure. One member shared, “I had to be off my meds for a certain amount of time before my dental work. Check with your rheumatologist, and see if it makes any difference. It all depends on what you're on.”

Never stop taking your lupus medication without first speaking with your rheumatologist, and tell your dentist about all the medications you are on before your dental procedure. This could be especially important if you take blood thinners or immunosuppressive medications. Work together with your dentist and your rheumatologist to decide the safest medication plan before and after your dental procedure.

Sedation and Local Anesthesia

Cavity fillings, crowns, root canals, and tooth extractions are generally performed using a local anesthetic, such as lidocaine. This means the dentist will use a needle to inject the medication into your mouth. Ask your dentist about their plan for local anesthesia, and check with your rheumatologist to ensure there are no concerns.

Sometimes people want to be sedated during their dental procedure. Nitrous oxide — sometimes called “laughing gas” — is commonly used. However, nitrous oxide is not considered appropriate for people with lupus as it can interfere with breathing. Ask your dentist about other options if you’d like to be sedated during your procedure.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 223,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Have you had a dental procedure while living with lupus? What advice can you offer to others who have to get a root canal, extraction, or implant? Share your experience in the comments below, or start a conversation by posting on your Activities page.