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Immunosuppresants & possible infection

A

anon13

Junior member
Joined
Feb 14, 2011
Messages
3
Location
North East UK
Just some quick facts. I'm in the UK, aged 50, on immunosuppressants (tacrolimus, azathioprene) for life (liver transplant) and six other drugs. Apart from toothache I am in good health(ish).

I had a lost filling replaced in a lower 2nd molar seven weeks ago, NHS treatment. It has within the last two weeks become very tender to bite on. As a result I saw a [different] dentist at the same practice and she told me much to my surprise that it was capped. I've checked it and it is indeed entirely covered in what looks like poor mans gold. When she probed and picked at the tooth there was virtually no pain, however when she tapped it it hurts like hell. She mentioned dreaded words like "root canal", "extraction" and "antibiotics". I immediately alerted her to my immunosuppressants, she then looked in a book, the BNF perhaps? The verdict was that they are referring me to a specialist practice and they'll get back to me, who knows when? Meanwhile my tooth throbs and aches and has woken me up at night. I'm taking paracetamol & aspirin about twice a day to mitigate the pain. What I am thinking is that I should really be referred to a dental hospital. The nearest dental hospital is in Newcastle, part of the same NHS trust which performed my liver transplant. According to the BNF, Tacrolimus has a long list of interactions with other drugs, particularly antibiotics.

I suppose my questions are 1. Do I need specific care due to me being immunocompromised? 2. Do you think a dental hospital is appropriate for my problem.

Any advice will be much appreciated.

Regards, Ian
 
Hi Ian, in many areas of the UK, there's a community dental service (CDS) which deals with people with specific health problems/mental health problems/dental phobias. I'm not sure exactly where you are. You could google for "Community Dental Service" or "Primary Dental Care Service" plus your area. The dentists who work there (salaried NHS) have additional training in treating people with medical conditions which can impinge on dental treatment. You could also try ringing NHS Direct to find out who might be providing this sort of treatment in your area to find out more (or PALS - the Patient Advise and Liaison Service for your area if they don't give satisfactory advice and recommendations. Again, do a google search for it).
 
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