Many of us impacted by fluoroquinolone (FQ) antibiotics fear having dental work post floxing. These fears can be justified because of the treatment standards employed by dental doctors. Many of us have become sensitive to medications used routinely such as dental anesthesia or antibiotics.
Most dentists would argue against the idea that FQ’s could actually cause any damages to the dental structure in our mouths. However, anecdotal evidence has dictated to me otherwise. I have talked to many floxed folks over the years that have had numerous dental problems, from rapid tooth decay, to calcification of nerves, to severe oral neuralgia. I believe that the incident of these complaints rise above the general population and points an underlying pathology that could have many sources.
Like many FQ sufferers, my dental integrity has suffered since floxing. Even with stringent dental proactivity on my part, I have developed increased dental issues. A few years ago I noticed a sore spot on my right lower gum under a tooth that had previously had a root canal and a crown several years earlier pre-floxing. Even though I was not running a fever and had no jaw pain to speak of, I decided to go to the dentist when the sore spot started slowly swelling. To my shock the dentist said that I had an abscess under the tooth. The reason I did not feel pain was due to the fact that I had previously had a root canal and there was no nerve to ‘feel the pain’ in the tooth.
My dentist said that due to the nature of the abscess, he wanted to send me to an oral surgeon for a tooth extraction. Now, you can imagine my anxiety. I was now faced with oral surgery plus the need for an antibiotic which I vigorously attempt to avoid due to my medication sensitivities. Armed with my dental x-rays and information from my dentist I started researching the internet.
I had learned from my dentist, and could see from the x-rays that my infection or abscess was encapsulated. It had been there for a while without me knowing about it. It had not spread throughout the bone in the jaw or the soft tissues of the gum. What I learned was that encapsulated infections, i.e.…non-acute and non-spreading usually clear up when the offending item, in my case the tooth, was removed. In addition, there have been good reports of large doses of vitamin C can help to keep dental infections at bay.
The first oral surgeon that my dentist sent me to was an absolute condescending person (stating it nicely). He would not listen to my fears about additional medication and refused to treat me unless I started on a strong antibiotic, namely clindamycin, which I told him I could not have. He actually placed two pills in my hand and said he would not proceed unless he watched me take the medication. Oh, and his only other choice was a fluoroquinolone, which I told him was definitely out of the question. He refused to extract the tooth. Needless to say, we parted company.
So I left his office and went back to my dentist. Now luckily for me my dentist had had a bad reaction to the antibiotic ‘Keflex’ years ago and he understood my trepidation about medication. Underscoring the need to get the tooth extracted, he called around and found another oral surgeon who would remove my tooth.
The second oral surgeon was a godsend. He listened to me about my fears and the information that I knew about my particular type of infection, and agreed to remove the tooth…provided I would take a script for a ‘Z-pack’ and get it filled and use it, if I showed signs of getting worse, after the removal. The tooth removal went very well. I had the tooth removed using ‘twilight sedation’ of versed-fentanyl. The oral surgeon said the tooth came out easily and he was able to cleanly scrape the socket and disinfect the tooth socket real well. In addition, I had already started on large doses of vitamin C.
Within days the pain subsided. Several follow-up appointments showed no signs of infection, and the extraction site healed properly. To make sure, I even went my regular doctor to inspect the extraction site and look for any infection. Now I have to throw in the caveat that the ‘type’ of infection made it easier to treat without antibiotics. Had there been signs of a bone infection such as Osteomyelitis, treatment would have been much different.
I have listed some things that I do to help minimize dental problems:
- I remain very proactive with my own person dental care. Daily brushing and flossing.
- I try to stay very hydrated, to fight against oral dryness so common post floxing.
- I occasionally wash and gargle with salt water to kill germs.
- If I need a local dental anesthetic (which is very rarely), I always request a low-epinephrine numbing medication, since my body does not respond well to the amount of epinephrine contained in regular numbing injections (no-epinephrine is also available). I also try to make sure that my electrolytes such as magnesium and potassium are bolstered to avoid any cardiac arrhythmias.
- I do not use laughing gas (nitrous oxide) as sedation.
- For dental surgery I request versed-fentanyl sedation. This is same sedation I have used successfully in the past for colonoscopies and endoscopes. Post floxing recovery time is a little longer for me but I have used this combination safely numerous times for various procedures.
Like I have said many times before, stay informed. Discuss all treatment options with your doctor. If your dentist, doctor, dental surgeon or anesthesiologist doesn’t want to follow recommendations you feel you need, insist on it. If needed get a second opinion. They’re not the ones risking their bodies.
Finally do yourself a favor, allow yourself extra time to recuperate from any dental procedures.
If you have had any dental procedures post floxing, please share your experiences for others to learn from.