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Dentist visits and precautions for myasthenia gravis
Visiting the dentist can feel stressful when living with myasthenia gravis (MG). Dental work often involves long appointments, jaw strain, and the use of certain medications that aren’t safe for MG.
For example, some local anesthetics, certain antibiotics, and muscle relaxants used during oral surgery can worsen MG symptoms or even trigger a crisis. Even routine cleanings may feel more difficult because of jaw weakness, fatigue, and eye response to the lights.
How has MG affected your dental visits? Do you talk with your dentist ahead of time about which drugs and procedures to avoid? What strategies make your appointments more manageable?
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5 Replies
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I went to the dentist 4 weeks ago I cracked a tooth. Implant needed and toothe had to be pulled. Everything went smooth but the novocaine hasnt worn off yet. Gotten better but chin is still numb and inside my mouth is getting better. He said in his carrier he has had it happen twice the other person it came back and mine hasnt yet he was very worried. I should of thought about gas lol. Now I know when I was diagnosed thhey said no botox or tattoos!
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I have a checkup every six months. The one thing I do is have them work very upright as opposed to laying me almost flat. The times I have had work done I have the dentist inject the anesthetic directly at the point being worked on rather than use blocks. I have never had an issue.
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I recently had to have an upper wisdom tooth extracted. Nothing complicated. My bulbar gMG and ocular MG had been totally under control on low dose alternate-day prednisone for 6 months. Because of the location of an upper tooth and its nerves, way in the back, the injected anesthesia numbed the side of my nose close to my eye. Not the usual fuzzy lip feeling. All went well, until the next day when I had a flare of double vision. The screen on my phone looked like it had been removed and pasted back at an angle. My neurologist raised the prednisone for 6 weeks and tapered it down again. The double vision subsided within a couple of days. He wouldn’t acknowledge that the ocular flare was the result of the injected anesthesia. I am certain it was. I should have reminded the oral surgeon of my diagnosis and asked him to explain which type of anesthesia and location of injection he was using to avoid this complication. Jean
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I guess it helps when your long-time dentist of over 30 years has a wife with ocular MG, LOL!
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Yes indeed. Last year had a few implants but the pain i suffered and the immediate eye issues due to the numbing injection was severe. My eyes for the next few weeks were really bad…..not double vision but very blurry, plus I felt bad pain in one particular area near my sinus area for at least 6 weeks. I know I will need more dental treatment as I have to use a bipap machine due to severe apnea but I feel strongly that this has caused issues with my nose and air escaping into the eyes as use a pillow that goes in each nostril causing something called “Phantosmia” plus I just feel that my gums get sorer each day wearing this mask..but I need to sleep.
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