How to Minimize RA Pain at the Dentist

Patient Expert

When you have rheumatoid arthritis, your regularly scheduled dental appointments may be one more thing that gives you a great big pain in the"everywhere. But it doesn't have to be that way. Here are 12 tips to help relieve the pain and discomfort you might experience at the dentist.

  • First and foremost, get into the habit of looking after your teeth and gums. Regular flossing and brushing do make a difference. Confession time: I didn't spend a lot of time flossing when I was younger, and I paid for it. I eventually saw the light after I was diagnosed with gum disease. I have since cultivated the flossing habit, and now, my gums are much better. (Check out Lisa Emrich's excellent article:  On Dental Health:The Complex Relationship between Periodontal Disease and RA.)

  • Perhaps you don't floss because it is difficult? Compromised dexterity or a small mouth can present a challenge that makes you throw down the floss in frustration. A  flossing wand  can make all the difference.

  • If you experience anxiety whenever you go to the dentist, there are techniques that can help you relax. Consider some of the ideas in my post entitled  Overcome Your Fear and Get in the Swim. When you understand the basis of your fear, you can do a better job of overriding it. Start by practicing techniques that help you become aware of your  self-talk  and your  breathing. It's best to practice well before your appointment.  As part of your self-talk, remember that because of your RA, you likely are  used  to more pain than most people. Use that to your advantage. When I had a gum tissue graft, I was told to take some time off work because of the pain. I did, but it turned out that it was not necessary to do so. Your ability to manage pain is augmented when you build your resilience - I've discovered that the more I  address and  undress my stress_,  the better I am at pain management, including those additional pokes and prods that are part of a visit to the dentist.*Find a dentist who understands the nature of rheumatoid arthritis. I'm fortunate to have one who recognizes my needs.*If you have artificial joints or certain heart conditions, you may be advised to take preventive antibiotics before your appointment. Talk to your dentist and your rheumatologist to find out if this is important for you.*Speaking of pain, you may want to check with your doctor about taking a painkiller before  _your appointment.*The dental office is one of the few places you'll go that you'll be able to adjust the chair  to meet your needs. Don't hesitate to let the dentist or hygienist know which height is comfortable for you when getting on and off the chair.

  • One of the benefits of getting older is that your nerves shrink. In the case of your teeth, that means more dentin and enamel between the outside of the tooth and the nerve. As a result, my dentist often is able to patch a cracked filling  without  giving me a shot.  He also feels that because I have artificial joints, the fewer shots I need the better.

  • Lengthy procedures that require you to sit still in one position can be especially hard for someone with RA. Devise a signal to let your dentist know you need a break so you can shift around and unlock those frozen joints.

  • I was introduced to a  mouth prop, or dental block, a couple of years ago when two wisdom teeth were removed. This device helps take the strain off your temporomandibular joints (TMJ), as you rest your teeth on it.

  • If you do need to have  wisdom teeth extracted, be sure to ice for 20 minutes on/20 minutes off for at least two hours after the procedure. I did and, as a result, no chipmunk cheeks, no black eyes. I even had a good night's sleep.

  • When your dentist tests your bite, ask to be placed into an upright position. This has made a big difference to me and my  high-maintenance mouth -  no more return trips to the dentist to get a filling filed down because it was too high.

I believe in being proactive, whether it is in dealing with your RA or visiting the dentist. When you're in the dentist chair, take advantage of all the available tools, techniques and tips to make sure you have a less bumpy ride.

Marianna Paulson is also known as Auntie Stress. On her site you'll find her blog, which covers topics such as stress, life, humor and RA. You can sign up for her monthly newsletter, The Connective Issue, here. She's the author of the award-winning blog, A Rheumful of Tips.