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Tips for Wisdom Teeth Removal and Pain Med

My son has Crohn’s and he’s on Humira and uceris foam right now.
He needs to get his wisdom teeth removed so I’m in the process of looking for an oral surgeon. Does the fact he has IBD change the way I search for an oral surgeon? I don’t mean that to be a dumb question. But, are there things I should consider, such as the fact he’s on a Biologic, and what pain med will be given, etc…
 

my little penguin

Moderator
Staff member
My kiddo is in the same position
We have been told
No need to stop meds
No issues with pain meds
Gi just asked to minimize abx if we can
Still looking for an oral surgeon thougb
 
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My daughter had her wisdom teeth removed last June and it went well. She didn't have to change anything about her Remicade infusions, but we did hold her methotrexate for a week or two. She received IV antibiotics during the surgery but didn't need to take them afterwards. She took pain meds for several days afterwards--didn't need the whole prescription--and everything healed up quickly. It went much better than she (and I) had anticipated.
 
That’s great news! A couple more questions:
-Was she sedated? Or what did she do for the procedure?
-What pain medication did she use?
 

my little penguin

Moderator
Staff member
I would check with your Gi on nsaids
My kiddo has taken Celebrex (cox2 nsaids ) and has had no damage to the intestine on scopes or mri
So it depends
Advil and other nsaids do give him issues though
So it depends
 
My daughter is not great with dental procedures so she opted to go to the day surgery center for the extractions, where she was more fully sedated. She was on oxycodone afterwards for maybe 3 days? Then she moved to Tylenol.
 

crohnsinct

Well-known member
Throwing our satin the ring...T had her wisdom teeth removed over the summer. Just timed it right in the middle other infusion cycle. She took a lot ofantibioticsone day andthen nothing. She was somewhat sedated and took extra strengthtylenol after. She recovered better than all her friends without Crohn's. Our oral surgeon called the GI and went over everything within prior to scheduling the extraction.
 

Maya142

Moderator
Staff member
My daughters were both made to stop their biologics but that is now considered unnecessary (this was years ago - M was 15 and S was 18). Since they stopped their biologics, both flared (arthritis flares, not IBD - M was not diagnosed with IBD yet).

S was sedated for her wisdom teeth extraction - she was given Versed and Fentanyl I think and doesn't really remember anything. She was told to stop NSAIDs to minimize bleeding, so took Vicodin for 5-6 days.

M was not sedated for her wisdom teeth extraction - she and the oral surgeon thought she could "tough it out." I was pushing for sedation, but ultimately let her decide. She did well - it was a LOT of numbing injections (she stopped counting after 10) and she said she was surprised by how much force it took to pull out her teeth (some of hers were impacted, so she did have dissolvable stitches).
But it did scare her a bit, because she fainted right after they were done and in retrospect, she says she wishes she had been given a little sedation (every single one of her friends that had their wisdom teeth out was given IV sedation and they were asleep or do not remember their surgeries).

She was given Tylenol with Codeine but that wasn't enough to control her pain, so she was then put on Vicodin for around 4 days and after that she took extra strength Tylenol. She was also told to stop NSAIDs, though again, I'm not sure that was necessary.

They both healed well, without any issues. They were allowed to re-start their biologics about 10 days after surgery and honestly, both of them had pretty bad arthritis flares. We do know plenty of kids with juvenile arthritis who had their wisdom teeth out while on biologics and healed well (and avoided a flare)! But one of my daughters had a friend with Crohn's who had her wisdom teeth out while on Prednisone - that was a bad idea and hers got infected.

For both girls, day 3 was when the swelling was the worst. Ice cream helped ;). And for both, the oral surgeon talked to their rheumatologists, so it would probably be good for your son's GI to talk to his oral surgeon, especially if he is on steroids.
 
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