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Old 06-30-2009, 07:50 PM   #1
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Joseph SJ HB User
Question Severe periodontisis and accutane?

Hi,

I had a severe case of periodontisis in my late 20's (now 35) that nearly wiped out all the bones holding my teeth. I had 4 surgeries to remove necrosis tissue, I had gum grafts, scaling every 6 months with the metal hook from hell (my hygienist is hot, tough, so that's ok). Anyway, you know the drill. Literally.

I asked several dentists and at least 3 periodontists about the cause of this, and none of them can actually pinpoint a culprit. There's the "genetic" or "heredity" factor, but I think it's BS for docs who don't have a clue! (that's OK, I don't blame them...)

Anyway, during a conversation, I told someone about the fact that I took the drug accutane, for acne, soon after it was FDA approved in the 90's. That is before it was eventually dosed down because it was causing suicidal thoughts and all sorts of bad side effects, including gum bleeding. So this person told me that I was not the first one she was aware of with this history of accutane and a delayed onset of severe periodontisis.

So the question is the following: anybody out there had severe periodontisis and took accutane some time ago?

I don't expect much out of this, but I thought I would at least put this out there. I am still curious, after all these years, about a possible link with a specific cause. Or maybe it is, after all, genetic, and I am watching way too much House on TV... Who knows.

Take care and have a nice.... deep cleaning! Haaaaaa, the thrill of the first 5 minutes, the anticipation of the pain, the taste of blood in your mouth, the deliberate efforts to avoid looking at the x-ray's posted right behind you, as some sort of reminder to shop for dentures once you get back home... There's nothing I hate more than this. Besides maybe the democrats, but that's another debate!

Hey, how about "topless" scaling for the afflicted periodontites? We sure deserve it...

Joseph "Frenchy" SJ

 
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Old 07-01-2009, 07:29 AM   #2
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Re: Severe periodontisis and accutane?

Hi,

I'm 32 and currently being treated for advanced 'aggressive' periodontitis which snuck up on me while I avoided the dentist for a few years and had two children. It's also being blamed on genetics (but no-one in my family has it!?) plus the hormones/stress of pregnancy but like you I'm a bit confused about it all really and desperately hoping it can be halted. Is yours stabilised now then?

Anyway, in answer to your question I've never taken accutane or any other medications really. It's an interesting theory though, hope you get some answers.

And thanks for the light-hearted post, I totally agree about the x-rays, my dentist even expected me to be impressed with some enormous photos he'd made of my teeth for some sort of case study- aargh!

Keep up the good fight against the evil bacteria....

 
Old 07-01-2009, 10:55 AM   #3
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Re: Severe periodontisis and accutane?

Yes !

45 now & took Accutance from 2000-2004 as often as I could do each course of treatments. Still didn't clear everything up completely.

PD snuck up on me spring of 2007. By the time I had any pain, the #2 molar was gone. So had that & the adjacent wisdom tooth removed. Within a year, the upper molar on the other side was having major problems. A few fillings, bone grafts later & it's still hanging on, but I don't think it's long for this world.

Pocket depths everywhere are not good. Now the same side bottom molar is feeling weird. Just had the 2 wisdom teeth on that side taken out last month, and both oral surgeon & dentist say the adjacent molar pain is "healing". But I'm not so sure.

About 1.5 years ago, I started doing protein shakes for breakfast every morning to give my teeth a break from real food. Dentist says some gum appearance has improved (even tho' depths are bad) since then. Now I'm wondering if I need to do the same for lunches ! Horrible to think that good veggies & whole grains are creating havoc on my teeth.

Will be interested to hear what others say. As far as I know, I don't have any heriditary issues for this disease.

 
Old 07-01-2009, 07:58 PM   #4
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Re: Severe periodontisis and accutane?

Thanks guys for your answers.

Actually, as far as accutane is concerned, I contacted a law firm in this regards some time ago. I was not really after money, to be honest. I myself work as a scientist for the pharma industry and I don't see myself as such the "evildoer" that we have become in the general public eyes. Anyway, about the law firm, I knew that they were the leaders for representations of other known side effects of the drug, and I was wondering if they had any recollection of dental problems related to this. They told me that they were limiting their involvement with the already demonstrated side effects, and were rather shy on details. So no luck there.

The problem with periodontisis, is that it can develop over such a long period without any symptoms that you can literally have the disease for a decade before it finally hit you in the face..., so to speak.

To answer your question, Skymonkey, yes, my bone loss has stabilized. One of the greateast improvement was the switch to an electric toothbrush. This machine is worth every penny. First, it cuts your cleaning time down to 2 minutes, which is great. You know, sometime when I am tired, had way too much wine and would just love to go to bed right away (especially when I see my wife skipping the brushing altogether because she has such a thick layer of perfectly rosy gums that she can afford it), it makes it at leats a little easier to drag yourself in front of the mirror for the "ritual". Also, there as to be something with the vibration. Ok, here is a theory: You probably saw the news some time ago about a possible "ultrasonic induced tooth growing brace". Sounds like Star Trek, but it's real. Some guy at U of Alberta was trying to get mice's broken bones to regrow faster and as part of the study, they were using ultrasound to induce bone growth. Well, they found out that one of the mouse, missing teeth, started to literally grow new theet from scratch! They were talk about a possible brace adaptation of this, but it still sounds decades away. Anyway, believe it or not, according to my PD, my teeth should have much more mobility by now, due to my bone loss, but they are solid as a rock, still. For the time being, at least. So I don't know: There might be something in the vibrasonic motion of the brush that helps me...

Yeah, I am wondering if others will come forward with the accutane/PD link.

As for the genetic factor, I too am not convinced.

OK, here are some more risk factors that make more sense:

-I used to be a "social smokers" during college. That probably did not help. I am from Quebec (Canada), where they have those pictures of tobacco related diseases on each pack (it's a law). One of those pic is a rotten mouth, so that gives you an idea right there.
-Stress. I have GAD/OCD and am taking 2 medications now, which are doing miracle for me. But for a long time, I looked like those squirrels you see in the backyard, unable to enjoy anything in life without looking around like stressed out maniacs! Stress releases cortisol, which tend to accumulate in the saliva and cause inflammation. I once went 5 days without sleeping, not even a split second. I probably shorten my lifespan by a couple of years right there.
-My boyish good look (OK, maybe not this one...)
-Gum abrasion. When I was a kid, I used to (probably OCD related) brush my teeth RELIGIOUSLY 3 times a days. And I was going at it like my life depended on it. So the slow breakage of the thin gum line at the tooth base created a dent where there used to be a thin film of gum, transformig them into highways for bacterias. Besides, every mouth disease represent some sort of baterial infection, so brushing too ofthen is the equivalent of using antibiotic by the drum in hospitals: you create super bugs that can really hurt you.

Anyway, lots of theory but little facts. Here is something to chear you up: Dentures, at least, will allow you to bite into ice cream without pain!

Hope this helps...

 
Old 07-02-2009, 10:58 PM   #5
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Re: Severe periodontisis and accutane?

I asked this question a few years back and didn't get many responses so I am kind of glad in a way someone else raised the issue. I did 2 rounds of accutane in the 90's and suddenly - what seemed to be out of the blue - I was told I had advanced periodontal disease - but only around my front teeth. Within 6 mos they had to be removed and I went to implants but I was so upset with my regular dentist and hygenist as I felt they should have noticed something sooner during my 6 month checkups. I often wondered if it was due to the accutane but could never get a straight answer - now I am dealing with muscular tmj issues due to all the preventative and restorative dentistry I have endured and undergone - and my face still breaks out.

 
Old 07-05-2009, 06:24 PM   #6
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Joseph SJ HB User
Re: Severe periodontisis and accutane?

Guys,

Something you can do is to file a report to the FDA. (visit their website)

It's called form 3500, and it essentially consists in a brief report of a potential adverse event of a drug. You don't need to fill in all the details, just what you can remember (dates, etc...)

Considering that this disease is a sneaky one that develops over such a long period of time, maybe the full impact has not yet reach the maximum (it was only approved in the 90's, and the dose was lowered dramatically soon after because it was too bad. I was the lucky one with the elephant dose...)

Anyway, I think that if everybody with the same deal going on (periodontisis and a prior use of the drug accutane) file a report, maybe enough evidences will be gathered about this potential side effect.

Take care and stay positive!

JSJ

 
Old 07-08-2009, 08:06 AM   #7
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Re: Severe periodontisis and accutane?

hi there u say u had gum grafts, did u get charged for this, if so how much? i have the disease even though my dentist hasnt said it outright. i worked it out myself. my two bottom teeth are very mobile and i have just been given an appointment at the dental hospital finally after 8 weeks. my dentist says the teeth will not come out but i have lost a lot of bone, can u recommend anything.

 
Old 07-09-2009, 07:41 PM   #8
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Re: Severe periodontisis and accutane?

Kirsty,

My gum graft covering 3 teeth was charged for nearly 1800$. I live in Connecticut and have probably the best medical coverage one can get, so that explain the cost. Based on previous quote I got in the past, it range from 300$ to 500$ per tooth.

My advice is to tell you to consider your long term options. I am still young and want to desperetely postpone the inevitebale full mouth denture/implants, and my investment will "sit" there for at least 10 years (even with insurance, I paid around 700$ out of pocket for the grafts). If you don't think you have that kind of time, you may be better off investing on alternatives, depending on your financial situation.

Whatever you do, you have to stop the infection. Periodontal disease has recently been linked to pancreatic cancer, wich is pretty much a death sentence (no cure and always detected too late for surgery), and heart disease. Folks with periondontal infections are 7 times more likely to get pancreatic cancer. So for me, dentures or graft or whatever is irrelevant when compared to getting rid of the infection. It has something to do with the constant stream of bacteria that your mouth leaks down in your guts.

So this is not something you want to delay for too long.

Hope this helps,

JSJ

 
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