Does Wisdom Tooth Extraction Affect Inflammation Markers in Ankylosing Spondylitis?

Q: Does Wisdom Tooth Extraction Affect Inflammation Markers in Ankylosing Spondylitis?

Hello, thank you for your question. <br>Here are my responses：<br>1) My appointment on March 8th is for a quarterly follow-up with the rheumatology department, where I will have blood drawn for monitoring. <br>Should I wait until the swelling and pain in my mouth completely subsi

Does having wisdom teeth removed through surgery affect inflammation levels?

Hello, Director Gao.
I am 20 years old and a patient with ankylosing spondylitis.
I had my wisdom teeth extracted on February 22.
After the extraction, my cheek was swollen and painful.
It has been 10 days, and it has mostly improved, but there is still a little swelling and pain (it hurts when I open my mouth wide).
Besides that, I have not had a fever or any other symptoms.
When I visited the dentist the day before yesterday, they said to let it heal gradually and did not prescribe any medication.

I would like to ask you:
1) My rheumatology follow-up appointment for blood tests is on March 8, which is every three months.
Should I wait until my mouth is completely free of swelling and pain before going for the blood test? If I have the blood test on March 8, will the CRP levels be affected by the swelling and pain in my mouth, thus not accurately reflecting the inflammatory status of my ankylosing spondylitis? If I do not go for the appointment on March 8, I might have to wait over a month for the next appointment, as it is difficult to schedule with the doctor, and I do not want to delay too long.

2) Additionally, I would like to ask, in cases of common sports injuries, such as sprains, muscle strains, or joint injuries, there seems to be an inflammatory response.
Do these sports injuries cause an increase in inflammatory markers like CRP or ESR? If I have a sports injury and go for a blood test, will it not accurately reflect the inflammatory status of my ankylosing spondylitis?
Thank you, Director Gao.

Hao, 20~29 year old female. Ask Date: 2024/03/04

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your question.
Here are my responses:
1) My appointment on March 8th is for a quarterly follow-up with the rheumatology department, where I will have blood drawn for monitoring.
Should I wait until the swelling and pain in my mouth completely subside before going for the blood draw? If I have the blood drawn on March 8th, will the CRP levels be affected by the oral swelling and pain, thus not accurately reflecting the inflammatory status of my ankylosing spondylitis? (If I don't go for the appointment on March 8th, I might have to wait over a month for the next one, as it is difficult to schedule an appointment with the doctor, and I don't want to delay too long.) --> Yes, it will have an impact.
You can postpone the blood draw until after the gum swelling and pain have resolved, and then schedule another appointment.
If it is difficult to schedule with your doctor, you could still have the blood drawn and explain to him/her during your follow-up that you were undergoing dental treatment at the time of the blood draw; however, this would not allow for an accurate assessment of your current arthritis status.
2) Additionally, doctor, when we encounter sports injuries, such as sprains, muscle strains, or joint injuries, there seems to be an inflammatory response.
Do these sports injuries cause an increase in inflammatory markers like CRP or ESR? If I have a sports injury and go for a blood draw, will it not accurately reflect the inflammatory status of my ankylosing spondylitis? --> If it is just muscle soreness, it will not affect CRP/ESR levels; however, if there is an injury causing swelling and pain, such as joint effusion or localized heat, it could potentially affect the results.
In such cases, it is important to inform your physician.

Best regards from the Allergy, Immunology, and Rheumatology Department of Changhua Hospital, Ministry of Health and Welfare.

Reply Date: 2024/03/04

More Info

After wisdom tooth extraction, it is common for patients to experience swelling and pain in the affected area. As a 20-year-old patient with ankylosing spondylitis (AS), you are rightly concerned about how this procedure might influence your inflammatory markers, particularly C-reactive protein (CRP), which is often used to assess inflammation in conditions like AS.

1. Impact of Wisdom Tooth Extraction on CRP Levels: When you undergo a surgical procedure such as wisdom tooth extraction, it can indeed lead to localized inflammation. This inflammation can elevate CRP levels temporarily, which may not accurately reflect the underlying inflammatory status of your ankylosing spondylitis. Given that you are experiencing some residual swelling and pain, it would be prudent to wait until these symptoms have fully resolved before having your blood drawn for CRP testing. This will provide a clearer picture of your AS status without the confounding effects of post-surgical inflammation. If waiting is not feasible due to scheduling difficulties, you can still proceed with the blood test but should inform your rheumatologist about your recent dental surgery. This way, they can interpret the results in the context of your recent procedure.

2. Inflammation from Sports Injuries: Regarding your second question, yes, sports injuries such as sprains, strains, and joint injuries can indeed cause an increase in inflammatory markers like CRP and erythrocyte sedimentation rate (ESR). When tissues are injured, the body responds with an inflammatory process that can lead to elevated levels of these markers. If you were to have a sports injury around the same time as your scheduled blood test, it could complicate the interpretation of your CRP levels concerning your ankylosing spondylitis. In such cases, it is essential to communicate any recent injuries or surgeries to your healthcare provider so they can consider these factors when evaluating your inflammatory status.

In summary, it is advisable to wait until your wisdom tooth extraction site has healed before undergoing blood tests for CRP to ensure that the results reflect your ankylosing spondylitis condition accurately. Additionally, be mindful of any recent injuries that could also affect your inflammatory markers. Keeping open communication with your healthcare providers about these factors will help them provide the best care tailored to your needs.
Lastly, always remember that managing chronic conditions like ankylosing spondylitis requires a comprehensive approach, including medication adherence, regular follow-ups, and lifestyle modifications. If you have any further concerns or symptoms, do not hesitate to reach out to your healthcare team for guidance.

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