Does Wisdom Tooth Extraction Affect Inflammation Levels in Ankylosing Spondylitis?

Does having wisdom teeth removed surgically affect inflammation levels?

Hello Dr.
Tseng, I am 20 years old and a patient with ankylosing spondylitis.
I had my wisdom teeth removed on February 22, and my cheeks were swollen and painful afterward.
It has been 11 days since the procedure, and I am almost fully recovered, but there is still a bit of swelling and pain (there is still some discomfort when I open my mouth).
Aside from that, I have not had a fever or any other symptoms.
When I returned to the dentist the day before yesterday, they said to just let it heal gradually and did not prescribe any medication.

I would like to ask the doctor:
1) My rheumatology follow-up appointment for blood tests is scheduled for 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 a rescheduled appointment, as it is difficult to get an appointment with the doctor, and I do not want to delay too long.
2) Additionally, I would like to ask the 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 test, will it not accurately reflect the inflammatory status of my ankylosing spondylitis? Thank you, doctor.

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

Dr. Zeng Guosen reply Internal Medicine

After surgery, swelling and pain may affect ESR/CRP levels, but unless it's severe, the impact is limited.
Just inform your physician, and they will make the assessment.
2.
In the case of sports injuries, such as sprains, muscle strains, or joint injuries, generally, they do not affect these levels unless there is significant redness, swelling, or pain.
Thank you for your question.

Reply Date: 2024/03/04

More Info

The extraction of wisdom teeth can indeed have implications for inflammation levels in patients with conditions like ankylosing spondylitis (AS). In your case, as a 20-year-old with AS, it’s important to consider how the inflammation from your dental procedure might affect your overall inflammatory markers, particularly C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), which are commonly used to monitor inflammatory diseases.

1. Impact of Wisdom Tooth Extraction on CRP Levels: After wisdom tooth extraction, it is common to experience localized inflammation and pain, which can lead to an increase in systemic inflammatory markers like CRP. Since you mentioned that you are still experiencing some swelling and pain 11 days post-extraction, it is likely that your CRP levels could be elevated due to the ongoing inflammation from the extraction site. Therefore, it would be advisable to wait until the inflammation has completely resolved before undergoing your scheduled blood tests on March 8. This will provide a more accurate reflection of your AS status without the confounding factor of dental inflammation. If you feel that waiting could significantly delay your follow-up care, you might consider discussing this with your rheumatologist. They may suggest proceeding with the blood test but interpreting the results with the context of your recent dental procedure in mind.

2. Inflammation from Sports Injuries: Regarding your second question about sports injuries, it is indeed true that injuries such as sprains, strains, and joint injuries can lead to an inflammatory response in the body. This response can manifest as an increase in CRP and ESR levels. If you have sustained an injury that has resulted in swelling, pain, or heat in the affected area, it is likely that these markers would be elevated. Consequently, if you were to have blood tests done during this time, the results could be misleading regarding your AS condition, as they might reflect the inflammation from the injury rather than the underlying disease activity of AS.
In summary, both the inflammation from your wisdom tooth extraction and any sports-related injuries can influence your inflammatory markers. It is crucial to communicate any recent dental procedures or injuries to your healthcare provider when discussing your AS management. This will help them interpret your blood test results accurately and make informed decisions regarding your treatment plan.
In managing your health, it’s essential to balance timely follow-ups with the need for accurate assessments of your condition. If you experience persistent pain or swelling, or if you have any concerns about your AS management, do not hesitate to reach out to your healthcare provider for guidance. They can help you navigate the best course of action, whether that involves delaying blood tests or adjusting your treatment plan based on your current health status.

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