About a year ago I had a root canal and crown put on tooth #14 on the upper left side of my mouth.
The tooth had a crack in it and it became infected. An abscess above the root of tooth #14 formed and continued to grow in spite of the antibiotic amoxicillin.
After consulting with several dentists and oral surgeons the only solution was to remove tooth #14, which I did a month ago. I was also on amox clav to kill any remaining infection. Pain is gone, swelling is down.
An endodontist consulted wanted to fill the abscess with a bone graft. I did not use the services of that endodontist, and simply had tooth #14 removed because that was the consensus.
I went back to the oral surgeon that removed tooth #14 today and he said everything looks good but it will take 3 to 4 months for the abscess to fill in.
I have prescriptions for acarbose(25mg) and sirolimus(2mg) that I delayed taking while all of this was ongoing. I want to start taking them both now.
What do you think?
Wait for the wound to heal and make sure there isn’t any infection before taking Rapamycin. Rapamycin slows wound healing and will promote a bacterial infection.
Acarbose should be fine to take.
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Yes you should delay. I had a complication with rapamycin due to a preexisting tooth problem. Until that was resolved I would get a lot of swelling quite often.
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Delay rapa. One can argue whether low dose rapa might be OK, but then, what’s the point. Going on rapa at dosages commonly used for longevity purposes has some risk of exacerbating bacterial infections and slowing wound healing. Acarbose should be fine, and might even be beneficial in your situation.
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I concur. Stay off Rapamycin, get an implant for function and esthetics.
It’s not only for function and aesthetics, the issue is increased vascular disease and dementia risk. I don’t have the link for it, but Dr. Greger did a great discussion of this issue talking about placing dental implants in dementia patients and a resulting increase in their cognition.
Here is was I see on the neurodegenation risk on one quick summary:
Tooth loss and poor periodontal health are consistent, independent predictors of later cognitive decline and Alzheimer’s disease. Maintaining dentition and treating periodontal disease may modestly reduce neurodegenerative risk, with prosthodontic restoration (dentures/implants) potentially mitigating the effect.
Here is the summary on vascular disease:
Greater tooth loss correlates with higher risk of myocardial infarction, stroke, and overall cardiovascular mortality in a graded, dose‑responsive manner, independent of traditional risk factors. Maintenance of oral health and prevention of tooth loss are now considered **modifiable components of cardiovascular risk reduction.
As much as implants are expensive and quite a process … if you can afford it, any tooth lost should be replaced, as well as any dental issue causing chronic inflammation … as part of a longevity strategy.
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I agree 100% for what my layman’s opinion may be worth. It’s not merely dementia, but maintaining dentition seems crucial to keeping the biomechanics of the skull intact, which can prevent issues like TMJ and even more exotic and poorly understood complications probably having to do with the soft tissue wrapping around the skull. There’s a reason our bite is the way it is and missing teeth change the bite / occlusion. Besides there’s bone resorption from tooth loss, so the bone graft proposed in the initial consult seems spot on to me and what I would insist on, in fact, as a patient in that position.
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