SLK Related to Dental Work (Invisalign) ?

[KevinS]

Hello Folks,

I've been suffering from SLK for the past 3-4 months and as those know who suffer from it, it is quite intrusive. My eye doctor suggested I get my thyroid checked which I did and it came back fine. I've also been looking through a timeline of what I've might of changed to develop this and the only thing I can continue to pinpoint it to in getting started on Invisalign. I actually took a break with Invisalign and had the epoxy resin removed from my teeth while I was seeking treatment (wearing band-aid contact lenses, and taking a bunch of drops each day) and the SLK started to diminish. I then went and got the epoxy resin put my on my teeth (its similar material used to fill a cavity and allows the Invisalign to grip onto the teeth) and started back wearing the trays and now my SLK is back.

My question is whether dental/ortho work (Invisalign, Braces etc..) could be a trigger for SLK flaring up?

Any feedback would be appreciated.

Thanks

-Kevin

[deep_dry_eye]

Correlation does not imply causation -- I can't not think of any reason why they might be related. However, others might chime in.

[Guest]

What thyroid tests did the doctor do?

You could have hashimotos thyroditis euthyroid. The best way to diagnose it is to do thyroid peroxidase antibody test, thyroid receptor antibody test and there's one more that's slipping my mind right now. But this is an autoimmune condition and your tsh, t4 and t3 could all be normal. This is what I have. Took me forever to get an answer.

I also have these symptoms, see if anything rings a bell in your end. Burning and numb feet, excessively hot or excessively cold, hard time falling asleep and if you wake up, hard time getting back to sleep, heart palpitations, gastrointestinal issues, constipation or diarrhea, dry eye, dry mouth, brain fog, dizziness...

I have dealt with these symptoms for years. They have gotten so much worse the last two years then boom, dry eye hit me.

I think the doctors suggestion of TED is valid, id love to know what thyroid tests you had done.

[KevinS]

Dowork123, thanks so much for the reply. Could you elaborate on what this means "doctors suggestion of TED is valid" ?

On July 10th
TSH = 1.910
Free T3 = 3.7
Free T4 = 1.07

I did some research to eliminate hashimoto's and requested a TPO which is called a "Anti Thyroid Peroxidase Abs" in my lab results which I show a 10.This was done on July 12th.

I've had dry eye for a long time and pretty sure its been related to Effexor which is an anti-depressant/anti-anxiety medication. I was on 300mg daily and reduced it to 150mg daily but still had dry eye which caused me to eliminate it as a cause which was premature on my part. I'm currently on Pristiq 25mg which is the bare minimum one can be prescribed. The manufacturer recommends 50mg but I need something to calm me down a little and not cause dry eye.

As for the symptoms, I do have gastointestinal issues (acid reflex) which I take a Protonix for daily and also heard it could cause dry eyes. As for the other symptoms, I do have some of those but I would point to my changes with anti-depressant/anti-anxiety medication changes and the withdrawal symptoms im experiencing as ive tried different ones over the past few months to cut down on dry eyes.

Here is the type of article my research has lead me to where a correlation between Dental Triggers of Hashimoto's can exist. Google for "The Many Dental Triggers of Hashimoto’s"
This is the type of reading that makes me think there is a link between Dental -> Thyroid -> Eye Issues like SLK.

[sophie0416]

I just wanted to say that although I HAVE NO idea the answer for your question, I do work in an orthodontist office and our doctor is really caring and always pays attention to any other symptoms that you might feel developed due to braces or Invisilign... you might be allergic to the material and that's a possibility. We have had patients allergic to Invisilign or allergic to the brackets metal.

[Guest]

Yeah the symptoms for antidepressant withdrawal are similar to an autoimmune disease. That definitely complicates things. I think that it's definitely possible that the thyroid is the issue. That's what I mean by, doctor suggesting TED seems valid. Your labs look good, you said the TPO antibody was 10..what was the reference range? Every lab seems to use different values.

I thibk the dtugs play a huge role. I smoke weed, if I stop for 3 days, my tears come back much much better. But I use marijuana for mood stabilization. So I must take it daily. I don't know a workaround for that.

[KevinS]

Dowork123, thanks for the reply, here are my results with the ranges below. I went ahead and put Tray 9 of Invisalign in tonight which is a few days early but Tray 8 seems to of been cursed. I went ahead and scheduled an eye doctor appointment for Tuesday because if the SLK keeps on getting worse ill need band-aid contact lenses etc. Ah, I wasn't familiar with the acronym TED (Thyroid Eye Disease) but now i am..

TSH
1.910 u[IU]/mL
Date: Jul 10, 2018 10:33 a.m. EDT
Reference Range:0.300 u[IU]/mL - 4.500 u[IU]/mL

Free T3
3.7 pg/mL
Date: Jul 10, 2018 10:33 a.m. EDT
Reference Range:2.4 pg/mL - 4.8 pg/mL

Free T4
1.07 ng/dL
Date: Jul 10, 2018 10:33 a.m. EDT
Reference Range:0.60 ng/dL - 1.60 ng/dL

Anti Thyroid Peroxidase Abs
10
Date: Jul 12, 2018 01:04 p.m. EDT
Reference Range:0 - 34

[Guest]

From my understanding, if you have the TPO or TG antibodies it suggests you have hashimotos...if you're positive for tsh receptor antibodies, you have Graves' disease.

Id say based on these results and what I've read, you could possibly have hashimotos thyroiditus euthyroid. Euthyroid means, with normal lab values, which you have. I'd persue this further, seems like a legitimate issue.

[MGD1701]

Hi Kevin
Seems autoimmune issues/ocular graft-versus-host diseas (GVHD) - maybe you could do a bit research.
Serum drop and plugs should help for relief. Have you tried any?

[Guest]

Hi Kevin
Seems autoimmune issues/ocular graft-versus-host diseas (GVHD) - maybe you could do a bit research.
Serum drop and plugs should help for relief. Have you tried any?

Why did you say GVHD? He hasn't had a blood transfusion...unless I missed that.

[MGD1701]

I dont know anything about GVHD - just happened to hear of this recently & that SLK could relate to GVHD.
so I suggest Kevin do a bit research. Best is to find a specialist.

[Guest]

I dont know anything about GVHD - just happened to hear of this recently & that SLK could relate to GVHD.
so I suggest Kevin do a bit research. Best is to find a specialist.

GVHD happens when you have a bone marrow transplant or blood infusion from a non related donor. Beats dying of leukemia though.

Dr Jain oversees all the GVHD and dry eye at UIC...he's goooood lol! Met a guy there getting serum for the first time. He was super positive and doing wayyyy worse than me. I asked what happened to him, he said GVHD...and said, but at least I'm here talking to you, the rest is just little bullshit. Great attitude! He was wearing PROSE and sunglasses. He pulled the glasses down and showed me his eyes...there was no white in them and he had to hold the lids open without sunglasses. He was happier than me...made me feel happy and sad. Anyway...

[KevinS]

Since 7/12/18 I've been wearing "Clsr Lacrimal Punctum Plug Each" on my lower ducts.

I have an eye doctor appointment on Tuesday AM. From my research which I'd like feedback on is that Thyroid lab results can vary pretty quick even from the AM to the PM. The example I'd use is that its similar to ones blood sugar level. During Tuesday's appointment I'm going to ask about getting another set of bloodwork done while Im still wearing the invisalign and still having the full effect of SLK. I still think there is a correlation between invisalign which is simulating mouth/dental "trauma" and my thyroid reacting which is triggering the SLK. Its just that my last lab results were done when the "trauma" wasn't occurring (i wasn't wearing the invisalign trays at the time) thus my thyroid wasn't reacting. I know it all sounds a bit far fetched but from my timeline of when the SLK occurred it all goes back to my start of invisalign. Maybe its not the "trauma" specifically but maybe the tray that im allergic to.

In the meantime (today till tuesday am):
-continue wearing invisalign
-I have the plugs in my eye ducts
-using xiidra in AM and PM,
-using refresh drops through-out the day
-use bruder mask twice a day
-take omega 3 pills every ~3 hours through-out the day
-pray it doesn't get worse so i can work on monday and make it to the tuesday am appointment.

By worse is what happened before which was the skin on the top of my eye would get peeled off by my eye lid and sit ontop of my cornea. Everytime i blinked i would feel that skin and it wasn't pleasant and was mitigated by the band-aid contact lense which im no longer wearing.

[KevinS]

My eyes were so bad i applied lotemax twice yesterday and removed the invisalign trays. Im not sure if its an allergy to the trays or the pressure being put on my teeth but they appear to be the cause of my SLK. Im leaning towards it being the pressure on my teeth causing my thyroid to react which is causing the SLK. This all might sound far fetched but this is what im going with for now. I have an eye doctor appointment tomorrow and am interested to see what he thinks since both my slk flare ups have coincided with starting invisalign. I think im just going to have to cancel my Invisalign treatment.

[KevinS]

I made the decision to end my Invisalign journey today.. I've tried it twice and both times results in severe SLK. I started treatment this morning to get it under control..