Hello, I m an orthodontist . A patient came yesterday to my office refering systemic erythematous lupus (2 years). She is under treatment (lupus) and needs orthodontic treatment and probably will need extraction of 4 premolars to accomplish treatment goals. Are there contraindications? I ve read that Orthodontic braces might make oral ulcers more common. Could you help me?
Hi.  Extraction can be done in Systemic Lupus erythematous (not systemic erythematous lupus), especially those who are maintaining well under treatment. It should be done in a hospital environment with an infective endocarditis prophylaxis, and increased dose of her morning steroid for that day(consult her doctor). Mentally prepare for bleeding management, if occurs. Orthodontic braces with brackets can be done, provided patient strictly maintains oral hygiene.