Dental Treatment before Radiation

[Hotcars74]

I have two small meds on my T-6 & L-2 my MO wants me to consider zapping them, but told me to see a Dentist first and make sure my teeth are in order, the Dentist I seen wants to do extensive work $$$ my question is, what should I be most concerned in and why,

[Tall_Allen]

One is usually sent to the dentist before starting on Zometa or Xgeva. I don't know why your doctor is sending you to the dentist only because of radiation. You should ask him.

[Hotcars74 in reply to Tall_Allen]

ty Tall Allen, I'm not sure what the MO was trying to get at, he wants to put me on xtandi after I see the dentist, and also a shot to keep my bones from breaking, I like the feed back I receive from this site

[Tall_Allen in reply to Hotcars74]

"... and also a shot to keep my bones from breaking" That's the Zometa or Xgeva. Good idea to get the dental work then.

[Hotcars74 in reply to Tall_Allen]

could you explain in detail, what and why I need this dental work, I did not know what to ask MO or the dentist at the time, something to do with the jaw bone ? what does it cause, what kind of dental work are we talking about ? what are the odds of something going wrong ? ty

[Tall_Allen in reply to Hotcars74]

Zometa and Xgeva (that shot you got) carry a risk of jaw osteonecrosis. The risk is small in the short-term, but increases with cumulative dose. The dental work may prevent this from occurring. The danger is in having dental work (like tooth extractions) after therapy. This is from the prescribing information:

"5.4 Osteonecrosis of the Jaw

Osteonecrosis of the jaw (ONJ) has been reported predominantly in cancer patients treated with intravenous

bisphosphonates, including Zometa. Many of these patients were also receiving chemotherapy and corticosteroids which may be risk factors for ONJ. The risk of ONJ may increase with duration of exposure to bisphosphonates.

Postmarketing experience and the literature suggest a greater frequency of reports of ONJ based on tumor type

(advanced breast cancer, multiple myeloma), and dental status (dental extraction, periodontal disease, local trauma including poorly fitting dentures). Many reports of ONJ involved patients with signs of local infection including osteomyelitis.

Cancer patients should maintain good oral hygiene and should have a dental examination with preventive dentistry prior to treatment with bisphosphonates. While on treatment, these patients should avoid invasive dental procedures if possible. For patients who develop ONJ while on bisphosphonate therapy, dental surgery may exacerbate the condition. For patients requiring dental procedures, there are no data available to suggest whether discontinuation of bisphosphonate treatment

reduces the risk of ONJ. Clinical judgment of the treating physician should guide the management plan of each

patient based on individual benefit/risk assessment [see Adverse Reactions (6.2)]. "

[Hotcars74 in reply to Tall_Allen]

thank you very much, for making this more clear, now I can have that talk with the dentist, And have more faith in my MO

[timotur]

Fire both of them. Mandibular necrosis is not indicated as a SE of radiation. Get a 2nd opinion on the dental work.

[dentaltwin in reply to timotur]

It certainly IS related to radiotherapy--but radiation to the head and neck. But radiation to the thoracic and lumbar spine? The patient deserves an explanation.

[dentaltwin in reply to timotur]

...and, why are we firing the dentist?

[j-o-h-n in reply to dentaltwin]

Pain... 🦷🦷🦷🦷🦷🦷🦷🦷🦷🦷🦷that's why....👀

........... 🦷🦷🦷🦷🦷🦷🦷🦷🦷🦷🦷

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 09/15/2019 1:34 AM DST

[Hotcars74 in reply to timotur]

ty timotur you may be right, I need to get to the bottom of this, before any work is done,