I have recently experienced more frequent and profuse bleeding from my gums.
Given that my white cell count is still relatively low (early thirties) and that I am careful to maintain good oral hygiene, which includes the use of Corsodyl (frequently), Oral B toothpaste (all the time) and Listerine (also frequently), does this indicate a significant stage in the development of my CLL and does anyone have any recommendations. I see my dentist every six months and there is no significant build up of plaque.
This might be a sign of low platelets, so I'd get to a doctor promptly to have that checked out via a blood test. Your haematologist should also be involved if your platelets are low enough to explain the bleeding. (Having a low white cell count unfortunately doesn't mean your platelets are safe from being impacted by CLL.)
While the normal platelet range should be between 150 - 400 (actual limits can vary by country, etc), they can be lower in CLL for various reasons. They'd probably need to be lower than 100 before you had any obvious symptoms like bleeding gums. If they drop below 70, it is one indication for treatment, but they need to get below 20 before you have an increased risk of bleeding without any injury. There could be other causes than CLL too, for example h.plori, a gut bacteria as well as some medicines, or you might just need a softer toothbrush!!
Platelets levels can drop quickly as they only last around a week before being replaced, so you need to get this looked into fairly promptly to find out the cause. If you do have low platelets, they may recover on their own or with some assistance - not necessarily treatment for your CLL.
Low platelets would, as others have indicated, be the first thing to have checked. but, as Neil indicated, it could be the use of blood thinning medications, so be sure to have your doctor look at a complete list of medications and don't forget to include any supplements you might take. I had issues with bleeding gums for years - long before CLL was in the picture. I found that using the softest toothbrush possible and brushing with baking soda and listerine only has solved the problem. My dentist is very happy at my check ups so I see no reason to change.
Corsodyl is a very harsh mouthwash... it kills an awful lot of the germs in your mouth. The mouth is not a sterile enivronment, and it seems that it needs to have a normal bacterial population to be healthy.
If you kill all the germs then you can bet that the ones that grow back are the "bad" ones, which cause problems like gum disease, and now there are no "good" bacteria to keep their numbers in check.
I used a mouthwash that was too harsh and ended up with sticky stuff all over my gums that hadnt been there before the mouthwash, and then eating live yoghurt to get things back in balance. I now use a mouthwash that's herbal based, with neem and tea tree, and just use it occasionally, and that seems to be okay. My gum health is now good.
It was actually my dentist that pointed out to me that Corsodyl was too harsh. I was using a different mouthwash, but he said Corsodyl was the worst one.
Speaking as a Dental surgeon and suffering from CLL for the last- approximately- six years,
my advise to you is to stop using mouth washes. They are meant to be used during acute
inflammation of the Gums, or for patients- who for some reason-can't brush there teeth.
The best way to keep a good oral hygiene is, as you are doing, to brush with any tooth paste which contains fluoride. You also need to clean between your teeth by flossing, or using inter-dental brushes, as the tooth brush can't clean between the teeth. Your Dentist can demonstrate to you how to do that, if you are not doing it already.
As mentioned above, the bleeding might be due to low platelets count. However, the count has to be very low for that to happen but it is better to check that.
Thank you everyone for the helpful answers.
I do find it a little disturbing, however, that two of the answers suggested that it might be the use of mouth washes that have contributed to the problem.
It was my dentist that suggested that I use both of the types that I mentioned in my original post. Mmmm!
I next due to visit Haematology on 3rd June, but maybe I should get a blood test done before then. My GP is about as much use as a concrete parachute, so I'll try to get an interim visit to Haematology arranged.
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