Neutropenia - Antibiotics good idea before dental work?

My neutrophils are quite low right now. I have not been having problems with infections. I will be going in for some dental work - a cleaning and then later a filling or crown. Would it be advisable to begin a short course of antibiotics before going to dentist, given that oral bacteria can enter tissue or blood system during dental work?

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  • I would be most surprised if your haematologist doesn't provide you with prophylactic antibiotics to take beforehand.

    Neil

  • I can only speak for myself..no dental work or cleanings etc. without prophelactic antibiotics...

    ~chris

  • Does your dentist know you have CLL? And, does she/he know the implications for infection? You may need to educate.

  • No, dentist does not just know I have CLL. Have not been in to dentist since receiving my diagnosis. I am all for educating health care providers.

  • Thanks for replies, all.

  • I had a friend that would snap dentists into shape by telling them he was HIV positive... 😜

    That they know...

  • I have never had a problem in Canada... I think the CDA may have protocols for CLL and immunocompromised patients... the ADA only deals with stem cell transplant patients, last time I looked... it may have changed...

    ~chris

  • You are right Chris. My dentist has been President of Ontario dental association. She is well informed about diseases. I have not had to have antibiotics for regular cleanings but I get three cleanings a year and have a strict cleaning regime every night. Sjogren's creates plaque build up. I always get asked if there any changes to all of my health conditions. Presumably for dental treatment implications.

  • So can you ask your GP? Whomever you talk with, talk first about the neutropenia.

    Hope all goes well for you.

  • thanks! Yes, can ask my GP for sure.

  • Definitely if your are neutropenic make sure you ask. Your doctors may want a longer course of antibiotics in that case. I usually get 4000 - weird that a C comes up - four thousand MG of amoxicillin an hour before most procedures. For some, like colonoscopies it is alive in the IV along with everything else.

  • While I have been undergoing FCR treatment and my neutrophils have been as low as 0.2 or 0.3, dental work has been strictly forbidden! Obviously, if there is an emergency as you are in pain then action needs to be taken, but do please seek medical advice before having dental work. I was told most dentists would not want to touch a CLL patient who is neutropenic.

    All the best.

  • thanks holly.

  • Can this be delayed until your absolute neutrophil count gets above 1.0? At 0.3, you are at risk for infections from all directions.

  • Possibly. Not sure when neutrophils will climb. It's a bit of a yo-yo. thanks for reply.

  • On page 2 of this link for patients suffering from netropenia: "Except in emergencies, do not have any dental work done."

    Infections Precautions for Patients with Low Neutrophil Count

    hopecancerclinic.net/yahoo_...

  • Thanks for this document, Lynn! Very useful overall.

  • Excellent 5 page listing of dos and don'ts, to which I would add 'Don't floss your teeth'. I was told to stop doing so by my specialist at diagnosis, when my neutrophil count was 0.4.

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