CLL side effects

[JJSI]

Hi everybody , I am 78 years old male, I have been on Ibrutinib for 3 years with excellent control of my CLL , with minimal side effects (bruising ) except for important dental decay, with multiple and frecuent visits to the dentist. My hematologist is against dental implants, my dentist is suggesting then extraction and an upper denture. What is your expirience with this problem, what to you think the solution of both my hematologist and my dental physician. Does anybody have an answer to the etiology of the problem and is there any treatment for it.

Thank you

[cajunjeff]

Hi JJSI. I am on ibrutinb and have three dental implants. I have had a wonderful result with my implants. I think I got all three before starting ibrutinib though.

I do not understand why your cll doctor is against the implants. Yes, there will be risk with implants. But there will be risk with the extraction too. Doing nothing carries the most risk as living with an infected tooth can lead to all sorts of problems, even infections that travel to the heart.

Many people suspend ibrutinib therapy to undergo dental and other procedures where bleeding is a risk.

Maybe you can revisit the issue with your cll doctor and see if he will reconsider. Perhaps there is something about your condition that does make implants too big a risk, I do not know. Maybe your cll doctor and your dentists could do a phone consult and discuss the implant to see if it is feasible for you. Implants have gotten much easier and maybe your cll doctor could be convinced the procedure could be done safely.

Its hard to really answer your question without knowing exactly why your doctor opposed implants. If it is just the bleeding issue, people suspend ibrutinib to do procedures all the time. Maybe your platelets are so low, its too much risk. But its not like you will not have bleeding with extraction anyway. There is not enough info in your post to know.

Good luck to you.

[Jcilom]

I'm not a professional. Just trying to put myself in your position. I would go ahead with the extractions but just one tooth at a time. If anything goes sideways it might be easier to quickly rectify. Before starting dental work, I would have a course of antibiotics to get rid of the infection. I hope you find a solution soon.

[JJSI in reply to Jcilom]

thank you for your advice

[onu1tadi2]

Dentures are rough and uncomfortable i have noticed. My specialists say getting implant is fine with short break from Ibrutinib.

[morepork]

My dentist and Haematologist are against implants for me not because of bleeding, though I have low platelets but because of deep level infection risks apparently - bone infection was mentioned . I have very low IGs. Yes I do have the standard antibiotic cover for extractions and deep cleaning,