Need extensive dental work- any precautions for someone with CLL?

[Jonquiljo]

I have put dental work off long enough. I actually don’t have a choice anymore. I have extensive dental work needed.

My CLL is fairly indolent, untreated w&w. Any precautions to be taken? There might be extractions needed - not yet sure. Thanks.

jon

[MistyMountainHop]

Hello Jonquiljo, I had a wisdom tooth removed, about 2 years ago. I took Amoxicillin an hour before the procedure, and 3 hours after (as advised by dental surgeon). My dental surgeon supplied the Amoxicillin. I had no problems at all. Speak with your dentist/doctor, explain your condition to them. Good luck🤞.

[lankisterguy Volunteer]

Hi Jonquiljo,

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When I had extractions and crown work done, my dentist favored Chlorhexidine rinse in addition to oral antibiotics suggested by my CLL expert doctor. Here is a discussion of that vs. alternative rinses for extractions:

google.com/search?q=chlorhe...

oralhealthgroup.com/feature...

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Len

[Davidcara]

ok, I read the article about Chlorhexadine rinse after oral surgery. I assume the information is for immune competent patients. But anyways, I have had extensive periodontal surgery. My oncologist said, no antibiotics needed, even with my IGG level in the low 400s. My periodontist prescribes seven days of amoxicillin and 10 days of Chlorhexadine oral rinse post op. I think he does this for most of his patients. Have not had any problems yet, but definitely feel uneasy about the situation.

[Jonquiljo]

Thanks everyone. I will go over this in detail on my next visit. Luckily, in general, I have not had even an infected cut or any infection whatsoever since diagnosed with CLL 5 years ago.

Jon

[Graham2222]

Hi. Good luck with the treatment. I asked for stand-by antibiotics, but didn’t need them. The dental surgeon also took extra precautions (more wadding etc) to prevent excessive bleeding as my platelets were low - worth letting him or her know your last reading.

[stevesmith1964]

Stop treatment and have start antibiotics 5 days before. Resume treatment 10 days after.

[Lenny123]

Thoughts: wear a nose mask, focus on breathing through nostrils. i have done this in pandemic to reduce risk of covid. A little weird, and not proven. can get them off Amazon.

consider rinsing with peroxide, excellent for oral hygiene. Hope is to reduce bacterial burden, infections are bane of dental work.

good luck.

[CLLBGone]

FWIW . . . . . I was prescribed four 500 mg Amoxycillin tablets to take 30 to 60 min before my dental surgery.

[AussieNeil Administrator in reply to CLLBGone]

"Four 500 mg Amoxycillin tablets to take 30 to 60 min before my dental surgery" is what my dentist insisted on when I came in while already on a amoxicillin course, so I was required to make another appointment. I was neutropenic at the time.

[CLLBGone in reply to AussieNeil]

Sounds like your dentist was on top of things.

It seems that with CLL, and granted this may not be the best analogy ..... the sailing often stays somewhat smooth & uneventful for a decent period of time, and then alomost out of the nowhere, the sky darkens, the wind picks up, the temp rapidly drops, the swells become very choppy, and its all hands on deck.

[Jonquiljo]

thanks… I’ll let my dentist know. I guess this adds one more bit of stress to one’s least pleasant task That’s either dentistry or a colonoscopy.

As far as being masked, I think I will just risk it. I’m in a peculiar situation where I now live alone with 2 dogs. No friends or family to help if I got sick - to help with the dogs - they’re more important than I am.

To top that they’re high maintenance dogs. And spoiled.

[Skyshark]

I'm due to start treatment V&O ASAP, delayed by need to get teeth in a condition that won't require dental work for next 12 months. I believe my support team has moved heaven and earth to bypass the average 14 week hospital Maxillofacial surgery waiting list, so I was seen in 2 weeks. I had 5 teeth removed last week, they had had root canals but as there wasn't much of the teeth left the filling/crown had fallen off more than once. After extraction I was given Co-amoxiclav 500/125mg, 3 a day for 5 days. Morning of day 3 after tablet 7 I got diarrhoea. I went back to the clinic and was told to stop taking them if they caused problems, so I stopped. I had diarrhoea 9 times on day 3 and 4 but volume wasn't consistent with food input. Day 5 I had a very large bowel movement and I've been fine since.

I have had Amoxicillin by itself before without any problems that I can recall.