Dental antibiotic : Hello everyone. I broke a... - CLL Support

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Dental antibiotic

GAVIOTA profile image
43 Replies

Hello everyone.

I broke a tooth and the dentist gave me an appointment in 10 days, he has told me to take an antibiotic called Amoxiciline,(penicillin) for 7 days,starting today so I will finish the antibiotic three days before my doctor's appointment.

"Amoxicillin should be used with caution in patients with lymphocytic leukemia who are more susceptible to rashes (maculopapular skin reactions).

Do you know anything?

What other antibiotic could I substitute it for?

I called my hematologist, but she is off today, I can't contact her until Monday.

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GAVIOTA
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43 Replies
MistyMountainHop profile image
MistyMountainHop

I had a wisdom tooth extracted, a couple years ago. I took Amoxicillin a few hours before the extraction, and just after. I was absolutely fine.

I can't remember the exact dosage, but it wasn't a huge amount.

Good luck 🤞 I hope it all goes well.

GAVIOTA profile image
GAVIOTA in reply toMistyMountainHop

My regimen is seven days, three times a day 750 mg., I have no symptoms of infection, he must have sent it for prevention I guess.

Thank you very much

mrsjsmith profile image
mrsjsmith in reply toGAVIOTA

Is the dentist removing or repairing the tooth, you don’t say. Amoxicillin is the antibiotic of choice for dental work. Looking back with a recent extraction I was given 500mg by the hospital and 15 tablets so would imagine 3 for 5 days.

Colette

GAVIOTA profile image
GAVIOTA in reply tomrsjsmith

Hello, I do not know, I did not see my dentist, I'm out of town.

I went to the emergency dentist where I am, he did an x-ray and told me that the tooth had to be removed. I called my dentist, sent him the x-ray and he sent me the antibiotic and an appointment in 10 days.

mrsjsmith profile image
mrsjsmith in reply toGAVIOTA

Good luck. Hope it’s not uncomfortable.

GAVIOTA profile image
GAVIOTA in reply tomrsjsmith

Hi, I am finally having a root canal tomorrow, I have not been able to contact my hematologist.

Did they give you antibiotics before and after the procedure?

mrsjsmith profile image
mrsjsmith in reply toGAVIOTA

Afterwards. But reading other replies it seems to vary and I have also had before.

Good luck

MistyMountainHop profile image
MistyMountainHop in reply toGAVIOTA

You're welcome.

I'm not sure all dentists are aware of CLL, so we get conflicting information.

I guess we should err on the side of caution.

mrsjsmith profile image
mrsjsmith in reply toMistyMountainHop

I am lucky my dentist has three patients with CLL that I am aware of and she is very knowledgeable.

MistyMountainHop profile image
MistyMountainHop in reply tomrsjsmith

3 x CLL patients? Maybe it's catching😁

I'm lucky because I've only ever had one tooth extracted.

I've never had any problems with teeth. That is lucky.

I know people that had false teeth in their 20s.

mrsjsmith profile image
mrsjsmith in reply toMistyMountainHop

One is a fellow patient that I recommended to my dentist so perhaps that is tilting the odds.

I was in a car crash when I was 18 and had to have most of my top teeth reset, sadly not very successfully so I have always had problems 😕

MistyMountainHop profile image
MistyMountainHop in reply tomrsjsmith

That's sad to hear🌻

Steffi50 profile image
Steffi50 in reply toGAVIOTA

Hi, if its any help I was ok on amoxicillin whilst on W&W.

MisfitK profile image
MisfitK in reply toSteffi50

As was I - I had a 10 day course 2 years ago while in W&W. No issues from the med.

GAVIOTA profile image
GAVIOTA

Thanks everyone, I get so overwhelmed with dentists.

😅

SofiaDeo profile image
SofiaDeo

Do you have a diagnosis/history of maculopapular or other skin rashes?

Remember the drug warnings include every single thing that has ever happened to anyone, that could possibly be traced to the drug. This warning notes that people with a lymphocytic leukemia, are *more susceptible* to them. Not *a guarantee* you'll get one, or a warning to avoid the drug. If something is severe, the literature clearly states "avoid this drug while X (other drug, disease, whatever)".

A rash is not a life threatening side effect, so go ahead and take it but watch for skin things. Takes pictures if you aren't sure. Avoid the sun; I foolishly went sunbathing (much younger of course) once while on amoxicillin and got a rash everywhere except my bikini. Being immune compromised, you probably need to minimize the bacteria in your mouth, before procedures in that area where bacteria from there, can get in the blood. Especially if that tooth happens to be infected.

Call your hematologist if you are concerned, I am sure they will say much of what I told you. If you have a history of reactions to penicillins/amoxicillin, then that is a different story, and you should consult with someone about the risk of this drug versus another.

GAVIOTA profile image
GAVIOTA in reply toSofiaDeo

Thank you, Sofia, for your explanations.

I have already today started the antibiotic..

What doesn't make sense to me is to take it for 7 days and I have the appointment on 11 days.

,If I have my tooth removed, or if I have root canal work done the antibiotic will still be present?

I know that my concern is nothing so important, but with this disease anything new overwhelms me.

Thank you

SofiaDeo profile image
SofiaDeo in reply toGAVIOTA

Someone miscommunicated something somewhere. You got the Rx issued promptly to get it filled/to have it on hand, but you are not supposed to start until 7 days before the procedure, according to what you originally wrote. In my area, sometimes Rx's can take 2-3 days to be filled, even for antibiotics. The delivery doesn't get done (bad weather, people sick), the Rx doesn't get filled immediately, they are closed, etc.

You wrote "he has told me to take an antibiotic called Amoxiciline,(penicillin) for a week before the appointment" so IDK why you started already, that instruction means "start taking the medicine a week before the appointment" so Day 1 of taking it, is 7 days before that date.

GAVIOTA profile image
GAVIOTA in reply toSofiaDeo

That's right Sofia, I made a mistake in my first message.

I was told to start the antibiotic today for 7 days and the appointment in 11 days.

SofiaDeo profile image
SofiaDeo in reply toGAVIOTA

Then clarify, because either they wrote the wrong number of pills/wrong number got dispensed, or you were supposed to wait to start.

I am guessing a likely error is 14 days worth was intended, and somehow you got 7. For patients with an actual or suspected infection, I commonly see the prescriber have the patient start immediately, then continue for a few days after the procedure.

Hope you can get a phone call in before your weekend. If it's already the weekend, I would just take the drug through the weekend & get it resolved on Monday. If you are positive the dentist said "start immediately."

GAVIOTA profile image
GAVIOTA in reply toSofiaDeo

I called my dentist again this morning before starting the pills and he told me to start now for seven days to prevent infection.

But now I only have a broken tooth, an external piece fell out and left a hole,

I have no pain or symptoms of infection

GAVIOTA profile image
GAVIOTA in reply toGAVIOTA

😓

SofiaDeo profile image
SofiaDeo in reply toGAVIOTA

Hmmm sounds like your dentist is forgetting your appointment isn't for 10 days. Because I've never heard of someone taking it the way you described, stopping 3 days ahead of the procedure.

If it were me, I would be saying "excuse me, I'm a little confused. You want me to start taking it now, for 7 days, and have finished & been off it for 3 days before the procedure? I've never heard of that, can you explain more? I am being told by others that it's more usual to take it until the day of surgery, if not even longer. I don't understand this protocol. I've read that in immune compromised patients like me, any antibiotic is continued at least through the day of a procedure".

Me being a pharmacist, I would word those sentences slightly differently, but the gist would be the same. A few times when I've questioned a provider on a prescription that "didn't make sense according to previous prescribing practices" I would hear about something new they read about in a journal.

I'm curious as to why your prescription would be done this way, if nothing else lol!

GAVIOTA profile image
GAVIOTA in reply toSofiaDeo

You are right, on Monday morning I will call the dentist again and explain to him that with my disease the protocol is different.

The thing is that I have already started today, I have already taken two pills ,one every eight hours, I don't know if I should stop.

SofiaDeo profile image
SofiaDeo in reply toGAVIOTA

Do you have any symptoms of infection in that tooth/area? Do you have an elevated temp, any lymph nodes that side larger/tender, any aches or muscle spasms or tenderness? Do you feel "flu-y"?

Since your dentist definitely said "start today" if it were me, I would continue it and get it clarified Monday. It shouldn't hurt to have a few days extra of this antibiotic, but stopping then starting is how resistance comes out. It's why on many antibiotics they say to take a dose ASAP if you forget one; trying to keep the blood level high enough to affect organisms.

GAVIOTA profile image
GAVIOTA in reply toSofiaDeo

“It shouldn't hurt to have a few days extra of this antibiotic, but stopping then starting is how resistance comes out.”

Do you mean that instead of 7 days it would be better to stay 10 days until the appointment?

I have the appointment on May 27th

No, I do not have any symptoms of infectoon

SofiaDeo profile image
SofiaDeo in reply toGAVIOTA

I'm not sure what you mean when you say "better to stay 10 days until appointment."

When taking antibiotics, it is generally better to not start & stop them. Since that is one way how resistance develops.

Your dentist said "start today". So you started today. Call on Monday to clarify if you truly are supposed to only have 7 days of treatment, stopping 3 days before the procedure. You asked a question here, and got feedback that the "stopping 3 days before the procedure" isn't commonly done.

I've commented on what I have seen done, as have others. But IDK any of your medical history, why you need antibiotics, or what "broke a tooth" is actually describing/what your dentist thinks that means, or why "start today for 7 days before appointment" when the appointment is 10 days out.

I think you should speak with both your dentist & hem/onc.

grandmaof10 profile image
grandmaof10 in reply toSofiaDeo

I've always been given docycycpine

Spark_Plug profile image
Spark_Plug in reply toGAVIOTA

You mentioned you are out of town, that this is an emergency dentist, They may be just giving you more net in case you fall, especially if you told him you're immunocompromised.

Skyshark profile image
Skyshark

I was given co-amoxiclav, Amoxicillin/clavulanic acid, 3 tablets a day for 5 days starting after the extractions. By day 3 I had severe constipation with overflow diarrhoea.

This was odd as I had Amoxicillin some years ago without any problems. Either it was the clavulanic acid or the Amoxicillin wasn't very effective without clavulanic acid.

SofiaDeo profile image
SofiaDeo in reply toSkyshark

Or your gut really dislikes clavulanic acid! And let you know!

RamOren profile image
RamOren

I had a root canal last week, and the dentist prescribed Amoxicillin, advising me to start taking it one day before the procedure. I also consulted with my CLL specialist, who confirmed that it was safe for me to take Amoxicillin.

GAVIOTA profile image
GAVIOTA in reply toRamOren

Did you have to stop Acalabrutinib? And how long did you take Amoxicillin after the root canal?

Thanks a lot

Zigster49 profile image
Zigster49 in reply toGAVIOTA

I’ve had a couple of dental procedures since being on Acalabrutinib. In each case, I was told to stop taking the Acalabrutinib three days prior to the procedure and for two days after because of the increased risk of bleeding.

I can’t remember which antibiotic I was given, but I have become allergic to some. As SofiaDeo recommended, just watch out for signs of an allergy. I was given Azithromycin after a root canal and within a day had swelling in my mouth and throat. I stopped it immediately and took a Benedryl, as per my doctor, and was fine. Another antibiotic was prescribed that I tolerated.

opal11uk profile image
opal11uk

My husband, who has CLL, is allergic to Amoxiciline and it does indeed cause him a rash and his face swells so that he looks like an ape (I kid you not), strange thing is, this happened way before he was diagnosed!!! There are alternatives but I can't remember which one he has, your dentist/GP will be able to advise

LeoPa profile image
LeoPa

Amoxiclav is what my dentist prescribes me when necessary. But I don't know why would he prescribe it a week before the procedure. Normally I start taking it after the procedure to prevent an infection.

Ashlar677 profile image
Ashlar677

I have had CLL 7 years with treatment for the last 4 years. In 2024, I had hip replacement, I was given amoxicillin. Now every time I go to the dentist I am prescribed amoxicillin before any procedure even a tooth cleaning. Thankfully no side effects.

J1015 profile image
J1015

I only had to take two amoxicillin tablets three hours before my procedure. A whole week might be too much.

TartanAlum profile image
TartanAlum

FWIW I took Augmentin (which I believe includes Amoxixillin) for 7-10 days recently for a sinus infection. I am on Calquence. No side effects whatsoever.

Cosby profile image
Cosby

I have taken amoxicillin several times without any problems, but my doctor does seem to like to give cefdinir more than amoxicillin. I’ve never asked why. I assume it is the type of bacteria that he thinks I have and he is treating.

chif888 profile image
chif888

Hello Gaviota,

I had been on Imbruvica 420mg since April 2021, after CLL diagnosis in December 2011. When I went for some gum treatment this year in February, I took amoxicillin 500mg capsules twice a day. Somehow after 5 doses, I had to stop because of chest pains & dizziness and felt sick. My periodontist directed me to stop the antibiotic, and to just wash with some salt water instead. I guess my case is unusual, as I was not allergic to penicillin before. Presumably, you won't have the same trouble as you are younger & stronger.

Good luck with the good LORD's blessing.

michaeledward profile image
michaeledward

Myself, I always take amoxiciline before every dental appointment and never had any problems afterward.

Melvynn profile image
Melvynn

Hi there! I’ve been in a similar situation before when I had a dental issue, and Amoxil (Amoxicillin) worked really well for me. I found good quality Amoxil (Amoxicillin) at this pharmacy - delivery-service24.com/buy-.... The order arrived quickly, and the medication worked well. It helped control the infection effectively, and I didn’t experience any side effects. However, I completely understand your concern given your medical history.

Amoxicillin is generally safe and effective for dental infections, but since you mentioned lymphocytic leukemia, it’s good to proceed with caution due to the potential for skin reactions. If you can’t reach your hematologist, you might consider reaching out to your primary care doctor or a pharmacist to discuss alternatives like Clindamycin or Azithromycin, which are also commonly used for dental infections and might have a lower risk of skin reactions. Be sure to monitor for any signs of rash or other adverse reactions while taking the antibiotic, and discontinue use immediately if something unusual occurs.

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