Frustrated

[Avamarc10]

On watch and wait. Not on any meds. Need to have a cracked tooth extracted. Dentists won't take it out until l can get more information of my consultant. Do not know how to get in touch with him. Is it alright to have it done.

[Spark_Plug]

I appreciate your urgency, my mother needs to leave a nursing home for another extraction, and now is being required to get a referral first, a monumental chore for an 88 year old who isn't ambulatory.

Regardless, I can only suggest you do the consult, it wouldn't be right to give you advice. We are not professionals with you as our patient. Could you call your doctor's office and have the nurse relay the question for reply?

Hope it works out for you, sorry you're going through this.💐

[Notmuchenergy in reply to Spark_Plug]

Contact the consultants secretary explaining the situation. Ask if you can have a letter stating that it’s ok to have an extraction to give the dentist. Maybe also get her to send a copy of latest bloods as well

[Janeerp]

Hi. So frustrating. I am in a similar situation and had an extraction recently. Luckily my dentist is much better informed. The only thing he needed was for me to stop my anti coagulants (for another condition) so can't really see why he would need more. No bad effects after mine, although he did ring next morning to check all OK as I do bleed more than most.

Hope helpful

[Pinkcat62 in reply to Janeerp]

I had a tooth extraction last month and dentist phoned haematologist to corroborate what I had said. On watch and wait. No antibiotics needed.

[AussieNeil Partner Administrator]

Your dentists are understandably playing it safe with your health. They will want to know from your consultant your bleeding risk (what's your platelet count?) and risk of infection (what are your neutrophil and Ig counts?).

Neil

[Shedman in reply to AussieNeil]

Avamarc - Neil's correct.. Knowing your most recent blood results and those key details of platelets (safe clotting health) and neutrophils (infection safety) is key to confidently informing your dentist (and side-stepping medical letters)

In truth, it may be persuasive that the dentist prescribes antibiotics to cover your risk from the extraction since CLL presents us all with immune dysfunction.

I had dental woe in the summer and just managed to persuade the dentist with confident self-advocacy:

- blood thinners, apixaban (precautionary) stopped 48 hours before treatment

- blood counts all in good range

- no other treatment

..in fact, I needed antibiotics to treat infection, but there were no other complications.. dentist went ahead.

[Avamarc10 in reply to Shedman]

All done now and came away with antibiotics.

[Shedman in reply to Avamarc10]

Excellent.

[RZ8983DV]

I have been on Watch and wait for. 16 years with relatively low Lymphs and WBC platelets around 200 and have had a tooth extracted and an implant a year ago I can't see a problem get your hospital to send the dentist a letter

[stevesmith1964]

HiI am well down the CLL path after a stage 4 diagnosis in 2020 , had O+I cycles and have been in remission for 3 yrs. My NHS dentist refused to so extractions and referred me to the dental hospital which had a 6 month waiting list. I went private which was brilliant, I provided all my monthly bloods results, came off alcalibrutinib and took additional antibiotics prior to the extractions. All.went well and was back on Acalabeutinib within 10days

[Avamarc10]

Thanks. I will see what happens this morning.

[Curious79]

Hi. I am 79 years old. Have had CLL (mostly in remission) for 7 years, am on venclexa. I had an extraction but it led to a nuisancy bleed that did not stop for a few days. I forgot to stop taking my blood thinners the day before the extraction. The dentist told me that extractions are fairly simple and rarely bleed much. I'm going for another one next week but this time I will stop taking the blood thinner, epixaban, ahead of time. The bleeding stopped when she gave me some solution to apply to the tooth area. I bit on some guaze meanwhile. I think you will be OK as you are not on any meds. And dentist said extractions are simple procedures, and rarely cause bleeding or complications.

[Avamarc10]

Thank you. Just got in touch with the hospital my consultant away for 2 weeks. Off to the dentist now. Hopefully they will do it.

[Mijoed]

My dentist was quite happy to do several extractions. My platelets were slightly low and IgM and IgA very low.

I had a plan to then get implants but a slight deterioration in blood counts ment that treatment was needed and the implants needed to be put on hold as the risk of infection is higher than having extractions.

[Avamarc10]

Thanks everyone. Had it taken out. 😁

[keeptalking]

well done you. Hope you heal well.

I’m due to have two extracted in two weeks. 😫😫

[Avamarc10]

It really wasn't bad. 😁

[ChristyAnne_UK]

How odd. I've had two extractions without my dentist batting an eye.

[Skyshark]

Your point of contact should be your Clinical Nurse Specialist, they should have given you a card when you were Dx.

Otherwise you may have been returned to your GP for W&W and your GP is your contact.

The two main concerns will be platelets for bleeding and neutrophils for infection risk.

[Phil4-13]

Avamarc10, my dentist required the same input on mainly my neutrophils before finishing his work on my bridge. Fortunately, my dentist office called my hematologist office to get an ok. I had to get a current lab result. All came back good enough to move on with the dental work. I was precribed antibiotics for 3 days that would give me a 2 weeks protection against infection. All went well. 😊Sandra

[DanceonaVolcano]

100% - could lead to worse problems if left to fester

[skipro]

Probably okay to do if your ANC is normal

Good Luck and God bless

Skipro

[Braveheart19]

I’m on W&W too and recently had implants, my dentist gave me a large dose of antibiotics 1000mg. I didn’t question it at the time but I suppose that was because of my CLL. No after effects except bruising of my face.

[oldguy68]

When I need a teeth work done by oncologist advised stop taking my imbruvica for 3 days before and then 3 days after. I did that and had no problems.