Dental teeth cleaning

[Sandikai]

Did anyone need to provide their dentist a note from their medical oncologist before having their teeth cleaned or other dental work. If they did, what did the note have to say? My understanding is that I just have to be sure that my white blood count is in the normal range.

[Barbteeth]

I’m a retired dentist with metastatic breast cancer

If your white cell count is low then you may notice your gums bleed more..oral hygiene is very important if this happens so using floss interdental brushes and a good mouthwash such as curasept will help and stop bacteria from your mouth entering the bloodstream through bleeding sensitive gums

Your dentist takes a medical history at each appointment so you can mention your treatment then

Sorry this sounds like a lecture!!

[Garnet131 in reply to Barbteeth]

Helpful information, not a lecture! Is Curasept available at drugstores? (Haven't heard of it before)

[Sandikai in reply to Barbteeth]

Thank you. It was my dental hygienist that requested a note from oncologist. I’ve known her for a long time and she had me call her at home and she would work me into her schedule.

I am on xeloda, and have my blood drawn every three weeks, when I see my oncologist. My WBC has been around 5 after I have stopped xeloda for 5 Days.

[Sandikai in reply to Barbteeth]

Where can I buy curasept? I couldn’t find it on amazon but I did find Curaprox that are wonderfully soft toothbrushes. My dentist has me brushing with PreViDent 5000 every night.

[nstonerocks]

I wasn’t told I need a note

[kit5]

make sure you tell them what you are taking. olaparib seems to increase plaque build up and if you are getting xgeva shots, there may be issues if you need dental work. something about the teeth and the bones...

[Sandikai in reply to kit5]

I’m on xeloda, 2000 mg a day, two weeks on, one week off. I also have a zometa infusion every three monthsI carry a list of all prescription meds, plus otc meds, I take, and include a list of all surgeries and recent procedures I’ve had.

[Cshipley123]

I was told I would have to stop the zometa infusions before major dental work. My doctor said cleanings are find and important to have done. No note needed.

[Wildcat1]

My onc just said to tell him that I was on Xgeva shots. I told the hygentist and she asked my she needed to know this. Smh

[Rhwright12]

Hi Sandikai!

I think it’s mostly if u have bone Mets like I have...and only for major dental work like extractions and root canal...I have to be off Zometa for 3 months before tooth extraction on the 8th and like 6-12 weeks after...apparently it strengthens all bones but may cause problems with the jaw bone...otherwise you’re good to go...😀

[Barbteeth in reply to Rhwright12]

That’s correct..only extractions and rott canals are to be avoided..normal hygienist and fillings are fine

B x

[Garnet131]

Didn't need a note, but mbc status and drugs came out during health interview at beginning of appointment (as someone mentioned above). Because I'm very nervous about the ONJ, I had special dentist appointment before my 3rd Zometa treatment. Dentist did exam and panoramic x-rays to view jawbone and said everything looked good (and she didn't even charge for the visit!). At most recent visit, a different dentist in the practice said there's a chance I may need a crown replacement in future. He said that is OK because it doesn't involve bone, but believe me, I'll be checking further if that need arises.

[Jaxon2007]

Mine experience was just the opposite, I had to provide a note from my Dentist that my mouth was healthy and had no issues before I could start Ibrance treatment.

[Barbteeth in reply to Jaxon2007]

That’s usual in UK

B c

[kit5]

this from xgeva site... i knew there was some issue with dental work (above and beyond cleaning - routine cleaning is fine.

Osteonecrosis of the jaw has been reported rarely in patients with cancer receiving treatment regimens that include bone modifying agents. Many of the reported cases were associated with dental procedures, such as removal of a tooth. A dental examination with appropriate preventative dentistry should be considered prior to treatment with denosumab, particularly in patients with additional risk factors (ie cancer, chemotherapy, corticoseroids, poor oral hygeine). Invasive dental procedures should be avoided during treatment.

[Sandikai in reply to kit5]

Thank you.

[PJBinMI]

I've been on Zometa and then Xgeva for most of the last 15 years and have not had lower jaw issues! When I was first diagnosed with denovo bone mets in 2004, my local rural area dentist had not heard of ONJ, and as far as I can remember, I was not warned about it by my onc, either. She was very well informed. After just a few monthly Zometa infusions, I had to have a tooth pulled and a bridge put in. Have had no problems with any of that. It was in Dec. 2004, at the annual San Antonio Breast Cancer Symposium that info about ONJ was presented and became widely known. When I first heard about it, my imagination went wild and it terrified me! (I was still very new to MBC and much more easily frightened than I am now, LOL) A couple of years later, I met two metsters with ONJ and never would have guessed that either of them had jaw issues. They looked fine, were not in obvious discomfort, and ate normally. One of them saw a dental school dentist who saw alot of people with ONJ. She'd had a series of mouth infections and he suggested she brush with Arm and Hammer Peroxicare tooth paste and use good old fashioned original Listerine mouthwash and she stopped having infections and I started using those in a somewhat superstitious effort to keep ONJ at bay. My onc did tell me that those of us who have a history of good oral hygiene and regular dental care,the risk of ONJ is lowered. I have had a bridge in the front of my lower jaw for a tooth that was damaged and lost over 40 years ago. The bridge recently became loose but not obviously so, at least not to me, and there was a bit of shifting of teeth as a result and some discomfort. My dentist was able to replace the old bridge and my lower jaw is fine. So I've had a couple of risky events but have done okay. I was told that for "invasive dental work' we should be off the bone drug for 3 months before and 3 months after. I did have to take a break from the bone drugs for a while after non cancer related back surgery revealed that my bones had become "brittle on the outside, soft on the inside.' The surgery was successful but it took about twice as long as originally planned and the neurosurgeon had to really think on her feet and replan what she was doing. I've had two surgeries in that area of my spine since getting bone mets and the mets there have not been stirred up by the surgery. I don't know if I am just super duper lucky with the cancer or with the choice of neurosurgeon! I always figure that women in medical fields dominated by men have to be really good to get where they are! Not many women neurosurgeons!

[Sandikai in reply to PJBinMI]

Thank you PjB. I also live in Mi.

[SpongebobMom]

I do...my dentist refused to do a cleaning on me...and my oncologist wants me to wait a bit to get further along into treatment and she has said that if and when I do go to the dentist it needs to be on the "off" week.

I see my oncologist next week and I am going to ask again because I really want my teeth cleaned, even the smallest amount of plaque drives me batty.