Wisdom tooth extraction

[Stage4Gir]

Has anyone had to deal with this? I’m 62 years old and now a wisdom tooth has popped out and some is on the side of my gum. Guess I’m a late bloomer I’m going to the dentist this afternoon after a rough weekend but also at the end of my Ibrance cycle so counts are low and think I’m having difficulty fighting infection. He’s probably going to send me to an oral surgeon for this and I was wondering if any of you has had the same issue or problem getting surgery with low counts?

[nstonerocks]

OMG I went thru the same thing last summer. The oral surgeon required medical clearance because of the cancer and drugs. My oncologist wouldn’t clear me. But she wanted labs drawn. My internist office and onc office went back and forth as to who was going to order labs. It was a nightmare and I was in so much pain by the end I was in tears and sitting with icepaks on my cheek. Finally the internist office ordered the labs that the onc office wanted. I think the NP at the onc office was the obstacle. It wasn’t the NP I usually see. Good luck. Just make sure you get whatever clearance you need from whoever will do it. I felt immediate relief after the d@mn tooth was pulled. Didn’t even need Motrin. Recovery totally uneventful.

[SoCalLady]

You're probably already had your extraction by now and I hope it went well. I too had to have a tooth extracted recently. At the end of my cycle, so was off my Ribociclib, which I figured was good-- less interference with the drug. I'm also having an implant, so the total process is taking eight months. No complications, no infections, everything is good. Don't forget to gargle with salt for a few days. I have low white blood counts, but it was a non-issue.

[Stage4Gir in reply to SoCalLady]

Thanks ladies. You’re right I had it done. Got my onc office on phone with dentist and although there’s some concern about healing all went ok. Love this site. More info here than any Dr gives me. xo

[Betbop]

I've had surgery and was required to be off of my Ibrance and Faslodex for almost 2 months. Thankfully my scans continue to be good. Wishing you lots of luck.

[Purple60]

I haven’t had the issue of a wisdom tooth but similar set of circumstances. I have a fractured tooth that was protected by a crown but it keeps falling out. My dentist wants me to have the tooth extracted but I am on Xgeva. I don’t know if it is used routinely in the U.K.. It is a once a month injection that addresses the bone loss and bone mets. The problem is not with the counts but causing issues with healing of the tooth socket (as I understand it). Has anyone had this issue?

[Bubbles001 in reply to Purple60]

I was on Zometa and had a wisdom tooth extracted. I got osteonecrosis of the jaw. I had to stop Zometa and can’t take anything similar. The regular dentists and oral surgeons don’t seem to know much about this situation. I now go to a specialist oral surgeon In Miami who has seen this a lot.

[Barbteeth in reply to Bubbles001]

You were very unlucky

Barb xx

[LisaT23 in reply to Purple60]

Hi Purple60,

Make sure you go to an oral surgeon who is up to date on Xgeva and ONJ.

I had cracked a tooth completely in half 7/2017, dentist sent me to oral surgeon. He didn't want to pull the tooth since I was on xgeva. I had done 1 month Xgeva then tried switching to zometa for 2 1/2 monthly doses ( felt worse) then back on xgeva. He was afraid of the risk of ONJ.

Instead he did a root canal then cut the tooth below the gum line. The goal was for the gum to close over it and never expose the bone. The tooth kept trying to push out, like a baby tooth, and gum was filling in behind it. It looked fine until 1/2019 when a small sliver on bone started to poke out on the outside side of my gum behind the tooth. Turned out to be ONJ. stopped the xgeva (last dose was 12/2018) My oral surgeon sent me to an Oral Maxofacial surgeon that is well known for teaching and lecturing about "medicine related ONJ" he had been the chief at my hospital for years before going private, and now teaches still teaches there.

The new surgeon pulled the remaining parts of the tooth and removed a 3.2 x 2.6 x 1.1 cm piece of tissue and bone from behind and above the tooth (was the back top tooth) on 4/23/19. Made me use peridex mouth wash for months. Luckily it did not affect my sinus and is healing well.

I will stay with this oral surgeon for any future issues, wish I had heard of him before. He is the best. I am on Long Island, if you are local and need a name.

Lisa

[Purple60]

Thank you for your reply. Yes, that is the danger...osteonecrosis. I understand there are some surgeons who use hyperbaric chambers to help super saturate the area with oxygen.

I hate to put Barbteeth on the spot, but wonder if you have any thoughts on the issue.

Thanks!

[Barbteeth in reply to Purple60]

Ha

I’ve just replied

Barb xx

[Kathyquilts]

I had cataract surgery. I took a month off the Ibrance so my counts were good.

[Mindysooty]

Im glad Ive read these comments. Ive had a dental check a couple of months ago before I started Ibrance as I was told I was going to have Denosumab (the monthly bone treatment injection). I didnt need any dental work at that time. They then decided I wasnt having the injection but now, as two more areas have shown up on my spine, Im meant to start it on 18th July. Trouble is Ive now started with toothache. Ive been trying to convince myself its nothing, particularly as I also just had a smear test result come back positive and I now have to have the LLETZ procedure to remove cells. Ive been trying to arrange blood tests etc before they can do it but getting nowhere fast. I can just see the same happening with the dentist but obviously ON is a very real threat so Id better get my a**e in gear. Sigh. X

[Barbteeth in reply to Mindysooty]

Osteonecrosis of the jaw is extremely rare

When I was practicing...I had many patients on denosumab and bisphosphates and none had a problem

Barb xx

[Mindysooty in reply to Barbteeth]

Oh really. Thanks Barb that reassures me. I was so pleased when I didnt need any work but unfortunately I think Ive done something when I chomped on a cacao nib or nut that Id put on my fruit n yogurt - ironic as I was trying to be healthy 😏.

Thanks again x

[Barbteeth in reply to Mindysooty]

I know...most fillings and teeth get chipped with healthy foods...banana chips are one of the worst...pumpkin seeds are notorious for getting stuck between teeth and gums!!.. you can’t win!!

Make sure you have regular scale and polishes every 3 months ideally...oral hygiene is so important...as you know

Sorry if I sound bossy!!

Barb xx

[Mindysooty in reply to Barbteeth]

Not bossy at all. Any and all advice accepted 🖒 x

[Purple60 in reply to Barbteeth]

Thanks so much. I read up on it today and found the same...but my doc told me today during chemo that they referred me to an oral surgeon at the cancer hospital where I get all other care. Appreciate your insight.

Dear stageIVgir I apologize deeply if I hijacked your thread!

[Stage4Gir in reply to Purple60]

No need to apologize all info is good! I had my tooth out Monday night and was at the end of my Ibrance cycle. No problems so far and reading replies here helped me so much. xo

[Purple60 in reply to Barbteeth]

Just to clarify though....on denusomab and underwent tooth extraction? That is the situation I am facing. Thanks