Problems with teeth ...

[Sunnydrinking]

I went to the dentist as an emergency today as I’ve developed a wobbly and bleeding tooth.

The dentist took an X-ray and was very concerned..... I kind of hoped she would pull the troublesome tooth. I’ve been put on antibiotics, amoxicillin & metronidazole. I’ve also been referred to the hospital urgently for them to extract the tooth is necessary.

My dentist advised she was concerned that because I’m on Denosumab that extraction could cause osteonecrosis of the jaw and indeed she was worried that I may be showing some signs of having it.

My gum has receded and I have a lump ....

Always something to deal with eh?,

Any comments or advice would be appreciated.

In the meantime, I’m also rinsing my mouth twice a day with chlorhexidine.

I’ve also contacted my trial nurse and she confirmed the antibiotics are OK to take with my trial med. She also suggested they could stop Denosumab for a couple of months if I need to have the tooth extracted.

Jo xx

[stardust1965]

I am sorry you are having this problem. It sounds like you have a good dentist and has done the right thing by referring you to the hospital.

I had a milk tooth extracted a few months in to having monthly zometa infusions and was nervous about that. I decided to have it extracted so it wouldn’t cause problems further along in my treatment. It was fine but my oncologist said (with zometa) it builds up in your system over time and stays for many years. I think I read Denosumab didn’t stay in your system as long so delaying having your next dose may be a good idea. I hope all goes well. xx

[Hidden]

I have ONJ. Please stop your Denosumab if you have dental problems. I had a jab a week after a tooth extraction and it shouldn’t have happened. It caused ONJ and the tooth socket never healed. I’m 15 months after the extraction and still having problems I.e. protruding jaw bone through the gum. The jabs I think are now damaging other teeth. I had an inexperienced dentist who acted under hospital instruction for the extraction but it was the jab that caused the damage. I had 5pieces of jaw bone removed, they were only small but not a good thing. I’ve been waiting since June for an emergency appointment with the Facial/cranial clinic. So much for emergency.

Do take care, rinsing is fine but it does stain your teeth strangely enough. I wish you all the best and take care. Ask your dentist for some Duraphate toothpaste. It really helps.

Cheryl.

[Bestbird]

I am sorry to hear you may be dealing with ONJ. Below from my book, "The Insider's Guide to Metastatic Breast Cancer (which is also available as a complimentary .pdf) is some information about it. To learn more, please visit insidersguidembc.com/about

Treatment objectives for patients with an established diagnosis of ONJ aim to eliminate pain, prevent or control infection of the soft tissue and bone, and minimize the progression or occurrence of bone necrosis (bone death). A small study of 34 patients randomized to receive either 8 weeks of daily subcutaneous injections of teriparatide (also known as the osteoporosis medication “Forte”) or a saline solution revealed an increased rate of resolution (45.4% vs. 33.3%) of medication-related osteonecrosis of the jaw lesions in the teriparatide group. Additionally, a higher proportion of patients receiving teriparatide (80.0% vs. 31.3%) showed increased bone volume and a reduction in the size of bony defects at 12 months compared with those receiving saline injections. However, the study authors stressed the importance of limiting the cumulative dose of teriparatide due to findings from preclinical studies showing an increased incidence of osteosarcoma in rats treated with this medication. From: oncologynurseadvisor.com/ho...

Individuals who have been diagnosed with ONJ should seek the care of a Maxillofacial Surgeon (a physician who combines dental, medical, and surgical skills and who specializes in the face, jaws, and soft tissues). A list of Maxillofacial Surgeons by State is located at: healthgrades.com/oral-surge...

[Magz52]

I have had problems with ONJ but fortunately I was referred to Maxillofacial Unit at the local hospital. I had a loose tooth removed along with some small fragments of bone. I was prescribed a long term antibiotic & I stopped my monthly Denosumab injections.

Everything has settled down now but if I have any pain or discomfort I should contact the Maxillofacial Unit for an emergency appointment. I have recently restarted Denosumab because I believe the benefits probably outweigh the negative. However, I plan to reduce the frequency of the injections as a precaution. I’m not currently taking the antibiotic but I know to restart it immediately if I have another flare-up.

[mariootsi]

I hope all goes well. I had dental work done in June and had to stop my Ibrance at that point.

[Sunnydrinking]

Hi Ladies

Many thanks for your very helpful replies.

I’ve now got an initial appointment, via a telephone consultation for next Tuesday with a Maxillofacial consultant. He/she would have received a copy of my recent X-ray and will no doubt be able to suggest next steps.

Meanwhile I’m popping the antibiotics and I’m not in any pain with it, just a nasty taste and smelly breath!

I’ll keep you posted.

Thanks again

Jo xx