what is the main dental management for Neutropenia patient ?

[jumanah]

dental management

Neutropenia patient

[AussieNeil Administrator]

Ask your specialist, but it is usual to have an antibiotic prophylactic just prior to any dental work that could result in mouth bacteria entering the blood stream via inevitable cuts and abrasions in your gums.

Neil

[JigFettler Volunteer in reply to AussieNeil]

Yes I agree Neil. Dental source of infection is very important. I had 3 teeth issues during FCR. Attended to with minimal intervention when neuts were up a bit. No local. No drilling.

I spent my watch and wait period sorting out my dental health pending FCR. My dentist talked about dental clearance he was so worried. We settled for 2 extractions. I've been fine. Fastidious attention to teeth cleaning.

Your local maxillofacial hospital department will have experience. Talk to them. They are v helpful.

Jig

[AussieNeil Administrator in reply to JigFettler]

You make an excellent point about getting any known dental issues resolved prior to treatment. It's certainly much easier and less risky than when undergoing treatment, when febrile neutropenia could become a concern.

[HopeME in reply to AussieNeil]

Neil: You also need to be careful post treatment with dental work. I finished six rounds of BR in early October. I have a tooth that probably will need a root canal at some point. It had been acting up so I was considering exploring a root canal. I was in to see my new specialist last week and I asked about dental work. He said if at all possible put it on hold for a few more months.

[AussieNeil Administrator in reply to HopeME]

Good point! With treatments incorporating CD20 monoclonal antibodies (e.g. Rituximab/Mabthera, Obinutazumab/Gazyva), there's a risk of what's known as Late Onset Neutropenia, particularly if G-CSF injections have been needed to boost neutrophil counts during treatment. This can occur for up to a year after treatment with the likes of FCR or BR has been completed. T cells are also depleted by CD20 monoclonal antibodies, which can stay in circulation for up to 6 months after treatment. CLL also tends to reverse the CD4/CD8 T-cell ratio, which can take a while to correct after treatment ends. All CLL treatments reduce our healthy B-Lymphocyte count too, as we don't yet have a treatment that selectively targets just the cancerous CLL B-Lymphocytes. All of these factors reduce our immunity during and post treatment.

Neil

[MsLockYourPosts Passed Volunteer]

I have never dealt with neutropenia during or after treatment, but my dentist won't touch me if I don't take 2000 mg of amoxicillin an hour before any appointment. He once rescheduled a cleaning appointment because I forgot. I know that there are differing opinions about this, but I like better safe than sorry for this. Some take something before and after.

[jumanah]

thank you all for replying