Question about the Dentist

[Maryanne]

Hi all,

I have a fast question.

Can you go to the dentist during Chemo? Or do you have to go before.

Joel is having problems with a tooth which Iam sure will have to be root canal and crowned (or hopefully filled)

I heard that you cannot do this during chemo. So I am wondering if he should go now before the Chemo.

We still do not have a new appointment with the Oncologist yet as we are finishing with the endocrinologist hopefully the week. So we figured that when we are finished with the thyroid thing that he will go back to the Oncologist and start the chemo.

If we can't do both (dentist and chemo) then the Chemo will be put off, until this tooth is taken care of.

He will be having carbo/taxal.

thanks

Maryanne

[Addie]

Call your onc. He'll probably want to check his bloodcounts. I went for a cleaning sometime during my first 6 cycles of chemo....but only because my counts were good AND I take 2000 mgs.of penicillin before each cleaning anyway....because I have a mitral valve prolapse.

The risk is bleeding and bacteria getting into the bloodstream when one's immune system is suppressed. But this is a call for your onc....and will likely require bloodwork first!

Jeez....it doesn't pay NOT to read things better.....I see now that DH hasn't started chemo yet. So you should be okay....but you know, I'd still call the onc because maybe he'd want him on preventative antibiotics for the dental work, simply because he's about to start chemo!!

[Ry]

As a person with mitral valve prolapse that has contracted endocarditis twice now...please check and ask for antibiotics just in case. The last thing he needs now is a major infection.

[Hebbie]

I think you definetely want to go to the dentist BEFORE starting chemo. My dentist told me that chemo can damage your teeth -- now, I know we have more important things to worry about than rotten teeth, but I took the persepective that chemo was going to provide the complete CURE for me, so if I was going to be walking around smiling from ear to ear all the time (with JOY), than I may as well keep those pearly whites looking great

Anyway -- my dentist gave me a super good cleaning before starting chemo, and gave me a fluoride rinse to use during chemo to keep my teeth strong, and then saw me again after completing chemo, just to check on things.

I don't think it ever hurts to be proactive!

[cindi o'h]

Hi Marianne.

I agree with all of the above.

Get the tooth fixed before he starts chemo. If the tooth needs a endo therapy (root canal) then get that done and a temporary otherwise called a provisional crown put on.

Then wait for 6 months to a year to have the crown done..if that indeed is the treatment that is needed. You don't want to do a crown right away in case the tooth requires further treatment for the damaged/infected nerve. (you don't say what his symptoms are)

I also agree that his teeth should be thoroughly cleaned from the base of the attachment of the gum to the tooth all the way to the top. He should have instructions in how to take care of his teeth during the chemo. He should be told to avoid alcohol based rinses as these contribute to a dry mouth and can also exacerbate sores in his mouth from the chemo. Chemo affects fast growing cells. The mucosa in the mouth (epithelial cells) are very much a part of our fast growing cells, so it stands to reason that our mouths are affected by the chemo.

Meticulous home care must be in place to minimize the risks of gum infection. There is an oral rinse that is really good to use: Biotene. It is non alcohol based. Also there is a product that they make for dry mouth which many of us suffer. It coats the mouth and makes eating and talking more comfortable.

There are so many aids that can be used in addition to the softest toothbrush you can find. Some are proxy brushes that gently clean spaces in between the teeth. Stimudents. floss piks, if advised. A good hygienist or dentist can evaluate his situation and make recommendations for personalized care based on their findings.

Talk to the dentist about antibiotics.. I doubt they are necessary unless he is already compromised. But, it sounds as if his Grave's is under control now. So really, he should be all right. The only reason that I could think that he would need pre-med now would be if he has lymphadenopathy or cysitis. I don't hear either of those from you. If he did, he would be a hurting guy and be screaming to get to the dentist instead of wondering if he should go or not....

Get the tooth cleared from infection if there is one. That is the main priority. He would not be able to fight infection should his lab values drop during chemo.

Too much information, I know....!

love anyway,

Cindi o'h

[ellakc2]

Maryanne,

I had the same problem. I went before Chemo. I don't think a dentist will touch you during Chemo, because you don't heal as fast. Also if you have a port you must go on Anitbotics before dental work. If you tell them your situation they should get him in ASAP. Good luck.

[Cindy RN]

Go before if you can. I HAD to have a tooth worked on while I was on chemo-no choice. I went on antibiotics during that period.

Good luck-Cindy

[jcawork]

I agree w/ all that has been said. When you go, ask for a script for Perioguard mouthwash. It is what the Dentists use on themselves. It has an antibiotic in it and kills anything. It also has an anti inflamitory in it and if he gets swollen gums, mouth sores or an irritaion it takes care of it asap. I was given it to deal w/ issues that might crop up during chemo, which they did and to help prevent needing a dental appt during chemo, which it did.

Good Luck.

Jen

[Frank Lamb]

I was told by onc to have mine cleaned before I began chemo.