Dental extraction and chemo treatments

I needed some dental work done, however I’m not in any significant pain so my dentist decided to forgo any work since I’m stage 4. Was able to drop my PPO dental since all they will do is teeth cleaning! I think breaks in chemo more than 1 week can be dangerous, but it also depends on your CA19-9 numbers. If it continue to go down and there is no risk of infection, then you should speak with your oncologist to see if they agree about dental work.

Hi @altc321. I’m so sorry your wife is having to deal with these dental issues along with her cancer treatments. Having teeth extracted or any oral surgery while going through chemotherapy may be complicated. Chemo can lower the white blood cell count, platelet count, and red blood cell counts which can impact bleeding during surgery, the potential for infections and also the healing process.
I’m not seeing an Oral/Maxillofacial Surgery Dept in Jacksonville other wise that might be an option for collaborate treatment. I think the best person to ask for clarification on how to proceed will be your wife’s oncologist.
They may ok minimal work such as an emergency extraction. But at this time they may not suggest implants if that’s the consideration for replacment teeth.

If the oncologist oks the surgery, you’ll need to find an Oral/Maxillofacial Surgeon to do the extractions. They are specialists in oral surgery and would take all necessary precautions to avoid infection risks. After healing of the extraction sites, her dentist or prosthodontics (dentist who specializes in tooth replacement) could consider a partial denture as a replacement for the teeth if implants aren’t recommended at this time.

Tell me a little more about the teeth that need removal. Are they abscessed, broken, already loose? Have you spoken with the oncologist about the dental work?

I had unexpected dental work done while on chemo. Dentists and hygienists are well trained in addressing the needs of cancer patients on chemotherapy and experiencing immune suppression of WBC counts.

Delaying dental care can lead to even bigger problems of tooth loss, bone loss and endocarditis of heart valves that can be extremely serious morbidity. A consultation can occur between one’s oncologist and dentist to discuss the prophylaxis and procedures to be used. For low WBC counts following a chemo session, Filgrastim or peg-Filgrastim can be used to increase cell counts. Even though I was being treated for stage IV disease, I was focused on long-term survival and keeping up with dental care.

Dental Care
https://www.nidcr.nih.gov/sites/default/files/2020-06/chemotherapy-and-your-mouth.pdf
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https://www.ada.org/resources/research/science-and-research-institute/oral-health-topics/cancer-therapies-and-dental-considerations
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https://jada.ada.org/article/S0002-8177(18)30759-1/fulltext
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https://www.mskcc.org/cancer-care/patient-education/mouth-care-during-your-treatment
While on the subject- chemotherapy can result in dry mouth which ends up promoting dental cavities and loss of teeth. Saliva is bacteriostatic and prevents bacterial growth in the oral cavity that can lead to destruction of teeth and bone loss. The product Xylimelts by OraCoat stimulates saliva overnight leaving the mouth moist and refreshed. Xylimelts are small disks with xylitol that adhere to the gum line and stimulates salivation for approximately 7 hours. They were recommended by my dentist and his hygienist that has a large clientele of cancer patients. Since using Xylimelts, it has eliminated dry mouth and no more cavities or senstivity issues.

ORAL HYGIENE
https://www.oracoat.com/xylimelts.html?654=16335&651=16326
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https://www.listerine.com/mouthwash/listerine-total-care/listerine-total-care-anticavity-alcohol-free-mouthwash
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https://www.colgate.com/en-us/zero#

Thank you for your response….. none of he teeth are abscessed, but I am concerned if this occurs. Also, none are loose, but 2 or three are broken at the gum.
We do need a consultation with a Oral/Maxillofacial that will coordinate with her Mayo oncologist….. hope to get referral at our next meeting.
Thank you again for your helpful information.

stageivsurvivor, Your links and comments and suggestions are extremely helpful. We share the same priority that “long term survival and dental care” are the primary goals. So far her teeth are not a serious issue but restricts some foods from her diet. We now have a referral from our oncologist team for an Oral/Maxillofacial very close to Mayo Clinic and plan a consultation visit very soon.
Thank you again…. We follow you on this site and appreciate all of your posts/replies.