Dental Work and WG Medications

[KenL]

Hi,
I am currently on Cyclophosphamide, Prednisone and Bactrim for my diagnosed WG. I chipped a tooth filling tonight and will have to go to the dentist for repair. Has anyone here had to take any additional precautions for dental work? I have not contacted my regular “WG” Dr. yet but am interested in the type, if any, precautions you would recommend. I certainly do not want to be accessible to an infection at this point.
Thanks for the help.
KenL

[Al]

Actually, Ken, it is recommended that anyone on prednisone get a dental checkup. (I know that repairing a tooth is a bit more than a checkup, but still....) Just be sure to tell the dentist that you are on pred, and why.

Al

[KenL]

Al,
Thanks for the input. That's what nice about this site. Always great inputs/advice.
Ken

[drz]

For fillings no extra precautions were recommended to me. For cleaning they gave me a rinse of antibiotic wash before the cleaning. For root canal my doctor said to stop the ctx for day before till day after to allow WBC to rebound a little to help prevent infections. Other doctors may see things differently.

I see my dentist every three months (diabetes raises havoc with teeth) for cleanings and work as needed and had no problems while following these recommendations. You might be more prone to mouth sores after dental work due to irritation and stress on mouth and this could require additional treatment--usually some rinses

[pberggren1]

Palmayra is our resident expert on Dental things. I would message her about it.

[Rose]

I have had regular cleaning and a few root canal treatments over the years since diagnosis and no extra precautions were taken. In january I had to have an extraction and for that I was given a one off dose of about 2g of an antibiotic to be taken about an hour before the extraction because I was immune suppressed. All was well, no problems.

[Dryhill]

Al,
Thanks for the input. That's what nice about this site. Always great inputs/advice.
Ken

Yes and you can ask the dumbest questions and no one thinks you are stupid, they are just happy to give good advice. Thanks for asking this question as I have to have some dental work done soon.

Jim

[renidrag]

I had the same dosage of anti-biotics just before an extraction. Be careful though if you are on any blood thinner and make sure your regular Doctor is informed. They usually don't do any dental work if INR is above 2.2.
Dale

[KenL]

Thanks to all for your valuable inputs. Now I know I wouldn't have any nornal problems tomorrow during my dental appointment.
Ken

[Hammy8241]

It is very important that you inform your dentist of EVERY pill you pop as, even the what you may think innocent of drugs can mean adjustments in the way they treat you. I ignored Alendronic Acid only to find out that that it has serious implications with regards to dentistry. Tell all, and let them choose.

[Jaha]

I recently lost a filling and I gave my dentist a list of all my medications. I currently am on Cellcept and preds. The dentist contacted my WGs specialist to make sure it was alright to do that and other dental work I need to have done. I went in and had the filling replaced wearing a mask in the waiting room about 5 days before my 1st Rtx infusion. I am going to wait about a month to have more work done. I was very happy that my dentist cked it out with my Doc.
Jana

[Palmyra]

Hi Jack,

Late in responding to this post, but... I am a dental hygienist, and we treat people that are immunosuppressed all the time. As Al mentioned, be sure to tell your DDS all of the meds you are on. Restoring a chipped tooth is not terribly invasive, and should not result in much of an impact on your depressed immune system. When folks are on chemo to treat cancer, we proceed with caution after consult w/ an MD. We do not do elective proceedures.

Anyone with Weg should have their teeth cleaned regularly, to prevent gum disease.

Hope this helps!

Jane

[Dryhill]

Anyone with Weg should have their teeth cleaned regularly, to prevent gum disease.

Hope this helps!

Jane

Thank you Jane for that last bit of info.

Jim

[Al]

Hi Jack,

Late in responding to this post, but... I am a dental hygienist, and we treat people that are immunosuppressed all the time. As Al mentioned, be sure to tell your DDS all of the meds you are on. Restoring a chipped tooth is not terribly invasive, and should not result in much of an impact on your depressed immune system. When folks are on chemo to treat cancer, we proceed with caution after consult w/ an MD. We do not do elective proceedures.

Anyone with Weg should have their teeth cleaned regularly, to prevent gum disease.

Hope this helps!

JaneThis is good; thanks!

Al

[Palmyra]

As a note to those concerned...

Having one's teeth cleaned does produce a bacteremia (introduction of bacteria into the blood stream). Current recommendations for antibiotic premedication prior to a dental cleaning or a surgery that invades the gum tissues are specific for certain heart valve conditions and artificial joint replacement only. For those with immunosuppression that is profound (ie., nadir suppression in those that are being treated aggressively for certain cancers), invasive procedures are simply avoided or treated well before/after nadir.

Most Weggies never reach a nadir of all immune function, and premedication therefore is not necessary.

[Al]

As a note to those concerned...

Having one's teeth cleaned does produce a bacteremia (introduction of bacteria into the blood stream). Current recommendations for antibiotic premedication prior to a dental cleaning or a surgery that invades the gum tissues are specific for certain heart valve conditions and artificial joint replacement only. For those with immunosuppression that is profound (ie., nadir suppression in those that are being treated aggressively for certain cancers), invasive procedures are simply avoided or treated well before/after nadir.

Most Weggies never reach a nadir of all immune function, and premedication therefore is not necessary.Though, perhaps, they procedure should be avoided directly after a cytoxan infusion, when the immune system has been heavily whacked...?

Al

[Palmyra]

Yes Al,

I would advise dental cleanings before immunosuppressive therapy, or a decent amount of time after.