Is a prophalactic antibiotic needed to have teeth cleaned when taking Cytoxan?

[drz]

I was told no surgery while on Cytoxan, including something like having a tooth pulled?

Would this apply to having teeth cleaned since this often causes bleeding in gums when getting cleaned?

How long does one need to wait till off the Cytoxan to get cataracts repaired?

[pberggren1]

I'm not sure about that. I would double and triple check that one. Like you say even just a cleaning could be iffy. I have not been to a dentist for 3 years now and was not on ctx then.

[DEE]

[QUOTE=drz;21017

How long does one need to wait till off the Cytoxan to get cataracts repaired?[/QUOTE]

ive been told by ENT that he wont do surgery for six months after coming off cxt unless an emergency DEEx

[Jack]

I asked about the dentist thing and was told that I should have antibiotic cover, but only for a couple of days.

[elephant]

Last year when I was on 60 mg of prednisone, and the other immunosuppressants that I'm still on, the doc put me on antibiotics for one day ( high dose).

[Sangye]

I had oral surgery to remove a molar about 2 months after going off ctx. He didn't mention the ctx, just the general immune-compromise stuff and risk of infection. I had also just gotten off the big pred, so that was a concern. I think he probably had me do a single high dose of antibiotics like Elephant said, but I don't remember.

Palmyra is in the dental profession and can give you the real expert opinion.

[Col 23]

Just a bit of info for those in Australia. Found out that people with Chronic illness can be eligible for about $4,200 for dental care over a 2 year period. Apparently your doc assessess your eligiblility something to do with Allied Health. Im going to ask the doc about this on Monday. Does anyone else know about this.
Col 23

[Palmyra]

Ah hah! Finally I get to work again! Even if only on this forum, I get to make use of my professional training

Pls see the following, if one has had a transplant:
Oral Complications of Chemotherapy and Head/Neck Radiation - National Cancer Institute

For those taking bisphosphonates (Fosamax, boniva, many others), dental management is also different, especially if bisphos therapy has been longer than 2 Years and accompanied by corticosteroids/immunosupression.....more info available at:
ADA: American Dental Association - Bisphosphonate Medication (Fosamax, Actonel, Boniva, Aredia, Bonefos, Didronel, Zometa) (Osteonecrosis of the Jaw)

Regarding prophylaxis prior to having one's teeth cleaned, I only know the standard of care as it is currently recommended in the United States. Guidelines are from the American Heart Association, the ADA and the ACA (see below *) It does get confusing, and as always, is subject to individual presentation.

Several determining factors that are currently requiring prophylaxis, including, but not limited to: presence of heart disease (specific to valve replacement or previous infection with endocarditis), recent artificial joint replacement (knee, hip..) or long term use of bisphosphonates (boniva, other Rx's to increase bone mass). These conditions all warrant prophylaxis, or in the case of bispho use, extreme caution with extractions, especially with immune compromise (including history of smoking/diabetes)

When one is taking immunosuppressive medication, it is generally advised to complete all elective dental procedures prior to intensive treatment if at all possible. The level of immunosuppression with WG therapy is generally considerably less than that which is used for those taking like drugs for cancer treatment. If one knows that immunosuppression is profound, dental work should ideally be delayed until nadir of white counts is past.

For management during maintenance suppression for WG or other AI diseases, prophylaxis is generally not recommended, as more serious incidents occur from the antibiotics themselves, than from the temporary bacteremia caused by dental work. It is strongly recommended to have a screening for periodontal disease, appropriate surgical procedures or scaling to eliminate gum disease if present, regular dental cleanings, and top notch home care.

Current meds for prophylaxis, if needed are: amoxicillin, or clindamycin. The ADA recommendations are for one dose, one hour prior to treatment, with no subsequent dose following treatment.....much different than ten years ago. Oral disinfectants are also recommended prior to treatment (chlorhexidine gluconate rinse, for two minutes prior to treatment)

Please note: Sound oral hygiene practices and regular dental care may be the optimal approach for prevention of bacteremia or dental related problems associated with immunosuppression. We induce a bacteremia regularly when we eat, brush, floss. It appears having a healthy oral flora and healthy gum tissue is key to avoiding dental related bacterial infections, as opposed to addressing with antibiotic therapy alone.

Jane, BS,RDH, perio/oral medicine

[Lola]

Thank you for that excellent, professional report, Jane! Good stuff.

[elephant]

Thanks! Very informative!