Teeth Problems

Hi, I've had quite a bit of chemo over the past 5 years. I'm currently on weekly navelbine/herceptin. Now I'm having a lot of trouble with my teeth. They never were very strong, but since chemo they've just been breaking off. I have 4 teeth that are broken, two of them are painful. I'm severly lactose intolerant so can't do dairy products. Just read that I shouldn't get dental work done if my counts are low, which they are. Is anyone else having this problem? Any suggestions?

San

Dear San,
I don't know much about teeth but if it Ostio-related, have you tried Fosomax or one of the ostio meds?
I would ask your dentit.
Al

Hi there, the problem is that they don't want you to get an infection having treatment while on chemo, but at the same time they don't want you to get an infection from your teeth. I was to have reconstruciton surgery while on Herceptin/Navelbine and the stipulation was that I not have surgery until 72 hours after infusion, this is because the medical staff do not want to be exposed to cytoxic drugs. I suggest you take a course of antibiotics before you start your dental treatment then wait the 72 hours to get the work done. If you feel healthy in yourself I would not worry too much. I also take calcium tablets, when I had my bloods done my doc said my calcium was low so I doubled my dose from 600mg to 1200mg of Caltrate 600mg, 1 in morning and 1 at night and I will get another reading next time I go. Hope this helps.

Love & Hugs Lyn

[Lolly]

Hi San, I had dental work done while on chemo last year, weekly Navelbine/Herceptin actually! I had a crown placed, and 3 cavities filled along with hygiene work. This was with the approval of my oncologist, and my dentist gave me a prescription for antibiotics which I took an hour before my appointment for each procedure, four pills each time. Although I don't remember the name of the antibiotic or the strength, I could get this information for you but any dentist should know the proper protocol for what's termed "prophalactic antibiotics". Good luck, I know it's no fun having your teeth bothering you on top of everything else we have to deal with.

<3, Lolly

Hi,
I am a dentist. Glad to answer something I know about. If your counts are low, the danger in doing dental work is present. We get set off an infection which could be more trouble for you. Are you doing your best to brush and floss? You are not supposed to use flouride according to the "natural" principles for cancer fighting, but you can try some Cholhexidine (antibacterial mouthwash by prescription only). My mom uses Peelu and Sea Wead mouthwash from the natural food store and it seems to help. If you want your broken teeth fixed, ask your onc. if you can have any shots to boost your counts and consider having all work done on one day when you are feeling good. You need to find a good dentist just to consult first. Try to find someone who is knowledgeable about cancer and if you believe in the whole "holistic" movement. I can give you any further advice if you want.

Take care,
Anne

Dear Anne, I would like more of the info you have on holistic methods and teeth. Am having some problems, too. I suddenly have a very tender-to-touch front tooth. There doesn't seem to be any apparent cavity, it is just extremely sensitive to touch and I can't bite or chew with it. I haven't seen a dentist yet-being a coward-but I will have to and am quite concerned. thank you for your help. Tricia

....me, too...

Hi Tricia,
It sounds to me like you might have some gum disease going on(also know as periodontal disease). Either this or you may have developed some sens. due to lack of flouride if you are using a "natural" toothpaste. Where do you live? I practice in Northern Virginia and will be more than happy to see you. I like patients who are fearful. Don't worry I will just talk to you if you want. If you don't live in this area, you can try having a "deep cleaning" of the gums and maybe a nightguard if you grind your teeth and this may help. My stand on flouride is mixed. Use it sparingly and we can try to use it in a way you minimixe swallowing.
You can email me at saxenachetana@yahoo.com if you want any more advice.
Take care,
Anne

[StephN]

Hi ladies -
I found that I could not brush as hard as usual with the mouth sores and some gum tenderness while on my various chemos.
A friend who is a jaw surgeon suggested I use Biotene toothpaste and mouthwash. This really helped a lot! This product has enzymes that we need for healthy gums and really cleared mine up. Helped with the mouth sores, too.
I also use Vicco, an ayervedic formulation sometimes. I like it a lot and it is not expensive at $2.00 a tube at the natural food store I frequent.

The tooth breaking may be due to other problems, and only a dentist can really say why this is happening. More to due with enamel strength? I have had a piece of tooth shear off due to "general wear and tear" and my dentist ground out the old filling and did a nice patch up job so I did not need a crown so far.

I was also put on Fosamax, but not in time for enough bone loss to take place that my teeth started moving. They were always straight without having braces, but especially the bottom are crooked now. I should have gotten a night guard then, and am going to look into it even now before it gets even worse. I am not a tooth grinder, but need something to keep my teeth from moving more and perhaps cracking, as they are crowding forward and the pressure is causing them to go sideways and start to overlap.
I had my wisdom teeth out as a young teen, so there is nothing to take out now. Just trying to preserve the health of what I have.

Thank you all for your suggestions.

My oncologist held my navelbine for a week so that my counts would be a little higher. I'm getting the worst tooth pulled this week. Also got some vicodin to get me through until my dentist visit.

I really appreciate all your support.

San