A toothache (molar) led me to my dentist earlier this week. He took a couple digital xrays and told me I have an infection in my jaw below #1 molar. The tooth has already had a root canal, many years ago. I've been on monthly Aredia for almost a year (widespread bone mets). My oncologist says extraction is out of the question, so I am being treated with anitbiotics for 8 days to see how it responds. My dentist indicates this is a standard abcess and not ONJ. I have had extensive dental work my entire life, but had been lucky the last few years, until now. If the antibiotics don't control the infection and extraction is not desirable, what do you do if you have a significant tooth issue. Does this become an issue of chronic antibiotic use to control? How high risk is an extraction if nothing else seems to work? Would surgical removal be better than an extraction? How about laser dentistry as a less invasive modality?
Any info would be appreciated. I'll see my oncologist next week for my routine appointment and we'll be talking about this of course.
The differentiation between abscess and ONJ is critical. If your dentist thinks that this is not ONJ and just an abscess, then I believe an extraction can be discussed, but indeed there can be risks of non-healing of the area.
If this does not respond to antibiotics, then another option is surgical debridement of the area to remove as much of the infection as possible and continue with the antibiotic treatment. I'm not sure if laser surgery can be applicable in your situation.
Your situation will really entail close communication with and between your doctors since the risks of operation are really there.
Thank you Doctor. I am duly concerned, but trying to not worry (too much). Seems to be responding ... at least there is very little pain/ache now after 3 days of antibiotics so far. Should know more in about a week. Thanks again.
My mother has metestatatic breast cancer throuought her body. Last night she was discharged from the hospital after four days. She had a very severe abscess in her jaw (external).
When the lump started to appear and cause severe pain in her jaw, the doctors took xrays and said, "Yes, cancer in the left and right mandable... and it looks like the lymph nodes are being affected."
Now, the doctors say that cancer is not likely in this area and the infection is severe. They lanced the area, drained and started IV antibiotics.
This morning she says that she has a hole in her gum.
There is no sign as to what casued the abscess. Before we left the hospital, the microbiolgy report had not come back. We will follow up on Monday or Tuesday with the doctor.
The doctors say they don't know what caused this. I know that science has come a long way, but is it ridiculous not to have a mircrobiology report back within a few days? Is it ridiculous that the cause of this abscess can't be caused by bad oral hygene or cancer?
The doctor is taking mom off Zometa even though there are no signs of dead bone. He is concerned that her body is reacting to the Zometa.
Can you help with any of this?
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