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Anybody having Dental problems with triple therapy?
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Anybody having Dental problems with triple therapy?

I have never had such a screwed up mouth.  I really think this triple therapy has totally effected my dental work. Am I alone in this?  Anybody else experiencing these sides?  These are sx are not listed. I have had 2 crowns fall off in a week.  Is it just me?

Thanks guys for any feedback!
~carolyn

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1856046_tn?1330240845
I use the Biotine as well for all the meds I am on and I have diabetes as well. Wouldn't have any teeth left without it!

Sometimes I get cottonmouth soooo bad.

Matter of fact, here's a clip of it to brighten your day Carolyn (hopefully!)

www.youtube.com/watch?v=z8X09Nmftos
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32 Comments Post a Comment
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1726450_tn?1316286111
My Dr said it is a side effect-

I have been having some issues with teeth for sure.
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1807991_tn?1323023215
Last week I had my teeth cleaned, now my crowns are falling off.  I feel like my mouth is bathed in side kind of acidic metal.  It does feel like it's slowly dissolving my gums, it's such a nasty flavor.  What if I loose all my crowns?

WOW, They somehow forgot to talk about that sx in class!
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789911_tn?1368640383
yikes!  I have been having severe dry mouth the last couple of months.  It doesnt matter how much water I drink or other things I do.  It is just there and its driving me a little nutty.  I know that is very bad for your teeth.  I have been trying to take better care of my teeth but I was on the verge of having problems before treatment and did not have my teeth examined before I started.  i would certainly suggest anyone starting treatment to have your teeth and gums looked at before starting tx.
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317787_tn?1373214989
Hey there, as you know I have been having severe dry mouth, no saliva, can't use much but water and biotene cause my mouth was so sensitive
Now, off incivek saliva coming back, I can see that the anti nausea anti itch, both antihistamines did not help.
Funny you should should ask about crowns,  8 weeks ago I was eating my peanut butter with an apple when my crown split wide open, had to get it replaced.  Coincidence?  Not sure but I have been extra careful with my teeth during tx due to the fat eating and I have diabetes.
Good luck
Dee
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1840891_tn?1383280315
Yikes! What a vivid reminder for us all to keep working at drinking and using Biotene, as dry mouth can sure make your teeth rot fast! It just happened to my husband, although his dry mouth is from a different kind of med,  he had 5 crowns go bad in only one year - and we dont have dental insurance.  So far this hasn't hit me but I'm only 6 wks into TX. I've gotta be extra careful - we can't afford that many dental bills.
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1765684_tn?1333822768
I'm not on the new triple therapy but I have severe dry mouth, sore tongue and now sore gums in spots, too.  So I'm not sure that the new drug is to blame...

I was in the drug store and saw some kind of patch you stick in the roof of your mouth for dry mouth.  Anyone tried these?
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my gums are defenely weaker and bleeding more but not excesive ..but my gaps are becaming biguer ..for sure and that isnt good ..good luck
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Avatar_m_tn
I read much about this here before starting treatment and was warned by both my doctor and pharmacist regarding making extra efforts in terms of oral hygiene.  The Pharmacist mentioned that oral thrush was common.

Having teeth cleaned every 3 months to make sure they are in the best shape they can be was suggested by my Dentist, also to purchase a water pick and mix approx. 25% Hydrogen Peroxide with water and use a couple times a week.  Flossing several times a day and brushing 3 to 4 times a day and use Listerine.

Even with all this I started to develop sores on the roof of my mouth, insides of my cheeks and sides of my tongue within a couple of days of starting triple therapy.  I started using Biotene Dry Mouth Oral Rinse immediately and the sores went away literally overnight.  I have faithfully continued to use this product.  (Week 5 and the bottle I s almost empty.)

I just had my teeth cleaned on Monday and was talking to the Hygienist about this.  What we discussed was the huge amount of bacteria that is normally present in our mouths flourishes because of the dry mouth.  The fact that our WBC gets knocked down compounds the problem because the weakened immune system doesn’t do as good a job keeping the bacteria in check.
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1807991_tn?1323023215
Okay, i see its not just me...looks like at least 4 times a day I need to brush, water pic, gargle, floss, biotine, magic mouthwash and go back to the dentist often.  What a nightmare!

Thanks a lot :-(
Lol
~carolyn
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163305_tn?1333672171
There's a mouth wash you can get for dry mouth at drug stores.
My dentist got me started on xylitol products specifically to deal with dry mouth. There is gum, toothpaste, mouth spray, etc. You can order them online. Google epic xylitol.

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1856046_tn?1330240845
I use the Biotine as well for all the meds I am on and I have diabetes as well. Wouldn't have any teeth left without it!

Sometimes I get cottonmouth soooo bad.

Matter of fact, here's a clip of it to brighten your day Carolyn (hopefully!)

www.youtube.com/watch?v=z8X09Nmftos
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317787_tn?1373214989
Hi I lost a crown the same week you had your teeth cleaned.  I do not know if one has anything to do with the other
I did notice, no saliva, bleeding lips, gunk in my mouth I could not easily brush away, a biofilm I have been reading about
I think Biotene is great, have every product.  I did not produce salivva for weeks.  I bought some other mouth products but my tonge was so sensitive I could not use candy or gum.  I just kept using mouth gel and spray.  Now that I am better I am usin a peroxal alternating with salt water and am much better
I am completely comfortable today compared to yesterday and last week.  I have received no return call from my hepatologist bu another doctor helped me over the phone as he has heard how tough this tx can be.  I know it is tough this is my second triple tx (relapsed from last one 6 weeks after stopping)
Good luck C
Dee
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317787_tn?1373214989
Hi I forgot I tried magic mouthwash cause the mouth problem first started with thrush which I had the last time.  The thing that has really helped me is biotene and they make everything in mouth care and a peroxol rinse
Thank you for asking
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408795_tn?1324939275
Unfortunately one of the sx's of tx is a dry mouth and anytime you have a dry mouth your teeth are not getting the saliva they need to stay healthy.  Also, if you even had a very slight case of gingivitis before tx, then tx may push you over the edge into full blown disgusting gum disease=gingivitis.  The only thing you can do during tx to fight the effects of the INF/Riba and whatever else is to keep your mouth as wet as possible.  It's not just about drinking a gallon of water and more a day but taking anything that promotes good oral hygiene is a plus too.  Biotene products are very good  in the fight to keep good chompers. lol  
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Avatar_n_tn
I had the dental problems from just combo therapy.  I don't think the triple makes it any worse.  My oral surgeon said that the interferon can really do a number on teeth, tissues, gums, and roots of teeth and surrounding bone.  After my tx, I found that three molars had deteriorated significantly in root structures, as weell as bone surrounding the teeth.  Gums receded quite a bit also, in spite of rigorous dental hygeing, flossing, frequent brushing, Biotene, etc. etc.  The immune system stimulation from the Interferon can just cause lots of nasty things to happen in the mouth.  Ulcers and sores can also develop from the tx, and can get very, very nasty in some of us.  I have read a number of accounts of people having to undergo extensive surgical and dental work after tx, me included.  I had bone grafts and implants, etc.  

DoubleDose
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1794638_tn?1345158661
Any time a person is on chemical therapy, anti-histamines, Anti-depressants, Anxiety medication and probably a few other drugs  they are going to depress saliva production.   I have spent over $33,000 in the past 15 years in dental work doing my best to keep a beautiful smile and nice teeth.  From Braces, to crowns to bridges and jaw surgery and numerous cleanings and the last recent cleaning and images shown that my gums are receding and most of my bottom front teeth are loosing their root system.  Dentist said it was due to lack of saliva.  ( which is caused by most of my past meds)   During the past 12 weeks of tx I have noticed a significant amount gum recession along with dry mouth to the point to where I mean I am bone dry when I wake up in the morning.   Biotene has helped quite a bit, also a humidifier and more water consumption has helped as well.     I have had no teeth or crown loss as of yet (fingers crossed) , however I am expecting some extractions and new choppers probably soon after I am finished slaying this monster.   :)
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1807991_tn?1323023215
Okay, now I know I am not alone in this.  I have read about a lot of people who have had tons of dental problems on these hep c drugs.

Thank you all soooooo much!

After all your suggestions...
I think I will attempt to build "Wolfbanes" invention too!
Sweet Bill referred me to this link!

http://www.medhelp.org/posts/Hepatitis-Social/what-to-do-for-dry-mouth-while-sleeping/show/649129

I am determined to keep a moist mouth and not loose any more teeth!
~Carolyn
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1746242_tn?1318213302
Act mooth wash for dry mouth works well to. I always have my biotene whereever I go. Early on in treatment I had a tooth abcess (abscess) and it was under a beautiful bridge that I spent many dollars on in 08,
The new dentist who took over the practice when mine retired says it was a beautiful crown and she couldn't understand that it happen. Think I kknow why now.
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317787_tn?1373214989
Hi the good thing about MH is you are never alone I think that the problem with MY teeth is that I have had Hep C for over 30 years and I had diabetes.  I have read that a systemi underlying illness can affect your teeth.
You are young you found out early you have cleared.  You know you have to be extra vigilent.  I started having what I have seen on a commercial is called biofilm the supposedly the toothbrush can miss.  Perhaps that is why my mother uses Listerine three times a day.  Thank Goodness I have my Dad's teeth
Anyway, there are some mouthwashes that do not have alchohol which is drying to the mouth.   10 days from Incivek I know longer have dry mouth however I am vigilent
Good Luck to you
Dee
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317787_tn?1373214989
Hi, is it possible that they did not use a post on your crowns but glue and the glue did not stick well?...then during cleaning they sometime really get in their
The crown I had a problem with was an old one thought I still agree with the film and INF causes that gumminess/biofilm

Again, good luck
Thank God for this forum
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Avatar_f_tn
Has anybody's hepatologist ok'd the use of biotene? Or any of the other products?  Would like to recommend to my brother who is on the triple (teleprevir) therapy, but dont' know if I should.  He's having terrible dry mouth.  Thanks!!
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Avatar_f_tn
I've been back and forth to the dentist recently getting prepared for tx.  I've had a deep cleaning, root canal, and extraction.  ( I just don't know what happened to my teeth within the last year).  At any rate, we were discussing tx and the sx on my teeth.  He said it could be brutal to our teeth.  He immediately recommended all of the Biotene products and also a different tooth paste.  It's call Fluoridex, tooth paste with additional fluoride.  I live out in the boonies and use well water where there is no fluoride in it.  He said its by prescription use only but he gave me a tube at the office for $12.00.  Said to use it twice a day and don't rinse after 30 minutes.  Then rinse and use the biotene for dry mouth immediately after and up to 5 times per day.  Also told me to take Calcium 600 mg w. Vit D 400 I.U. 2X daily.  He said the interferon wreeks havoc on your gum and bones so these supplements are a must.  Also have your teeth cleaned every 3 months and have xrays also to check for bone loss.

Happy Brushing and Gargling to everyone!  lol

Jules
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1807991_tn?1323023215
Thanks Everyone,  
  I sure wished my doctor and dentist had more of a clue about the dental sx.  That's what I got for not having a specialist!  I can only pray we will all still have our chompers after our hepc has left our bodies.  
God bless you all for answers.  
Wonderful stuff here!
You all are the best!
~Carolyn
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Avatar_f_tn
My husband has not, doesn't have this issue now, but I've read on several boards that this product works well, especially at night.  Best of luck to you.
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Avatar_m_tn
in case anyone picks up this thread in Google, I need to tell you that Biotene only helped me so much, the breaktrough for me was Mylanta liquid.

I had full involved consolidated mouth ulcer and sores. My doc was appalled.  He looked up a few recipes for magin mouthwash and, based on my description of the acid nature of what was going on with my mouth, especially from riba but worse after adding Incivek (I did a 8 week lead in before adding Incivek so that is how I know).  THe main feature of the recipes that affected me were lidocaine 2% to numb otherwise I would not eat at all but the main thing that worked was the Mylanta liquid, swished with that started getting better in 15 minutes after a week of agony. Biotene is good for dry mouth but that bad taste is chemical.
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Avatar_f_tn
My husband had dental problems over this past month due to dry mouth.  He has been using the Biotene products, but probably not consistently.  He had a cavity under an old filling that required a crown.  When he went in for the dental work related to the crown, they discovered an abcessed tooth that had to be extracted.  They felt that these problems were due to the dry mouth.
Advocate1955
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Yes... this is side effect..Thanks to all friends to share it's valuable review.
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Avatar_m_tn
I have no crowns, but since starting treatments I have had the enamel literally falling off my teeth, 5 teeth have broken off at the gum line with more to come. Insurance would pay for repairs if it could be linked to the treatments. Has anyone else had this problem?
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190885_tn?1333029491
going into tx my teeth weren't great to say the least...by post tx they were a mess..so bad that 3 months post tx i had them pulled....i just wanted to healthy so bad...are your toe and finger nails splitting? s*** happens on tx...my nails are now fine....i was afraid of adding anything to the drugs i was on ...afraid that one thing might block another ...like in hydroponics...when you adjust ph up or down you can block the plant from taking in the right nutrients by adding stuff into the water......so your ph might be fine but nothing gets absorbed into the plant...so what did you do? ask more about this in a new thread...interesting stuff...
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4113881_tn?1401895587
".....I have had the enamel literally falling off my teeth....Has anyone else had this problem?"

Yes, same thing...at the gum line. Enamel falling off on 3 teeth like its the thing to do. Dentist said use the Biotene mouthwash, Pronamel paste, and soft bristle brush while on TX...hell fix-em when Im done.
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Avatar_f_tn
   The first 4 weeks, my teeth felt okay, but as soon as I added the third
med, which for me, was Victrelis, I began to experience horrible teeth problems.  I got a tooth ache which smelled lie a rotting cadaver, almost immediately, and my Treating Doc prescribed Amoxicillin for it, which didn't help. The infection was where I had a crown put in, over a root-canal.
    All the other teeth also began to taste terrible also. But I did find some
relief with a natural (and affordable) mouth-wash, made by Desert Essence, which had Tea-Tree oil in it. I used it about 10 times a day and it got rid of the taste/smell for awhile.
   But now, my crown still stinks, and hurts. I may have to do what Billy
(workingdog) did, and get it pulled, but I cant even stand to wear my partial plate on the top, where I am misisng 3 teeth on the side, plus I cant chew food with the plate.  
    I have heard that Interferon is hard on teeth, but dont have any documentation on that, to prove it, as a fact. It affects our bone strength so it must deplete our calcium.
  The briken teeth should be pulled, but not during Treatment, if your platelets and WBC are low
    
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Abstract

BACKGROUND:

There has been little discussion about the importance of oral management and interferon (IFN) therapy, although management of the side effects of therapy for chronic hepatitis C has been documented. This study determined whether dental problems delayed the initiation of IFN therapy for hepatitis C virus (HCV)-infected patients.

RESULTS:

We analyzed 570 HCV-infected patients who were admitted to our hospital from December 2003 to June 2010 for treatment consisting of pegylated IFN (Peg-IFN) monotherapy or Peg-IFN/ribavirin combination therapy. The group comprised 274 men and 296 women with a mean age 57.2 years. Of the 570 patients, six could not commence Peg-IFN therapy, despite their admission, because of dental problems such as periodontitis, pupitis, and pericoronitis. The ages of six whose dental problems delayed the initiation of Peg-IFN ranged from 25 to 67 years, with a mean age of 47.3 +/- 15.2 years. IFN therapy was deferred for 61.3 +/- 47.7 days. Among the six subjects for whom IFN treatment was delayed, only one had a salivary flow that was lower than the normal value.

CONCLUSIONS:

Treatment of dental infections is required before IFN therapy for HCV infection can be started. To increase the depth of understanding of oral health care, it is hoped that dentists and medical specialists in all areas will hold discussions to generate cooperation.


http://www.ncbi.nlm.nih.gov/pubmed/20712912
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