Yet another sx, could use some help

[ASmile4U]

Last Friday did shot 10/48, honestly haven't felt too bad.  Not too good somedays, nonetheless tolerable.  I awoke at 2 am this morning with a severe toothache.  Called my dentist (waited til 8 am!) just got back from visit with him.  Apparently there are 2 lesions under the gum on 2 different teeth.  One tooth is already loose and needs pulled ASAP, the other he is hoping to save, depends on how it heals from here on out.  There were no problems 5 months ago at my regular check up and he seemed somewhat surprised today at the extent of damage in such a short amount of time.  My dentist and GI both agreed to put me on Augmentin, Percocet and Advil to clear the infection before pulling the tooth and eliminate the pain and inflamation (inflammation).  Has anyone ever had this sx with tx and if so , what was the outcome? I guess if worse comes to worse, and I have to have them all pulled, I can have nice perfect teeth with dentures! The percocet is working great for the pain, however 2 hours later I am sicker than a dog and having hot flashes...any advice would be greatly appreciated...Thanks.

[cougareyes]

Haven't heard of that one, I hope you start feeling better. I have to thank everyone that responded to "contemplating treatment" a few days ago. Your input, encouragement, and pushing did help me finialize my decision. I have decided to start treatment probably the 1st week of July. I have a Drs appt on Fri., I'll keep you posted

[layla]

Be very careful of the hot flashes. If you are not having menopause this is often a sign of thyroid problems which can be casue by the tx. You should have you TSH tested right away in my opinion. There are quite a few of us who lost our thyroid on tx. I believe if it had been caught earlier they can be saved by useing meds for it before it is gone. LL

[AK - Hepper]

Treatment is hard on the teeth, no doubt about it. It just dries you out too bad, and that is bad for the teeth.

I finished tx a little over a year ago and got 7 cavities since then, all the while brushing twice a day and flossing regularly. GRRR!!!!

[chellski]

thanks for info - just after shot 6 my doc tested for thyroid and for 4 weeks bloodwork includes thyroid check.  i'm glad he tests early for this. (test will be repeated every other month)
I'm scared also about my teeth - been afraid to go to dentist (dentist phobia)
thanks all-
michelle

[artgal]

I think you should have your doctor test your thyroid much more frequently than every other month. So much can happen in two months! After hearing so much from Layla and others regarding loss of thyroid function, I have told my doctor I must have the TSH (thyroid) test done every three weeks. It is not an expensive test so I would not think there would be any reason not to agree to this (unless the doc wants to call all the shots...). This way, as Layla suggests, you will hopefully be able to catch the problems before they get out of hand and use meds to help save the thryroid function.

[ASmile4U]

Thanks for the advice, I am scheduled to have a TSH June 14 along with all the 12 week labs.  Although I haven't experienced menopause as of yet, I am 43 and realize it could start at any time.  The tx does weird things to the monthly cycle.  Hoping  the hotflash was a direct result of the percocet since it was shortly after I took it and the augmentin that it hit me.  The percocet kicked my butt!  Good stuff, it worked immediately.  I will definitely keep a closer eye on my teeth from this point on out.  I just hate having to put my dentist at risk.  I feel quilty.  However, he was very compassionate and understanding yesterday.   And also very willing to work closely with my GI which is important because my platelets dropped back down again this week and that causes concerns as well.  Hopefully only 8 1/2 more months of tx...I can do it!!!

[cuteus]

My teeth have been deteriorating for years prior to my '03 hcv dx. No one could come up with an answer as to why so many cavities were copping up. I had two fractured teeth before tx, and  subsequent extractions. During tx I got two more, now three fractures, on teeth weakened by deep fillings.  Dentistry has not advanced too much since ammalgalm was invented, unfortunately.
I am now facing another extraction, possible two.  Dollface also had dental problems where she lost bone density in the gum. HEp c infection starts a process by which the bone density is affected in some sensitive individuals and it seems to increase the cavity issue. then tx comes and accelerates the process even more. I only found one study about hcv and dental problems. I guess it is the interferon (ours and theirs) that seems to be the culprit.  Not many people complained of this problem, so it is not for most to experience it, just like thyroid issues.

[MichaelT]

Consuming sugar whilst on treatment can be very bad. The sugar combined with the dry mouth is almost a guarantee of cavities and harm to the gums.

If you have a Coke or some ice-cream, at least rinse your mouth well afterwards. Uh, with water. :)

[Docsgold]

If you are on tx, thyroid symptoms are very similar to side effects of hcv tx.  But menopause on top of that? I hope your thyroid is ok.  It just gets so dang complicated to figure out what to blame symtpoms on.  Good luck to you.

[landfill]

In 2000 I got tonsil cancer.  Surgery and radiation cured it but left my mouth pretty dry (30% of normal saliva).  I've been able to avoid problems with good hygene and flouride.  Here are some options.

There's a prescription toothpaste called Colgate Prevadent 5000 that has more flouride than over the counter toothpaste.  It costs about $15 for a little tube.  I've used it for 5 years.  I've been able to get Blue Cross to pay even though I don't have dental coverage because the cancer created the need for it.  Maybe you can do the same with hepc.

For several years I soaked them in flouride gel once a day.  That stuff is cheap and the dentist can give you plastic trays that look like dentures that you put in your mouth to hold it against your teeth for 20 minutes.  Flouride hardens the surface of the teeth and makes them resistant to the acids that cause decay.

There's a prescription drug called Salagen that stimulates saliva production.  You take a pill when you get dry.  There are some products with the trade name Biotene for dry mouths.  Chewing gum, mouthwash and such.  You may like them.  A lot of people struggle with a dry mouth.  It's called xerostoma if you want to google it.

When I started tx I knew that I would get even drier. Neither the dr or the dentist thought that hepc tx by itself damages teeth but it does dry you out.  While on tx my mouth was sore and I had a recurring fungal infection which I had antifungal lozenges for.  My tx ended in 8/03 and I haven't had any lasting ill effects from it.  I'm SVR.

It sounds like you have a periodontal condition that predates the hepc tx and needs attention.  If you get your dentist to help you into a routine of a lot of flossing, brushing and flouride you should get through the tx without compounding it.

[chellski]

i go everyweek for bloodwork - whats one more vial? (test) since i'm there anyway.  thanks for suggestion - i'll make sure my doc checks more regularly.  it seems like the thyroid sx sound alot like menopause which i'm starting anyway - i don't want to take any chances.
thanks again
michelle

[ASmile4U]

Thanks again for all the useful information.  Although I have always practiced good dental hygiene, it appears I will be one that needs to take extra precautions while on tx.  I have tried to eliminate some of the dry mouth with sugarless gum, lots of water and gatorade, it helps.  There's another flouride toothpaste made by Oral B, my kids used it while they had braces, they also used a flouride rinse.  I will ask my dentist about using them while I'm on tx.  I'll try anything that will help, I prefer to keep my teeth!  
michaelt - I have never drank a lot of soda but occasionally enjoyed a coke. I have not even been able to drink a coke since I began tx...I can't get past the strong taste.  The taste buds have definitely changed, there's not much that taste good anymore. I've lost 20 pounds.  A lot of things cause a burning sensation.  However, I am convinced ice cream  has helped my low platelet count...so I will be sure and rinse with water after I induldge!  :)

[doll face]

Hi, welcome to our family. Cuteus mentioned me above. Let me tell you a quick version of my dental problems. I have always taken good care of my teeth since I had no enamel. I went in for all my regular check ups, during my second round of tx. I went in for rountine cleaning. MY dentist walked in and the first thing he asked was what meds are you on ? and what chronic disease do you have ? It seem that I had lost 2 mm of bone mass in my upper jaw and 1 mm in my lower in less than 6 months. He suggested that I try a few differnt things, deep cleaning, extra flouride, ect. 3 weeks later I went in and had lost another mm in top jaw. He said that he had never seen such quick deterioration before and said that if I did not have all my top teeth taken out soon that they would start falling out as I was losing too much bone mass to hold them all in.

1 month after I finished tx, I had to have all my top teeth taken out and dentures put in. I am still trying everything I can to keep the bottom ones but it is not looking too good. I lost my dental insurance 2 months earlier so have to pay out of pocket for this ($6500) so far and climbing. I am in the process of trying to get my medical insurance to help with some of the cost so I had to research and prove that the hep had something to do with this. What I found is..many drugs cause dry mouth, and that leads to bacteria that causes dental problems. My dentist and my hep doctor have both written notes that interferon, antidepressants, and my thyroid meds all cause this type of problem. Put them all together and it could spell disaster.

This is one of those sides that you never read about anywhere, but is very real.

I believe that is one of the reasons to be drinking all the water is to keep your mouth moist. There is also a product called oral balance out there, to help with mouth dryness.

Please keep a close eye on this problem, and do everything necessary to keep your teeth, at the very least till you are finished with tx. Having dentures (although mine do look good) is no fun.

Good luck to you my friend.

[ASmile4U]

Thank you so much for taking the time to post, I really appreciate the information.  I am very concerned that so much deterioration has occured so early into tx and will do what it takes to try to rectify the situation. My dentist called me last night at home to see how I was doing, he also put another call into my GI, he won't stop until he knows exactly what is happening, why and what he can do to help prevent it.  I didn't talk to him long because the augmentin and percocet are making me very sick.  Think I'll back off the percocet today and see if that helps.  I agree with you, dentures may not be fun, however, I'd rather have dentures than Hep C.  Trying to be optimistic as things could always be worse.  Thanks again, Doll face.

[doll face]

That is something I definately agree with. "I would rather have dentures than Hep C. And thankfully I am now able to clain that to be true.

My top jaw has lost another mm of bone mass. Should it not slow down soon, they will have to rebuild my top jaw to be able to hold in my dentures. My bottom ones seem to be holding thier own still for now.

I do wish you all the luck with your dental problems, they are not fun.

[ASmile4U]

I do hope the bone loss slows down for you so you don't have to have surgery to replace the bone.  
I had my tooth pulled today, that's always fun.  My dentist did some investigating this past weekend with a navy colleague who also has a Hep C patient who is losing bone and having gum issues.  He has suggested that I brush with a flouride toothpaste and rinse with a flouride mouthwash several times a day.  He also wants me to rinse twice a day with the following mixture to help with the dry mouth causing build up.  Once in the morning after breakfast and again before bed.  Thought I'd share it...hoping it helps me.

1/2 cup salt
1/4 cup baking soda
Mix together dry and keep in a sealed container.
When ready to rinse, mix 1/4 tsp with 4 oz of warm water and rinse.

:)

[LvdByGod]

please be carefully monitoring liver numbers while on augmenten. it is very bad for the liver and can cause liver damage in some...ASK YOUR HEP DR ABOUT THIS ONE...i would beg for a less liver harmful antibiotic if there is one.

ASMILE i hope you get well soon and teeth recover...

[ASmile4U]

My dentist called  my GI before prescribing the augmentin and percocet, he wanted to be sure both were ok because of HCV and the tx I am on.  Was hopeful that between the 2, they knew what they were doing!  I know the infection was severe and perhaps augmentin was the best choice to get it under control quickly.  I see my GI the 14th for all my 12 week labs!!!  Anxiously awaiting.  Thanks for the input...I'll be sure and check it out, don't need to end up in worse shape than I sometimes already am in!  :)