bad teeth and tx

[runsincircles]

I have really bad teeth some are so broken that there's less than half a tooth left.  Right now I have an abscess and I'm gonna go get some antibiotics, but I'm wondering if I should find a way to get them pulled before tx.  If I get them all pulled I have nothing left to eat with so I would have to get something to replace them.  I can't afford to do any of this.  We have some money saved in case my husband has to take too many days off work for my tx but I really think we're gonna need it.  So if I take a course or two of antibiotics before tx do I really need to get them pulled?  There's a free clinic at the college but the waiting list is months long and they all need cut out, I don't want a student getting anywhere near my mouth with a knife.  Anybody ever heard of any problems doing tx with really bad teeth?

[BoceprevirGal]

  Just keep a very close eye on your health.   These meds can cause "dry mouth", which makes tooth decay worse. I drank tons of water, and used tons of mouth-wash.
   When you go to buy your mouth-wash, make sure to find one that
doesn't have alcohol in ut, as an ingredient. Often times we get mouth sores with this trreatment, and alcohol will sting too much.
   I got a mouthwash called Desert Essence with Tea Tree Oil in it, which worked great. I also have one made by Toms of Maine, that is alcohol free.
   I had to hit up that mouth-wash at least 6 times a day!

[Advocate1955]

One risk that you run is that if the abscess remains and becomes badly infected again while you're on treatment, and if your WBC and neutrophils drop while you're on treatment (which is a common side effect of the tx meds), you may end up with a serious infection that can spread or having to stop treatment due to infection and low WBC.  Those on treatment tx are more prone to teeth problems due to dry mouth, and they are more prone to infections due to low WBC and low neutrophils.
Yes, an abscess can lead to meningitis and it can also lead to bone infection.
Please be sure to inform your PCP and your hepatologist of everything and keep them both informed.
Perhaps your dentist could move you to an every 3 month cleaning schedule to try to prevent additional plaque which may help prevent further decay or infection.
Advocate1955

[Dawn703]

Please just make sure you take very good care of your mouth during tx. I would recommend you use a childs soft bristle toothbrush (so not to irritate gums and try to brush after meals and at bedtime, use biotene products or eguivalent to help keep mouth nore moist, try to rinse your mouth with salt water to help keep microbes in check. Above all drink plenty of water during tx. Good luck.

[runsincircles]

My teeth are so far gone there's no fixing them.  Everything left behind the eye teeth are almost completely gone.  I had 6 pulled 5 years ago and the rest just crumbled, because he insisted he could fix it even though my insurance was gonna be gone at the end of that week.  That one got all the others sick.

I saw the dr today and she gave me antibiotics and she's gonna see me in a couple months to keep an eye on it.  The infection hasn't moved to my sinuses or ears so it should be ok after the antibiotics.  Dr said an abscess can cause meningitis and she wants to stay on it.

I don't know the status of my liver.  Blood work is fine but I know that can be unreliable.  He says since I'm gonna tx soon he doesn't wanna risk an infection with biopsy.  I can get my reg dr to order one after tx just so I know where I am.

[BoceprevirGal]

  Hi there~  Yes, my Treatment was very hard on my teeth, but I am 50 yrs old.  I have spent the last 4 yrs working on my teeth, and I paid by the month, at $60. a nmonth,  and it is definitely worth it.
   I did have to have one tooth pulled last year, but only because the gum became loose around that tooth. It is better to get root-canals and then crowns, for sure.
    What stage are you at, in terms of liver damage? Because you may have to get a tooth pulled, during your Treatment, but that cant be done if you have low platelets, which come with cirrhosis~
    Good luck, and you can also take a stronger antibiotic, if the abcess comes back, while you are treating, but it has to be started as soon as you feel that abcess coming back, to nip it in the bud

[runsincircles]

I have my training next week and my meds will be here this week.  I can't put it off again or I won't do it at all.  I also can't see paying all that money now if tx is gonna be bad on my teeth anyway.  I know I may not be making the right decision but it's the one I have to make.  I can't pay thousands of dollars to get my teeth fixed if I may have to do it again after tx.  Even with the money we've saved, it's not enough.  We're in our first 5 years of our mortgage and I can't risk losing the house.  I will be seeing my reg dr tomorrow and she'll put me on a high dose of antibiotics just to make sure I don't have anything else going on.

[orphanedhawk]

We want to keep our teeth as long as possible. On the other hand, treatment is hard on our teeth.

Ideally, you would do all the dental work you need prior to beginning treatment.
Its important to take extra good care of our teeth during tx.

To help with the effects on our teeth and bones you should consider taking calcium supplements and definitely vitamin D.

[Idyllic]

I know times are tough and many will not agree with me but I would not encourage you to have any more teeth pulled. You need your teeth. Or healthy gums and a set of teeth (how's that?). I say that as someone who opted to have two pulled. I won't lie much of my dental problems were a combo of genetics, neglect, lifestyle and bad luck. I had periodontal disease and deeply recessed gums and bottom teeth that literally flawed straight out.

I opted to have two cosmetically fixed and some others pulled and I went to the dentist. It turns out my teeth were too far gone for those options. I had x-rays, a cleaning (took five hours for all four quadrants) and an assessment.

It took two years a payment plan and over 60 dental appointments and I had my teeth fixed. My dentist agreed to charge insurance rates for the dental and regular rates for the cosmetic.

My bite was totally collapsed so it look like my face was shrunken. Not only that I had headaches all the time. I was a bad grinder and my jaw was sore all the time. I had a bite guard made and it took about six months to open my bite then I had a few porcelain teeth put in along with a bridge. I have my teeth cleaned once every four months now. I floss daily and I even brush my tongue. I do not know how I got into such bad habits over the years but I did. I guess it is because my teeth basically *looked* OK.

I know I did not answer your question but I just wanted to encourage you to think of the long term. It is a tough decision and I really could have used the money for other things but I thought about it and read a lot about it as well and decided to have my teeth fixed. I feel like you should do yourself the service of posting on the dental forum rather than on a forum so you can receive the benefit of advice from someone who might know the short and long term consequences of your choices as well as possibly present options you may not have considered.

Best of luck to you♫

[Advocate1955]

I don't really know enough about teeth to say, but every time my husband has had an abscessed tooth, it has been too far gone to save and has had to be pulled to avoid further infection or damage to the bone.  He was told that antibiotics might suppress the abscess for awhile, but it will come back.  He had to be on antibiotics before and after the extractions though.  Biotene makes products that can help with the dry mouth caused by treatment, which in turn causes dental problems.  They make a mouthwash, toothpaste, lozenges, and even gum I think that increases production of saliva and helps to prevent decay.
My best guess is that you're better off to have any dental work that you need before you start treatment, because treatment is so hard on your teeth.
Advocate1955

[runsincircles]

I've been prescribed pegasys and ribavirin.  I'm waiting on a call today from the dr to set up training and the pharmacy to set up delivery.  I've had to put off tx 4 or 5 times in the last year and a half and I'm afraid if we put it off again I won't do it.  I have 5 teeth that would have to be cut out and all the dental clinics have waiting lists 8 months to a year and a half long.  Is there any way to get medicare to cover this?  Usually I go to their website, figure out their process and present my case to them as it applies to their methods.  This is how I got on disability in the first place.  However, I can't find any info on dental.  My abdomen is also pretty swolen so I really want to get this tx going.  I look 6 months pregnant and the dr says my spleen is not enlarged.

I don't have many good days as it is so I'm expecting tx to kick my butt.  Of course my motto is: expect the worst and you'll be happy when things go better than you expected.  As far as calling on another caregiver, the answer is no.  There' alot of illness in my family, both mental and physical and I take care of everybody else, it's gonna be hard enough to get them to understand that I can't for a while.

[Dawn703]

Good to hear you are going to get your abcess taken care of, this is really important tx or not. You do want to do something about your dental issues because mouth issues do come up during treatment. Not sure if this relates to pulling teeth, but hopefully others will chime in about that. I just wanted to comment on this tx in relation to your mouth so you know what your up against. First tx will dry you out, including your mouth. The mouth can become a breeding ground for microbes causing an imbalance in your normal mouth flora, not in a good way. So infection can become an issue, something you don't want to have happen during tx since you probably have/wil have a compromised immune system anyway. Other mouth issues are sores, fungal infections, receeding/sore gums, etc...My recommendation would be to talk with your Dr about this or ask your Dr to reccomend a reputable dentist. Good luck on this and def don't start treatment until your dental issues are resolved. I commend you guys on thinking ahead for your tx as far as money/caregiver goes. First you don't know how you're going to react to tx (you don't say what your tx is), you may not be too sick. I worked full time and at times overtime throughout treatment with taking very few days off, many others have/do as well. Meaning you may not hav sx that require him to take off all that much. Just a thought, is there anyone else you can call on as a cregiver (friend, family, neighbor) or are there any health clinics/organizations that offer help to those in need in case you do have to have major dental work done before tx?  May be a good option if your husband can't afford to take off work. Good luck with everything and keep hanging around, this forum offers a wealth of info and help.

[working dog]

i would get them pulled....this would be a drag to have to stop tx for a tooth infection..i had awful teeth...this did scare me...i wasn't having any trouble before tx so i treated....i went through so much during tx....about 3 months post tx i got my teeth pulled out...just didn't want to take a chance on getting sick from bad teeth....got dentures ....thats a trip....in 6 more months i'll get the clip in type and it will be simple.....how about you pull the bad teeth and keep enough to eat during tx......if you get a lot of teeth pulled it will take time to heal...like 6 months....and you should have temporary dentures while the swelling is going down....dentures are a drag the first year...then no big deal....so you see why i said pull just the real bad teeth.....good luck..you can pm me on this if you want to...billy