dental work,should i wait,??

[Kit-c]

Hi all,,,
Seems for the last 5 years or so,since my Hep-c has been really rearing it's ugly head,my teeth have gone to pot,,filling falling out,taking half the tooth with it,,cavities,,small chips falling out,?

and now two old caps(top Front),I had done years ago,,smart 19 year old,drunk,and skipping down a frozen,iccy side walk with my girl friend,,splat,there went my perfect smile---

anyways now my caps are starting to slip,Dentest says they need implants,,I guess it takes about 8 months for your gums to heal
over the steal pegs,,,bla..bla,,bla,,
big procedure,.,.,.,.,.,

So I was wondering,,,with my tx starting soon(Now I hope),,
should I put this off or get started ,.,.???
I just always feel like my Life is on Hold,.,
Know what I mean jelly-beans--------

see ya,,,,Gale,.,.,.,.,.,.,.,.,.,.,.,.,.,,..kit-

[Forseegood]

that's the million dollar question I guess...I have often wondered what, or how much the hep has effected my teefers...both my parents have soft teeth (lucky me) and their teeth were messed up and they've both needed loads of dental work...

so has my sister and she doesn't have hep....so maybe it's mostly genetic with me? Though I can't help but think that ongoing inflammation in the body has to effect many systems...I sure dont know for sure and I don't know if anyone does, again, hardly any studies, if any, on this subject...and dental health is really so vital to overall health, they are just beginning to see how much...

And I take such great care of my teeth, (brush and floss almost after every meal!) I have a very good diet with little to no sugar, etc etc and I had such rotten teeth! Anyway, I opted to get them all fixed, at no small expense as I'm sure youre aware...(though I didn't do any implants) you gotta be rich to go to the dang dentist nowadays, in this country anyway....I sometimes wonder how much the tx will effect all the thousands I paid in dental work, boy would that chafe my fundament! If I paid all this money to have nice teeth and they started plinking out like dropping china on the kitchen floor! But I would think you would be better off fixing them beforehand to bolster them and support them, though I'm sure some would dissagree...good luck on this, hopefully others will chime in cause this has always made me ponder...

[Kalio1]

I'd strongly advise you to wait on one or the other. Implant surgery is a long and involved process and with all the possible sides from tx, that could really be difficult to try to deal with both. Also your immune system's ability to fight infrection and your recovery time can be slowed by tx. I'd either do the tx and then when you are done do the implants or vica versa but I wouldn't do both at the same time.


I have read and also been told by the oral surgeon that HCV does severely affect our teeth and can cause rapid decay. breakage, etc.

[Forseegood]

hope youre doing better...anyway, has the tx effected youre teeth much? As conscientious as you are I'm sure you went into it with your teeth in good shape, I'd wager...

[Kit-c]

Thanks you guys,,
I too thought that the hep-c had something to do with my teeth falling apart,
thank goodness for this site and you guys,sometimes you think,am I loosing it,??---
I always had stong,good teeth,,Not any more----uuggggg-

Your so right about the big bucks F.S.Good,,,(whats your names?),,,
but what do ya do ,,,either do your teeth,,or get rid of the clunker of a car,,,?
---Do Teeth--

I think it would be too much  bite off,,(pun) getting everything going at the same time too,Kalio,,,but geezzz
I just want to get going,,, dang it----

How are you doing ??where are you in your roller-coaster ride,???

and you too f.s.good,.,.,doing O.K,.????

Take it easy.,.,.,.,Gale.........................................kit

[pigeonca]

In my experience, every time I put off dental work - for whatever reason - it made no difference - I ended up needing more work and more expensive work later.  A penny saved and all that, I guess.  OTOH, I would stay away from implants at this time.  A few weeks ago I had to have a heavily crowned tooth pulled, after it had cracked in half.  My choices were an implant or a permanent bridge attached to crowned teeth on either side (i.e. two crowns holding a false tooth).  I'm going for the bridge, because implants are invasive and involve bone, and I have osteoporosis.  I know lots of folks with permanent bridges, and they love them.  You do need a floss threader to get underneath the fake tooth, however.  But if I were in perfect health I'd probably do the implants.

[GoofyDad]

Y'a want to do one or the other, TX or implants, but not both together. I had lower braces on duning tx, and that was far from the ideal. My gums were messed up afterwards. A bit better now I think - but I've been avoiding the dentist :(

Forsee, I keep tellin' ya, there's a certain attaction to a gal with removeable teeth. You coulda invested that extra cash in a love shack in Escondido or sumthin....with a jukebox in the living room playing the B52's.

[Forseegood]

wow Goofman, you had braces on your bottom teefers??? When you kissed your wife did you leave tire tread tracks on her bottom lip? ouch!

[Forseegood]

sure didn't mean to imply that you should do implants before tx, I think they frown on a procedure that is invasive and would take a long time to heal...maybe you can get bridges?

[jmjm530]

Good rule of thumb is to wait if surgery is elective. Implants also prefer a certain bone density which interferon can alter.

-- Jim

[orphanedhawk]

I had a bridge crack before leaving Thailand last June . My dentist in Bangkok talked me into an implant . He told me I needed at least 3 monthes for the gums to heal but could wait up until 1 and a half years before getting the tooth attached. In the meantime I had a temporary bridge. I thought, I'd come home, do tx and finish the dental work after tx. Well, the bridge started bothering me,underneath it was bleeding and hard to clean. I decided to return to Bangkok and have my dental work finished.   I can't tell you how glad I am that I did. My teeth haven't bothered me. But the whole procedure takes time. And only you can choose what to do and when.
  BTW: I don't have insurance. When I checked the prices of finishing the implant at home, it was cheaper for me to fly to Bangkok and have it done there plus I got to eat sticky rice and mango, my favorite.  If your interested just ask, and I'll pass on my dentist's contact info.

[Forseegood]

wanted to say, course everyone is different, but I have a permanent bridge and it doesn't bother me as long as I keep it flossed, etc...course, not everyone wants to be that determined about flossing, the dentist told me that I should consider that before I got the bridge...you gotta keep it super clean...just my two cents..

[dmhrdh]

I'm a dental hygienist.  When you say your crowns have "slipped" what exactly do you mean?  Are the teeth mobile?  If they are, you need to get that taken care of.  Most likely there may be an infection...the teeth or the gums.  You have to get rid of the source of the infection.  If there is an infection I would definitely have it taken care of before starting any kind of treatment.
Treatment takes a big toll on your teeth.  I know from personal experience.  As a hygienist I have great oral hygiene.  I had a lot of cavities as a child but haven't had one for over 30 years. After only 4 months of treatment I developed several cavities under crowns.  I can only attribute that to my dry mouth and craving for carbs during treatment.  I've had it all taken care of but will be much more careful next time I treat with my carbs!!!!
If you have any kind of infection, please have that taken care of first.  
After that, the decision between an implant or a fixed bridge is a personal decision.  They each have their pro's and con's.  Just a couple things to keep in mind.....Implants are definitely more involved than a bridge.  If you decide to go with implants, I would only go to a specialist/oral surgeon.  You want someone who knows what they're doing if you decide to go that route.

[orleans]

I'm interested. jerry

[Forseegood]

I won't even try to pronounce your name, lol...anyway, nice to have someone who knows teeth! can I ask you a question? when you say you had to do a bunch of things after treatment, was this dental work relatively new that you had to redo? and did you just do the same things as before, or did you have to end up doing implants? I just have a whole mouth of fresh dental work, and of course I do worry about it, even though that should be down on my list of course...I just wonder..guess only one way to find out, sorry about the obsessing...

[Alady1620]

I put off getting a cavity filled until after treatment but your situation is different.  I think I'd probably go ahead and do it if I were you but this is a personal decision.

[dmhrdh]

Ha...a hint with the name the rdh stands for registered dental hygienist :-)
I just had to get several new crowns.  Oh...and a wisdom tooth extracted!  It was funny because I'm 50 years old.  I only had the one wisdom tooth and it had never erupted.....until I was on treatment!  
Sorry I don't have any first hand implant information but I do know that the key on treatment  is to limit carbs and keep your mouth moisturized as well as possible.  The next time I treat I plan to do regular fluoride varnishes also.  Some people don't like fluoride.  Personally, I don't worry about it. I've been a dental hygienist for almost 30 years.  I've seen the difference topical fluoride can make in reducing decay first hand.  I would also recommend people use items sweetened with Xylitol.
Before I went on treatment I really didn't think I would have a problem.  I assumed many of the tooth complaints people had on treatment was because of dry mouth, diet and poor oral hygiene.  I knew I had the hygiene part whipped and my diet was OK.  Well, I countinued to have good oral hygiene on treatment but my diet went to hell.  I had a terrible time with dry mouth and didn't like the taste of Biotin....although I do recommend it!!  
Anyway, I hope to avoid more cavities this next time.......
As far as obsessing....I understand.....teeth are my life!!  HA!

[Forseegood]

wow, good info from you! so you just had to redo your crowns? How many? Most all my teeth are crowned, yikes!  I'm thinking the whole root and tooth would come out! Glad to hear that didn't happen to you....Redoing the crowns is bad enough though, jeesh, they are charging a lot of those, one can pretty much take most people's dental coverage for one year, what a joke...Maybe I should look into seperate dental insurance beforehand? Wonder if you can even do that, when youre partly covered for dental by your major insurance?... I'll certainly take your advice about the flouride varnish, I hope I don't crave carbs all the time, but I hear that you just eat what you can, for most people anyway.,...then I have veneers on the front uppers (yeah, I'm vain) hopefully those won't chip off...

also, my dentist says that he has a special "mouth moisturizer" for people on chemo? you prob know about that...I do like Biotene, go through bottles of it...thanks so much for your input...

[friole]

- I went into treatment with 2 permanent bridges  and numerous crowns.  I was in the process of getting an implant when I decided to treat.  I had already had the bone graft and was about healed. When I decided to treat, I also decided to hold off on the implant until after txing.  To my surprise, the specialist said he wouldn't do it until I was free from hep C anyway.  I am not sure this is even legal (to deny treatment) but since I didn't want to do it then, I didn't push it.  I had my dentist make a temp and I am still using that and he has referred me to a different specialist to do the implant whenever I decide.

forsee - I can not see that there was any problem txing with the bridges or other crowns. Like you, I had made my mind up to keep them clean when I got them.   I told my dentist I was treating and asked him each time i went to see him (and the hygenist) if my teeth were any worse.  I did notice a dryer mouth, and, near the end started using biotin mouth wash (which I can't stand the taste of).  I sucked a lot of tic tacs and was good about flossing.  

After tx I got 2 crowns and a large filling, but I cannot attribute that to hep C or tx.  It was the quarter of my mouth that i had never had done before and my dentist had been harping on it for years.  Tx may have worsened those teeth, I don't really know.

[friole]

hit the wrong button - wasn't don talking.

Kit - I don't think I would want to do implants while txing.  I would worry about infection with a compromised immune system, but I agree with dmh that you need to do something before you treat.  

dmh - it is nice to have you here.  I have worried about the people in my office since I have come "out " with them on the hep C.  Do they give new dental hygenists any training on hep C coming out of school?  I am gla most wear rubber gloves now.

I too relapsed.  Are you currently thinking of retreating?  How long ago did you treat and what are your stats.
frijole
1a, 59 yof, 1.4million IU now, almost back to my 1.52millions pre treament number, treated 56 weeks, bx g1,s1

[dmhrdh]

You can get an individual dental insurance policy.  I have one.  BUT....the one i have is going out of the dental business so I will be switching to something else in the next year.  Usually they are quite expensive but I have a good one right now....but again, no point in sending you their way as they are going out of the dental business.

[dmhrdh]

Nice to meet you.
I'm sorry to say that the dental field does not do enough educating about Hepatitis C.  Most of the focus is on Hepatitis B and HIV.  OSHA mandates that every dental office have a bloodbourne pathogen program which they must comply with but again...the main focus is not on Hepatitis C.  I'm in a good position because not only am I a RDH but I am also the clinic manager and in charge of our bloodbourne pathogen program.  As you can imagine, our employees are quite well educated.  I wish I could say the same for all offices.
I treated last fall.  I'm a 50 year old female.  Pretreatment VL 2,380,000.  I hadn't dropped 2 logs after 13 weeks and stopped treatment in Dec.  In March my VL was already over 1,000,000....I can't remember and I'm too lazy to go look right now.  Pretreatment biopsy Stage 2, Grade 1-2.
The nurse called me today to schedule me for the PROVE 3 screening.  I have an appointment 1 week from today.  I'm excited...fearful...hopeful...full of dread...you name it!!!!!!!!

[Forseegood]

dm: hey thanks, I keep thinking that my dental probs are over, but maybe the best thing is to do another specialized dental insurance, with my "toothy luck" maybe even though the monthly is expensive, it's gotta be cheaper then thousands of dollars if they do go kaput...I'm just nervous now...my doc and I are talking about a start date...YIKES!

Friole: you prob don't know it but youre one of my "rocks" here, and I mean that in the best sense possible, ha ha! I'm really hoping that the second is the charm for you...are you interested in that relapser trial for Vertex? they aren't taking many naives this time around I don't think...

[orphanedhawk]

There are  cheaper dentists in Bangkok but my guy goes to dental seminars in Europe regularly. He's near the embassies. I've seen him for 10 years and got his name from a friend in Hawaii who's been going to him even longer.
  
  S. Thawaeesak D.D.S.      www.thaweesakdental.com
                                     emai:l    zthaweeksak at yahoo dot com
    72/2 Soi Sathorn 1
    Satorn Tai Rd.
   Bangkok, Thailand 10120

    tel.: [phone]

      

[dmhrdh]

Well, I guess time really does fly....
I went back and read over my reply to you and realized....I treated the fall of 2005....not this past fall!

[Kit-c]

Hi all,,
its late here,so I will want to reread these tommoro,,
good stuff to think about,and O-hawk I have a friend who lives in phuket,
I spent about three months there and in Bankok,,,So thanks I might give this fellow a call,.,

the 2 front teeth have caps on them,and the wee little stubs under,both
root canneled,the caps now have a small split inbetween the teeth,and are
kinda wiggely,,Dentist says the stubs under are just not stong enough anymore,as they are about 25 years old-
and then I wanted to get matching veneers 2,or3,on either side----

But I am going to look this over again tommorro,,,,
I think you guys are the best,,
Thanks,,thanks,,thanks,.,.,.,.,
Gale.........................................kit-

[nygirl7]

Do NOT wait.  

Your teeth will get much worse from the Interferon - whatever cavities and things you have now will be root canals by the time you are done with treatment.  It eats them alive.

Do all the work you can right away before treatment if you can.

I wish to God I had finished all of mine but I didn't...and now I'm paying for it big time.

[nygirl7]

Sorry I missed the implants line - I would wait on that big time if I could but for cavities - get em done they will just get worse.

[friole]

good thread, good information here

kit - I had to have  a root canal on a front toot redone a couple of years ago.  It takes a really good specialist - they go in and wiggle out (vibrate ) the old stuff (mine was silver, done about 1972), they refill it with this new rubbery stuff - gawapuddy (I know what is not how you spell it but it is something like that).  If your root is cracked I don't think you can do it - that is why I was going to get the implant on one. It was a root canal/crown gone bad and had to be pulled. THank goodness it was not a front one. That one toot - if I do the implant will end up being a $5000 tooth all by itself.   I don't remember what your stats are, but it sounds like you need to hold off on tx to get those teeth taken care of.

I had dental insurance for a few years but it cost $600 for the 2 of us and only paid a max of $1500 each per year so didn't help a whole lot, but anything does help.

foresee - you are too kind.  I am watching for your posts because I did think you were getting closer to treating and sounding a bit nervous.  I know you can do this.  I sent all my paperwork into the specialist a couple of weeks ago and wrote her a letter and did say I was interesting in the Vertex trial for relapsers.  I really would like to do that.  My only problem would be the 350 mile trips.   I think Southwest airlines has some kind of frequent flyer program and maybe if I didn't have to pay for treatment drugs it would work out.  I won't know until my appointment in May.

dmh - We treated at the same time.  I starte 07/05 and ended 08/06.  The Prove 2 trial is the vertex trial, isn't it?  Where are you located?  I am in Texas, and my new hepatologist is in Dallas

nygirl - I know you had lots of teeth problems.  Are you going to try to start getting that taken care of now?  I know it is a big job, and very costly.

frijole - kathy

[Kalio1]

I just wanted to add here that crowns are not forever. I know people spend huge money and fix their mouths and feel like "ok, Im done with that" but the truth of the matter is crowns have a shelf life. My Mother in Law had all hers done in her 50's. Now she's in her 70's and having to have them all done again!
She took excellent care of them but I guess they just wear out. Man was she floored. I asked my dentist about it and sure enough, he said that was true.

Dentistry is highway robbery in this country. It's a joke that it costs 250 just to I and D a tooth before any serious work is even done! Then thousands more for the crown, and that's for one measly tooth! Implants are tens of thousands of dollars. Be careful with implants, extra careful with who you have do them because complications from them can be DIRE and involve your bones in your face. Also be sure and research thoroughly if any bone loss repairs are done and make sure you know where any bone they use is from.

Dentistry prices are just far too high for what they do and the time they spend doing it. It is not this way in other countries where most of the population have teeth at least! Here people loose their teeth because the prices are just too high to care for them. Sure it's best to see your hygenist regularly but even they are far beyond affordable for the average person or family.

Our health care system AND our dentistry system have to be improved so all Americans can have affordable health and dental care.

[GoofyDad]

1. "kiss bottom lip"

need  I say anything?

2. "Special mouth moisturizer"

again, need I say it?

[orleans]

Hey, Thanks for the responce. Can you give me an idea of what he get per implant post? Round here it's 'bout $1200, not including the tooth. Thailand is a ways away but I might be willing if it would make $$ sense. I need 5 but could use 8. thanks, jm

[dmhrdh]

I'm in the Chicago suburbs.
My first treatment was from Sept. 2005 until Dec. 6, 2005.
I think they are recruiting for PROVE 3 in Dallas right now.  Have you checked with your hepatologist?