Is tooth extraction safe while on treatment?

[worry06]

Just want to know if anyone have extraction done because I heard different. I am on Procrit, stage 3 on 18/48, platlet 120, HGB is 11, Hemacrit 34, Wbc is 1.9, Anc 700.  Any input/commetnt is greatly appreciated.

[jmjm530]

When I asked my NP about implant surgery, she suggested to wait on anything elective because the interferon may soften the bone. This probably doesn't apply to tooth extraction, but I think the advice on "elective" versus necessary invasive procedures when on treatment makes sense. So how necessary is your tooth extraction is the first question. Once you get that answer, then I'd run it by your treatment doctor, or perhaps get the doc and the dentist on the phone together to work out a plan.

-- Jim

[FloridaMouse]

I have a friend that had a tooth pulled while on tx but here ANC wasnt' nearly as low as yours.   I wouldn't mess with it with a low ANC like that.   You could be setting yourself up for a systemic infection.

Mouse
Genotype 1a, Stage 3, Grade 3
finished tx 4/2007
relapsed 9/2007

[worry06]

Thanks for both of you.

I am on Amocixillin right now and still have pain on and off, the dentist suggest to take out, but he needs a clearance from my PCP or Hep Dr.  I asked the nurse, it seems like go nowhere she always said I can do everything I want.  She said the PCP or my Hep Dr would not give a clearance, it is up to the dentist and patient to decide.  I hope I take this antibiotic and buying some times till the end of May :-(
I will wait and see another week if it is really intollerable, I'll call my PCP/Hep dr to get a clearance.

[jmjm530]

I wouldn't mess around with a bad tooth if your dentist says take it out. Not sure what's going on in your doctor's office -- sounds like they're saying it' OK but don't want to give "clearance" -- not sure what that means. I'd just ask to speak to your Hep doc and ask what he suggests. Maybe they just want to sign something, don't know. BTW your ANC doesn't seem that bad to me, but I'm not a doc.

-- Jim

[GrandmaA]

I was told by my N.P. that tooth cleaning was O.K. and a filling or cap, but no surgery, unless emergency and they had a whole sheet of paper to give the dentist in that case.

[orphanedhawk]

If you can put it off until after tx, I would suggest you do that. Absesses are one sx of tx and getting a tooth pulled seems like asking for it. I had them after getting my wisdom teeth out and had to be on antibiotics.
Our bodies are being taxed by tx. I'd try cleaning around the gum with a toothpick in tea tree oil for up to three days and see if that helps. Keep the area brushed. And don't forget, either way, to eat lots of yogurt.

[mremeet]

If there's any way to avoid it during your treatment I would. Your neutrophils are low (neuts fight infection) and your platelets aren't "high". You might have bleeding problems and might be more likely to have a bad infection afterwards. One or both of these factors could put a premature end to your treatment, which wouldn't be a good thing at week 18 of 48. Sometimes you gotta do what you gotta do, but if it's avoidable I'd discuss the possibility of getting juiced up on neupogen and procrit before hand to help reduce the likelihood of problems before you go in to get it yanked. Good luck...

[worry06]

As always thanks for everyone response.  I'll try to finished the Amocixillin and see how I feel.  I also will have appointment with the hep C dr next week.

Jim, I forgot to mentioned, the reason that the dentist needs a clearance is I told him that I am on the treatment.  He is hesitate because he does not have my blood work results.  

[dperry10]

I started Tx on Dec 22 '06.   I was at that time before tx having dental work done, and it included extracting 5 teeth.    I had that done on 1/2/07.   They seemed to bleed more than normal, but I was also upset, becuz we had to put the 15 yr old dobie down.  So crying didn't help to stop the bleeding.  But everything healed up fine, no infection that the antibiotics didn't take care of.   I healed and everything is fine.  Both my PCP and Tx doctor, said that it should not be a problem for the proceedure to be done.  so I did it.  

[worry06]

Thanks.

[jmjm530]

It's an important decision because on why hand you don't want to subject yourself to unecessary surgery on treatment, but on the other, an infected tooth could potentially have significant health consequences if not treated -- including forcing you off treatment.  

Your medical team (doctor and dentist) cannot therfore avoid their responsibilities in what appears on some level to be a medical liablity call. If these two guys can't deal straight with you, then get opinions from someone who can. I know my doc wouldn't hesitiate for a second to tell me exactly what to do in a situation like that.

Again, I don't know what this "clearance" thing is all about with your doc and dentist, but it sound a bit like b*llshit to me. Of course, your dentist wanting to see your blood results is reasonable.

-- Jim

[jmjm530]

Don't mean to suggest that the idea of "clearing" you for a medical decision is wrong, but just that it seems things are getting bogged down into some sort of "who will take responsibility" thing between the doc and dentist.

[worry06]

thank again.   I'll see boh of them next week.