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7469840 tn?1409845836

Dental problems after Tx

Just got back from seeing my dentist, first time after triple Tx of Sovaldi/Ribavirin/Interferon. My gum pockets went from mostly 2s and 3s to some 5s and 7s. Will need to have some major gum treatments. Wish I had known about using Biotene while on Tx, but didn't find out until after. Neither my doctor nor nurse said anything about it. In the big picture of things a small price to pay for being cured, but a word of caution for those on or about to start Tx. Brushing and flossing not enough while treating, get some Biotene.
16 Responses
Avatar universal
I was blessed.  The first thread I was on got to discussing dental and mouth care as a result of dry mouth.  Someone recommended all the Biotene products, mouthwash, gel for nighttime, spray to carry with you, and toothpaste.  Someone else recommended using a water pik daily, and of course, the hydration issue cam up, so I had all those thing before I actually started treatment.  Then the week befor tx began a friend suggested seeing my dentist to get floride trays.  I hadn't even called to check om it yet, when I ran in to the dentist at church.  He said to check with my physician to see if I should use the trays.  Both recommended that because 1 had been on chemo which gave him severe dry mouth and his dentist pit him om the trays.  Th dentist had a lot of chemo patients.  

I had my 3 month check up this week and my gums were in better shape than they have been since I have been going ther ( approximately 25 years).  I had no cavities.  Dentist and hygenist both said they think getting tx for the hepc was helping my gums, and the careful care hwas protecting my teeth and gums.

So for all of you who have not head about mouth care, get the biotene products or one of the other natural dry mouth products, an inexpensive water pik, and see you dentist to at least get the prescription floride tooth paste to help.  In addition, good eye drops for the dry eyes, a good heavy duty lotion for skin care, of course, eat a liver friendly diet (helps all of the above) AND DON'T FORGET TO HYDRATE, HYDRATE,HYDRATE- 1 oz of water foe every pound of weight up to 1/2 your body weight.

Good luck and good treating.

Sandi:  Sorry you did not know about this befor/during treatment.  I hate to have to have dental work done so truly feel for you.  But, as you said, a price you are willing to pay for SVR!!    Pat
Avatar universal
I had the same problem with my gums post treatment.  However, with that being said, I did do extra things for 'gum hygiene' while on treatment and I did these 'dry mouth lozenges' and was chewing sugar free gum.., all supposedly good things dental wise. I also drank plenty of water and other fluids, so much so that I always have a low sodium on labwork.  Anyhow, my dentist told me that my home care was not lacking at all, but that my gum pockets had worsened quite a bit since my last appt., which I'm already going in every 4 mon., my last appt. was right before I started treatment.  It really is just the meds because they change the chemistry in your mouth.  I'm sure that some people will get it worse and others will maybe not have as many issues, as with everything.  But, just like with people who smoke cigarettes, versus non-smokers..., their mouths are usually affected by the chemicals in the cigarettes.  But, the good news is that now that we are off the meds, this extra pocket-damage thing can be reversed after time and several visits to our dreaded dentist...
142841 tn?1201975052
In addition to dry mouth, remember interferon is a powerful immune system modulator.  It's possible that the body isn't as effective at keeping dental bacteria at bay while treating.
7469840 tn?1409845836
I had seen my dentist just before Tx, and my teeth are in good shape, and you know I drank plenty of water, but I think you all are right, as it does affect the bacteria in the mouth. I wasn't surprised as I had read about it here. Well I go in next month for the deep cleaning, and having Arestin (antibiotic) microspheres injections between my teeth and gums in the affected areas. Told my dentist as long as he numbs me up! But this is supposed to do the trick, in the meantime will be cleaning and using oragel mouthwash in bring the bacteria under control. Just wanted to give a heads up to new members.—Sandi
Avatar universal
I'm only in my third week with S/O and just noticed some serious gum recession a couple of days ago. My dentist gave me Chlorhexidine and I'm using hydrogen peroxide right after to keep staining minimal. I need to get a new water pic - maybe next check.
Avatar universal
Just a cautionary thought.  Try to do a little bit of research on this deep cleaning procedure.  Know exactly what your in for.  My own conclusion
of this Tx was not what it's cracked up to be.  Make sure you have undeniable faith in your Dentist.
7469840 tn?1409845836
Thanks Kim, I do have faith in him. I think the good thing about this is it hasn't been going on that long, so should heal up ok. Almostsixty had similar issues too. My teeth are in good shape, and I want to keep them that way. I go in a month, so hopefully I will have made some progress by then on my own, will take a toothbrush and mouth wash into work too. This antibiotic he wants to use is quick acting and localized, and works within a week to clear out the deep bacteria. A 7 on the gum scale is huge! So far there is no indication of infection on the tooth root, trying to avoid that. Will let you know how it goes.
317787 tn?1473358451
Hi there! Thanks for sharing.  Yes, you can make a great difference in a month.  Good idea.  I did that and showed improvement in 2 weeks.

I used the Biotene during tx the water pick, still had pockets for first time in my life after treating..  The scaling wasn't as bad as I feared
7469840 tn?1409845836
Thanks Dee, my dentist knows I am a chicken when it comes to dental work, I figure if he can numb me up when the scaling is being done that should help. The probably motrin after for any pain. But I am going to do what I can to improve my mouth until then, thanks for giving me hope. Having gone through this Tx have given me a new-found strength.
Avatar universal
The deep cleaning is really not that bad. At all. I've also has the antibiotic microspheres and it worked really well.
7469840 tn?1409845836
Thanks for letting me know the microspheres worked, I read through the handout and it made a lot of sense to have it locally placed. You all are such great support!
2059648 tn?1439766665
Great post about treatment dental effects and care.   Deep cleaning after treatment I think is a very good idea.   I didn't get a deep cleaning till 18 months and pockets were deep.   If doing this over....would go to the dentist for a deep cleaning at SVR.    The effects are very much as chemotherapy.
Lost a tooth on chemotherapy.   You should have your teeth really looked at before treatment to identify problems and get them fixed before treatment.  
I failed to do this before cancer chemo.   Didn't take the chance with Hepatitis C treatment.  Regardless, my gums did suffer from Hep C treatment as many have stated.  Make sure when using a water pik you keep the water blast setting on low.  You don't want to create more problems by blasting your compromised gums with high pressure water.   This can also cause problems in deep pockets around your teeth.

Best to youw
Avatar universal
Thanks.  I was scheduled for my next cleaning in Jan, and my next x-rays in April, but I will call and set that up for Dec, after I dinish treatment.  

And best also  to you my friend.

On to SVR, All!,
Avatar universal
Hi everyone, I also suffered with extreme mouth issues .  From ulcers to constant dry mouth.  I started with everything Biotene, but found wasn't helping while sleeping, an a vicious cycle was started.  Spoke with speciality pharmacist an he recommended OTC XYLIMELTS that adheres to gum line overnight, keeping mouth moist.  Problem solved for me ..  They really work wonderful an I continue to used.  Lite mint taste, so no funky breath in the a.m.  All sides have resolved except for dry mouth an eyes which I'm using Restasis for eyes.  A small price to pay since my 4 wk EOT viral load was undetected today....take care.  Mary
Avatar universal
I had dry mouth during tx and still do. I am using "Oral7"
I used to use Biotene till I read the label one day and noticed that they don't put the saliva enzymes in it anymore! Well, not here in NZ anyway.
The saliva enzymes are what protect the teeth from decaying.
It's also very important to keep the mouth moist as the moisture helps flush out the food residue from between the teeth.
Saw my dentist and dental hygienist over the last couple of weeks and they tell me that my saliva quality is improving. the pH also is coming up.
Apparently the mouth should be 7 on the pH scale.
So just giving a heads up about the ingredients of your oral products.
7469840 tn?1409845836
Just got back from the dentist and my mouth had improved some over the month, very little sign of infection. He did one side of my mouth, will do the other side next month. He decided to use laser treatment instead of the microsphere antibiotics. Wasn't too bad, not too much bleeding, and the laser cauterizes as it does its thing. He said it takes 6-8 weeks for the gums to reattach themselves. He did see a small fiborisis cyst on one gum too. He said the meds disrupt the balance of bacteria in the mouth, plus the dry mouth is bad too. I told him my doctor said I am under the influence for a year after treatment. So fellow heppers, take care of you mouth when undergoing Tx!
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