I have been on letrozole, ribociclib and denosumab for about a year and a half. I find i have very sensitive teeth and my gums get sore too. The pain can also radiate to the side of my head. Should i be concerned? At my 3 monthly appointment
imentioned the sensitivity and my dentist couldn’t find wrong. It gets so bad i have to take painkillers an hour before eating
Dear jackbaz,
I have had something very similar, and have been diagnosed with TMJ, was referred to my dentist who suggested soft food and jaw exercises.
Wishing you well fingers crossed for a good outcome.
Hugs Tili 
Hi …I have been on the same medication as yourself for the last 18 months…I have not experienced any issues with my gums or teeth…I do experience joint ache in my hand …worse at night time. I also struggle with not sleeping.
The Christie home team always check about gum/teeth issues before having my monthly denosumab …my advice is to check with the BCNs and the home team. As you are having major issues does sound like needs further investigation
Hope this is helpful…
Hi Jackbaz. Im not sure whether this really answers your question but here goes. I had a similar problem with the pain going into my face and head. It came on after a replacement filling, top jaw, but the pain seemed to come from the next tooth. This was about 12 months after finishing chemo etc. My dentist, who id been going to for years, said it was TMJ and to go to the GP. GP said it wasn’t and the dental work had set the pain off. So i went another dentist for a second opinion and subsequently had a bite guard which i wear at night, and that has solved the problem. Regarding sensitive teeth, the hygienist recommended colgate sensitive, use twice daily, and at night apply neat to the affected teeth. That has really hdlped. I’m five years on now, but still get sore mouth and tongue from time to time. I’ve been putting up with it but was thinking of asking the question on this forum. I was told in the beginning that the treatment affects the whole of the digestive system and can last for two years or so, but obviously longer it seems. I hope you go on ok. Best wishes.
Hi .Thanks for your reply. I have not heard about it affecting the digestive system til now. Have you had issues with this?
The head pain is rare but the teeth sensitivity is an almost constant and changes sides and changes top to bottom. It can be excruciating. My gums get inflamed too. I have been using sensitive toothpaste and rub so much into my gums i am almost eating it!!
I also suffer from lack of sleep. I have been prescribed mirtazapine which in a lower dose helps insomnia. I does help a little but i long for the sleep i used to have.
Hi jackbaz
Thanks for your post asking about the sore gums and pain in your head you’re experiencing.
You say you’ve been taking letrozole, ribociclib and denosumab, for a year and a half. The symptoms you describe could be a side effect of any of these medications.
Bisphosphonates, such as denosumab, slow down or prevent bone damage. They’re often given to people who have, or are at risk of, osteoporosis (when bones lose their strength and are more likely to break). Side effects can include bone and muscle pain. There is a rare but serious side effect which is osteonecrosis of the jaw, that your dentist should be aware of when they assessed you.
As @jennifert74 says, it’s important you contact your breast care nurse or treatment team to check these symptoms out. They may want to investigate further. You could also seek a second opinion with another dentist before your next treatment, as @soos suggests.
In the meantime, do contact your GP, who may be able to prescribe some stronger pain relief for you.
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