Hi all. I wondered if anyone could advise?
I have a sensitive tooth which the dentist thought had an exposed nerve. He’s taken an x ray and there is a fairly deep filling which he repaired but he thinks it needs root canal or removal. It’s flared up three times in 8 months, the second time he suggested reviewing and I had not long been diagnosed with breast cancer and had a mastectomy. The third time it was sore but by the time I saw him it had settled. He said because of pending chemo it was probably better to remove the tooth.
I was booked in on Tuesday which was 2 weeks before chemo starts and it wouldn’t numb after 4 injections.
They have booked me in for sedation and this will be 4 days before chemo starts. I went through to breast team to speak to oncology to check it was ok. Their reprise was it depends if it needs to come out. So back to the dental receptionist to relay this to which he decided to email the oncologist, They had an email conversation and the dentists receptionist called to say ideally wait until after chemo but it’s up to me.
I’m struggling to make a choice as I feel I’m not qualified to make that decision!
I’m starting chemo and it’s every 2 weeks for 8 cycles. Im also due to have zometa so there is a risk with that but they said they wouldn’t start that until I’d had the extraction. I’ll also be having radiotherapy.
They are both saying it’s up to me. I generally don’t have pain until it flares up and then it’s sore, but generally it’s then settled down. I don’t think I would opt for root canal anyway as it’s a rear tooth.
I’m assuming if I have it removed it could become infected etc when chemo starts as there isn’t much healing time. But I’m also thinking surely my immunity would be better now than after chemo? If I don’t it could flare up during chemo and I don’t know if I could stand pain for that long.
Has anyone been in a similar position or can advise at all? I have to make a decision and just don’t feel informed.
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What a dilemma. I came on to ask of you knew if you were going to have Zoledronic Acid as having a dodgy tooth like that would increase the risk, I suspect, of jaw necrosis. Not a given obviously bit a risk. I would imagine that you would be in a better state before chemo, even though it’s only a few days, than after, but you’d need to keep a close eye for infection etc. You’ll be taking your temperature during chemo anyway.
I hope you can make a decision you are comfortable with and that you’re ok whatever you decide to do.
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I needed some dental work which was delayed due to chemo and before zoledronic acid. They thought it would be root canal but it wasn’t. Move on two years I had a filling fall out of a back tooth, dentist took months to see me saying to use temporary filling. The gum grew around the area and then by the time I saw the dentist, they couldn’t do it. I was referred to the dental hospital, which took 9 months. I saw a Phd student who did 3D scan and my case was discussed with a couple of consultants. They decided to cap the tooth and remove the overgrown gum. It has taken 5 visits with tests and treatment. I only have one more zoledronic left and they were very cautious not to extract or root canal, if they could.
Being the dental hospital it was free on the NHS. I have bought them some treats to say thank you. I will be returning next week for the cap to be fitted.
I did an online meeting with a dental consultant who wanted to get feedback from anyone having zoledronic acid/ bisphosphonates and was at risk of jaw necrosis. She said it was very rare and the Phd student said the same. (BCN Voices)
I understand your concerns, from an extraction I had before, it healed within two weeks but this was before my treatment.
Maybe you could call the BCN nurses 0808 600 8000 Mon - Fri 9-4 ( probably closed bank holiday Monday) Sat 9-1 to discuss this. Or call your own breast care nurse to talk it through. It’s not something you can easily decide for yourself.
I hope you get some clarification of the risks and benefits of delaying to after chemo versus extracting before you start.
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It’s hard to know what to do as the dentist said review it initially as it just goes in cycles, but then being aware of treatment suggested taking it out knowing I had chemo coming up. That said on the whole it’s completely fine and then it’ll just come on, and whilst not painful something isn’t right. I’d like him to be more detailed about the state of it really! If it’s something that will really need sorting then I can at least make that choice, if it’s a temperamental thing then that could be different. I’m all for patient choice but in this scenario they just need to tell me 
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Yes I agree, they are the experts. Give you all the details then you can make an informed decision.
That sounds such a difficult position to be put in, especially when both sides are saying it is “up to you”. I think I’d be asking the dentist and oncology team to speak directly and give you a clearer risk/benefit view, rather than leaving you to decide without enough information. Four days before chemo does That sounds such a difficult position to be put in, especially when both sides are saying it is “up to you”. I think I’d be asking the dentist and oncology team to speak directly and give you a clearer risk/benefit view, rather than leaving you to decide without enough information. Four days before chemo does feel very close, but a flare-up during chemo would also be horrible. I hope they can give you a definite recommendation so you can feel more confident with the choice.
The oncology consultant and dentist have emailed each other but the dentist called me last Friday and said they’d had a conversation and ideally wait until after chemo but it’s up to me. It doesn’t feel very clear in terms of risk/benefit etc. I could do with some facts to make a decision but I have to decide by the end of today as I’ll need to cancel the appointment tomorrow if necessary. If the dentist said it definitely needs to be removed at some point that would help, just some clarity of some form!
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Good to know they have ‘talked’ to each other. Maybe you could press the dentist to say for definite whether it needs to be removed. Try to call and leave a message and hopefully they will come back to you before the end of the day.
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Consult your dentist and oncologist for a clear plan. Timing is key with chemotherapy, so prioritize professional advice. You’re doing great, seeking the right info and support here!
Given your situation, checking with an implant dentist in Eastlake Ohio might give you additional options and peace of mind before starting chemotherapy. They focus on holistic care, which could balance both your dental issues and overall health. Their expertise in newer techniques helped me when I needed a dental implant, and I found their professional approach quite reassuring.