Tooth extraction

After being diagnosed with breast cancer, I was advised to ask my dentist if I had needed any dental work as I will have a bone strengthening treatment. I need to have a tooth removed and the dentist wanted to know what the medication was going to be and when it will start. As soon as I found out (Zometa 4mg to start in a few months), I called the surgery and left the details and ask to speak to the dentist. It took 2 weeks to hear back from them (I understand that I am not their only patient) only to be told that as I have now started my chemotherapy (EC treatment which is every 3 weeks) I need to be referred to the hospital. This is really frustrating as I tried to get it sorted before anything started. Anyway, what is done is done. I assume I will have antibiotics so how is that going to impact my EC treatment? Is the treatment going to be delayed? As it is on the NHS, it will probably take a while to get done but what is the best time to have it done? Thank you for any advise..

  • Dear Daxy,

    Thank you for getting in touch and welcome to our online community, I hope you find it supportive. My name is Jo and I am one of the Cancer Information Nurse Specialists on the Macmillan Support Line.

    I am sorry to hear that you experienced delays in communication from your dentist. Sometimes dentists will remove teeth that look like they could be infected or become infected during treatment when you are immunosuppressed. For patients already receiving chemotherapy, dentists should always liaise with the oncology team to find out when any dental treatment can be carried out safely. If you have been referred to a hospital dentist, then they too should be discussing the timing of any dental work with your oncology team first. Together, they may be able to make plans for the tooth extraction in between your EC cycles when your blood counts are optimised.

    Invasive dental treatment such as extractions should be avoided when taking Zometa treatment (bisphosphonates) because of the risk of osteonecrosis of the jaw.

    We’d recommend getting in touch with your oncologist or breast care nurse to discuss this with them and put a plan in place.

    I hope this information is helpful but if you have any more questions please don’t hesitate to get back in touch.

    Best wishes,

    Jo, Cancer Information Nurse Specialist 


    You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or email us.