Dental work before chemo

  • 2 replies
  • 479 subscribers
  • 263 views

Hi everyone

I have invasive breast cancer  grade 3 ER+ and HER negative.  My first step was a lumpectomy and sentinel node biopsy and I get results on 16th July.  Next step is chemo - they have told irrespective of whether lymph nodes are affected, due to my age (44) side and grade of tumor I will need a course of preventative chemo - likely to start August and I have been told it will be for 4-6 months (but obviously depends if I need further surgery). 

The BCN told me to get up to date with dental work so I have been for check up and have had xrays etc.  They will do a deep clean and replace a small filling, but they have also noticed a shadow under one of my my back molars and think it may be best to extract.  We haven't made the decision yet as she said it depends on the type of chemo I am having as to whether dental work can be done - she said there is one type of drugs where it is a complete no no. 

Does anyone know which drug would be likely for the above circumstance's - I am pre-menopausal.  I have also been told I will need hormone therapy and need to take tablets for 5 years. 

I know I will need to speak to my medical team before confirming all of this with the dentist but thought people may know more than me.

  • Hi - unsure if this is the same situation - but I had first appt with oncology doctor today - and he said that I should make a dental appt to check that I am able to have the zoledronic acid infusion ( A bisphosphonate) . He mentioned that it is connected to bone strength / jaw. Sorry am being vague, been a long day and so much information, I am post menopausal so maybe this is not the same? I am yet to start chemo.

    In the 'complete guide to breast cancer' book it reads - "you must see your dentist before you start taking bisphosphonate, especially if you need to have teeth extracted or major dental work done. Bisphosphonates can weaken your jaw bone, and there is a very, very small chance that your jaw bone might not heal after dental surgery".

    Sorry if this is not relevant for you

    jo

    x

  • Hello there,

    My oncologist told me to have all possible dental work done prior to starting chemo. She didn't specify any particular drug as the reason. The rule seems to be no invasive work once chemo starts.

    Like you, I had an iffy molar (in my case, with an ancient root canal) and my dentist referred me to an oral surgeon who extracted it and gave me good advice (rinse with salty water very frequently for first 2 weeks, now every time I eat anything at all, prior to brushing. Daily flossing too).

    Like jlw, I also read that the risk to the jaw bone was lower from IV bisphosphonates. Whereas the risk of dental infection leading to a pause in chemo was higher, and I didn't want that. Hence I got all dental work done really fast - cleaning, fillings that were planned anyway, plus the extraction under light sedation (which had the unexpected advantage of giving me my first good sleep since hearing my diagnosis) and I've not regretted it (7 weeks into chemo now and no dental issues at all). I'm still rinsing with salty water and I'm actually looking forward to seeing my dental hygienist ASAP after chemo - who would have thought it!

    Everyone's situation is different, but this might help your thinking while you wait to check with your medical team.

    Good luck!