Coachhoke,
As I understand it, how much lytic lesions can heal is a matter of debate. But there are some cases out there of dramatic healing. As an example, see this posting here in the forum.
One of the things that isn't discussed very often when it comes to Revlimid and maintenance therapy is that Revlimid doesn't do much to encourage bone regrowth. In contrast, other myeloma therapies, such as Velcade, often do help bone regrowth. See, for example, this article on the subject:
"Revlimid-Dexamethasone Has Mixed Effects On Bone Disease In Relapsed/Refractory Multiple Myeloma," The Myeloma Beacon, March 5, 2014
Forums
Re: Tooth / dental problems after treatment
JimNY,
I'm pretty certain there is no new bone formed where there were lytic lesions caused by multiple myeloma as NO osteoblasts will work there. The healing, if any, is scar tissue, NOT bone.
I'm pretty certain there is no new bone formed where there were lytic lesions caused by multiple myeloma as NO osteoblasts will work there. The healing, if any, is scar tissue, NOT bone.
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coachhoke - Name: coachhoke
- When were you/they diagnosed?: Apri 2012
- Age at diagnosis: 71
Re: Tooth / dental problems after treatment
Hi there,
This discussion thread is a few years ago, but it seems the most appropriate place to pass on information about the damage that chemotherapy and radiation can do to your teeth.
The dentists at the hospital I attend for multiple myeloma treatment are imploring haematologists and oncologists to support their patients in monitoring dental heath during treatment. I’ve had two autologous stem cell transplants. Prior to each I had a thorough dental check, which is part of treatment protocol. Both times, my teeth were in good condition (i.e., no work needed or looming).
Soon after the first stem cell transplant in 2010, I required six root canals. Soon after my second transplant in June 2017, I was referred to the hospital dentist with very sore teeth. The senior practitioner assessing my teeth said I had a typical presentation of someone who had received chemotherapy and/or radiation therapy. The dentist also said that neither cancer specialists nor patients have enough knowledge of this side effect.
On the left side of my mouth I had to have 20 fillings, 2 large, 18 small. Apparently, the teeth become pitted. On the right hand side, one gigantic filling (in a tooth that usually would have been extracted), one medium and 15 small fillings.
It seems that treatment for multiple myeloma can, and does in some cases, affect teeth.
This discussion thread is a few years ago, but it seems the most appropriate place to pass on information about the damage that chemotherapy and radiation can do to your teeth.
The dentists at the hospital I attend for multiple myeloma treatment are imploring haematologists and oncologists to support their patients in monitoring dental heath during treatment. I’ve had two autologous stem cell transplants. Prior to each I had a thorough dental check, which is part of treatment protocol. Both times, my teeth were in good condition (i.e., no work needed or looming).
Soon after the first stem cell transplant in 2010, I required six root canals. Soon after my second transplant in June 2017, I was referred to the hospital dentist with very sore teeth. The senior practitioner assessing my teeth said I had a typical presentation of someone who had received chemotherapy and/or radiation therapy. The dentist also said that neither cancer specialists nor patients have enough knowledge of this side effect.
On the left side of my mouth I had to have 20 fillings, 2 large, 18 small. Apparently, the teeth become pitted. On the right hand side, one gigantic filling (in a tooth that usually would have been extracted), one medium and 15 small fillings.
It seems that treatment for multiple myeloma can, and does in some cases, affect teeth.
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kefrewin - Name: Karen Frewin NZ
- Who do you know with myeloma?: Self
- When were you/they diagnosed?: 2009
- Age at diagnosis: 53
Re: Tooth / dental problems after treatment
I began developing osteonecrosis of the jaw (ONJ) in March or April after receiving monthly Zometa injections for 10 months. Both my oncologist and the oral surgeon say this is a side effect of the Zometa (the Zometa was suspended in April). I have learned since then that some oncologists no longer order monthly Zometa, but go as long as 4 months between Zometa treatments.
Peace and all good to you.
Bill
Peace and all good to you.
Bill
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Bill7 - Name: BillB
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: June 2017
- Age at diagnosis: 71
Re: Tooth / dental problems after treatment
My husband stopped Zometa a couple of years ago because he has constant dental problems and it didn't make sense for him to continue. His oncologist agreed. The only radiation he has had was on a plasmacytoma in his femur, likewise nearly three years ago.
Nevertheless, he continues to have an unusual amount of dental problems, though. A root canal here, a filling there, teeth that have pieces break off with minor stress. He is on monthly Darzalex and as little pain med as he can use reasonably comfortably, nothing else. Before this, he did not have anything approaching this number of dental issues.
I am wondering if this Is hopeless, something we just have to live with.
Nevertheless, he continues to have an unusual amount of dental problems, though. A root canal here, a filling there, teeth that have pieces break off with minor stress. He is on monthly Darzalex and as little pain med as he can use reasonably comfortably, nothing else. Before this, he did not have anything approaching this number of dental issues.
I am wondering if this Is hopeless, something we just have to live with.
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vmeyer - Name: vmeyer
- Who do you know with myeloma?: my husband
- When were you/they diagnosed?: March 2016
- Age at diagnosis: 65
Re: Tooth / dental problems after treatment
Vmeyer,
I don't think it's ever hopeless. I personally think it's a good idea to make sure your dentist has worked with cancer patients and Zometa patients before, though I would expect most would have.
I don't know if it's relevant, but I had to have a root canal for the first time in years after my first rounds of induction therapy and just prior to my autologous stem cell transplant. Also, since then while I'm on maintenance (Darzalex, Pomalyst, and dexamethasone), my oral hygienist notes that my teeth are get much more plaque and are more prone to decay. She said, anecdotally, that she sees this with other cancer patients. I bought a sonic toothbrush and now try to brush and floss after each meal.
I don't know if this will help, but hang in there. Make sure you have a good dentist and your oncologist on board. Oral health is vitally important to overall health,
Courtenay
I don't think it's ever hopeless. I personally think it's a good idea to make sure your dentist has worked with cancer patients and Zometa patients before, though I would expect most would have.
I don't know if it's relevant, but I had to have a root canal for the first time in years after my first rounds of induction therapy and just prior to my autologous stem cell transplant. Also, since then while I'm on maintenance (Darzalex, Pomalyst, and dexamethasone), my oral hygienist notes that my teeth are get much more plaque and are more prone to decay. She said, anecdotally, that she sees this with other cancer patients. I bought a sonic toothbrush and now try to brush and floss after each meal.
I don't know if this will help, but hang in there. Make sure you have a good dentist and your oncologist on board. Oral health is vitally important to overall health,
Courtenay
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