Hi,
I am awaiting my auto stem cell transplant after receiving 4 cycles of CyBorD (cyclophosphamide, Velcade, dexamethasone). My last cycle was in mid-December. I didn't notice any real negative effects from the treatment regimen and was able to continue on with life a usual.
There were various things that have delayed my transplant, one of which has been my teeth. Now, I have always had a certain amount of need for dental work, root canals, and fillings, etc. But in the past 2 weeks, I have needed 1 tooth extraction and 4 root canals. All of this has delayed my transplant. I am hoping that this last root canal, which began yesterday and will be completed tomorrow, will be my last and that I can move forward.
How common is deterioration of tooth nerves, or teeth in general, after treatment? Does anyone know if anything can be done to avoid it?
Forums
Re: Tooth / dental problems after treatment
Hi Debbie,
Did you receive Zometa or Aredia (bone building meds) during your chemo?
Did you receive Zometa or Aredia (bone building meds) during your chemo?
-
Little Monkey - Name: Little Monkey
- Who do you know with myeloma?: Father-stage 1 multiple myeloma
- When were you/they diagnosed?: March/April of 2015
Re: Tooth / dental problems after treatment
I did receive Zometa once a month, so I believe it was a total of 2 or 3 times.
Re: Tooth / dental problems after treatment
Does your haematologist know about the recent tooth problems? The reason I ask is that there is a possible side effect with Zometa involving the jaw.
-
Little Monkey - Name: Little Monkey
- Who do you know with myeloma?: Father-stage 1 multiple myeloma
- When were you/they diagnosed?: March/April of 2015
Re: Tooth / dental problems after treatment
Building on what LM said, does your dentist know that you took Zometa?
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Tooth / dental problems after treatment
Hi Debbie,
Your dental problems did NOT arise from your CyBorD or Zometa. Although I am not a fan of Zometa, there is NO way it could have caused your dental problems with just two or three treatments.
Did you recently change dentists?
Dr. Don Hoke (retired dentist)
Your dental problems did NOT arise from your CyBorD or Zometa. Although I am not a fan of Zometa, there is NO way it could have caused your dental problems with just two or three treatments.
Did you recently change dentists?
Dr. Don Hoke (retired dentist)
-
coachhoke - Name: coachhoke
- When were you/they diagnosed?: Apri 2012
- Age at diagnosis: 71
Re: Tooth / dental problems after treatment
Hi!
Thank you for all of the input. I have not recently changed dentists. In fact, I have had the same dentist for 40 years. He is in the top of his field. Also, have an endodontist and oral surgeon who are all part of his 'inner circle' of top notch practitioners. They are all talking to each other about my situation, and have never seen anything like this - 5 teeth needing treatment within 2 weeks.
I just wonder, my symptoms were subtle, but definitely there, and they all were in definite need of treatment once they were investigated. Under normal circumstances, the endo would have put these on 'watch' for a while to see if they resolved. Due to my imminent stem cell transplant, that isn't an option. Maybe, other myeloma patients have experienced this nerve/pulp inflammation without comment if the symptoms were subtle? Or if they weren't getting ready for stem cell transplant.
Normal x-ray wouldn't show nerve inflammation or necrotic tissue. It is all symptom-related prior to going into the tooth and actually seeing what is going on in there. I'm very glad that we found this as it could have been a big issue during neutropenia. Now I'm a bit nervous wondering if there are more teeth that are going to become a problem within the next weeks. Hope not!!
Thank you for all of the input. I have not recently changed dentists. In fact, I have had the same dentist for 40 years. He is in the top of his field. Also, have an endodontist and oral surgeon who are all part of his 'inner circle' of top notch practitioners. They are all talking to each other about my situation, and have never seen anything like this - 5 teeth needing treatment within 2 weeks.
I just wonder, my symptoms were subtle, but definitely there, and they all were in definite need of treatment once they were investigated. Under normal circumstances, the endo would have put these on 'watch' for a while to see if they resolved. Due to my imminent stem cell transplant, that isn't an option. Maybe, other myeloma patients have experienced this nerve/pulp inflammation without comment if the symptoms were subtle? Or if they weren't getting ready for stem cell transplant.
Normal x-ray wouldn't show nerve inflammation or necrotic tissue. It is all symptom-related prior to going into the tooth and actually seeing what is going on in there. I'm very glad that we found this as it could have been a big issue during neutropenia. Now I'm a bit nervous wondering if there are more teeth that are going to become a problem within the next weeks. Hope not!!
Re: Tooth / dental problems after treatment
Thanks Coachhoke. How long do you think one would need to be on a bisphospohnate like Zometa before one would likely start to see the beginnings of any oral issues?
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Tooth / dental problems after treatment
Debbie: I'm sorry you didn't get your decay under control years ago, but it has NOTHING to do with your multiple myeloma or treatments for it.
Multibilly: ONJ can only be detected by x-rays and even then it is hard to diagnose until significant damage has occurred. I don't know how many treatments of bisphosphonates before ONJ can occur. Everyone reacts differently. I have seen it occur in less than a year of treatment.
The other side of this coin is how much is this drug helping. I have seen studies that seem to indicate that it is synergistic with other treatments in helping to "control" myeloma. The usual reason for using it is that it strengthens the bones; how is that measured?
We know that once you have lytic bone lesions, they never heal (they don't allow osteoblasts to produce new bone). Sorry I don't have a very good answer.
Multibilly: ONJ can only be detected by x-rays and even then it is hard to diagnose until significant damage has occurred. I don't know how many treatments of bisphosphonates before ONJ can occur. Everyone reacts differently. I have seen it occur in less than a year of treatment.
The other side of this coin is how much is this drug helping. I have seen studies that seem to indicate that it is synergistic with other treatments in helping to "control" myeloma. The usual reason for using it is that it strengthens the bones; how is that measured?
We know that once you have lytic bone lesions, they never heal (they don't allow osteoblasts to produce new bone). Sorry I don't have a very good answer.
-
coachhoke - Name: coachhoke
- When were you/they diagnosed?: Apri 2012
- Age at diagnosis: 71
Re: Tooth / dental problems after treatment
Hi Debbie and all,
Before I was cleared medically for my stem cell transplant, I had an appointment at the dental clinic at our cancer centre. this was the most thorough check up I have ever had, since it involved getting x-rays on a panoramic scale. I am not sure of the exact terminology. They must have been checking for any problems that could have flared up during a period of low immunity. If I had had problems, there was a free service for dental work. I also had a follow up some months later.
Hope this information is useful.
Before I was cleared medically for my stem cell transplant, I had an appointment at the dental clinic at our cancer centre. this was the most thorough check up I have ever had, since it involved getting x-rays on a panoramic scale. I am not sure of the exact terminology. They must have been checking for any problems that could have flared up during a period of low immunity. If I had had problems, there was a free service for dental work. I also had a follow up some months later.
Hope this information is useful.
-
Nancy Shamanna - Name: Nancy Shamanna
- Who do you know with myeloma?: Self and others too
- When were you/they diagnosed?: July 2009
16 posts
• Page 1 of 2 • 1, 2
Return to Treatments & Side Effects