Anyone who on ibrance & xgeva had infected wisdom teeth extraction?
I appreciate all your inputs on this. I currently have infection in my wisdom teeth & the oral surgeon recommended to remove to avoid further complications even though my pain is not that bad. The pain is on & off, but it not bad at all even without any pain med, so I rather not having extraction, but afraid further complications. However, also concern about the risk of ONJ after extraction since I was on xgeva for 4 years & stopped 7 months ago.
Can you tell what your experience if you had one? & how long does it take to heal? Any complications after the surgery? How long you have to be off Ibrance?... Any advices are appreciated.
Thank you
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Hi 42 young, I just found your question. I am
now in similar situation, on xgeva since 2020, before that 15 months on zoledronic acid and probably will need the wisdom tooth extracted. I stopped xgeva two months ago. Did you get the extraction? Can you please write me how it went, I hope
all fine and no problems with ONJ.
thank you
Maaaki
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Hi Maaaki,
I had the extraction 2 weeks ago. It went ok & it's still slowly healing. I had no choice but remove it because it got infected & cause pain. The oral surgeon saw many death bones around the extraction site, so I do have ONJ. I may not able to get xgeva anymore.
I stopped ibrance 10 days before the extraction to make sure blood counts are good & also took antiobiotic 1 week after to prevent infection. I also use saltwater rinse several times a day.
I hope this helps & good luck with your extraction!
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I’ve had 2 extractions in the past few years (not wisdom teeth), the 1st while on another drug in the CDK 4/6 inhibitor class. Both sites healed without complications but I won’t get dental implants as replacements due to prior IV bisphosphonate therapy. Also, there’s some thought that taking Xgeva after Zometa may increase risk for osteonecrosis of the jaw.
We have a couple threads here on ONJ with Amontro posting her extensive experience. I’ll bump them by doing a search.
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Dear 42 young and vlnrph,
thanks a lot for your answers. I read all info from here about ONJ. It is very helpfull. I will need exctraction soon like you 42 young due to infection and fistulation of the wisdom tooth. My oral surgeon said, that around tooth can be necrotic bone even without the denosumab or bisphosphonates and he can clean the death bone while taking the tooth out. The important is that gingiva is closed and heals well, than after couple months we can be reintroduced to the xgeva again.
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I was put on xgeva directly after chemotherapy four years ago. Starting in September of 2023 I began loosing my appetite and then weight. At the time I was taking Piqray with shots of Faslodex and xgeva monthly. After battling 5 months of gum infection and feeling like I was being ignored about what was going on with my gum when I had doctors appointment. Finally got them to look in my mouth. They prescribed a mouthwash, magic mouth and dexmethasome. Did no good. At the time I was on TPN because I couldn’t swallow anything but liquids. The health nurse called several times asking for an antibiotic, the second time asking and describing what she saw was told I needed to go to a dentist. Went that day and was prescribed the same mouth wash I had been on for five weeks. Also told me I needed to see an oral surgeon. After the boil on my chin the size of a golf ball came to a head and burst with the same puss draining from it as was my gums, I said enough is enough and had my son take me to the hospital ER. They Admitted me and started antibiotics. They didn’t have an oral surgeon on staff but their large hospital did and was transferred there 4 days later and they did surgery. Lost three teeth and will probably lose more. They told me that my gums probably won’t reattach on my upper gum may have to do reconstructive surgery because of the sinus area. I been here almost 4 weeks on very strong antibiotics. Haven’t had any type cancer treatment since the end of October and pet scan was good. Told I can’t go back on cancer medication until I’m off antibiotics. I have since found out that this was a know side effect and something wasn’t done. Please if you have been on this medication for a while that you question every little change.
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Oh dear al36526, it’s hard for me to imagine what you’ve been through. How did you fight the gum infection for 5 months? I recently had a spot of irritation on my tongue after starting a new chemotherapy. Thinking it was a canker sore, I figured it would resolve within a few days. However, I almost never get those. It got worse, making eating painful & affecting speech.
Just like you, both my doctor and dentist both suggested Magic Mouthwash. Prior to my retirement as a pharmacist, we saw many different formulas we had to mix. That took time and was difficult to get through insurance. Now, apparently there are kits to use. I didn’t bother to get it filled. My oral surgeon did a 3rd extraction in as many years earlier that month.
The regular DDS missed the diagnosis but later that week, the oncologist looked into my mouth. I had thrush (yeast overgrowth) so immediately began nystatin swish and spit. It cleared up quickly. Good that you went to the ER when no one else would respond. I am sorry that more surgery is required. You sound like a very strong person to withstand all this.
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