Why is proper oral hygiene care important?
Oral hygiene is really actually a complicated issue in the myeloma space because of our use of bisphosphonate therapies to prevent skeletal fractures or RANK ligand inhibitors like denosumab. We know that with good oral hygiene, protecting against infections is important so that we don't have to then go through dental procedures like having teeth removed, which could lead to complications like osteonecrosis of the jaw. With concurrent bisphosphonate therapy like zoledronic acid.
So, good teeth brushing. You don't have to go crazy, right? We don't need to use the steel wool on our teeth, right? We got to be, you know, nice, gentle bristles so we're not introducing bacterial infections via the mouth, right? We know that the mouth has plenty of bacteria just living in it naturally. And so you don't want to be trying to induce blood borne infections with really aggressive oral hygiene, but flossing and brushing is really important. And routine dental checks every six months are really important as well. And good communication between you and your oncologist and the dentist to make sure that we've got the right meds held when you do need to have dental procedures is very important.
Do I need to take prophylactic antibiotics before a dentist visit?
Generally speaking, no. The prophylactic antibiotics tend to be for patients who are either on the most immunosuppressive therapies, and those patients probably shouldn't be getting significant dental work done right after those things like CAR-T cell therapy, like the stem cell transplant, those should be done beforehand. In patients who are just on routine, especially maintenance therapy, antibiotic prophylaxis isn't necessary. This is really reserved for patients who have prosthetic valves, especially metallic valves.
But a good, again, a conversation with the dentist that they shouldn't necessarily be doing anything like pulling teeth beforehand without earlier discussion is important.
HealthTree • October 2, 2023