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My wife's wisdom tooth is very painful and needs to be pulled. We have not been able to find out if this is a safe procedure when you are on Avastin. The pharmaceutical company, our oncologist and the dentist do not want to give us a recommendation. Avastin impairs healing and my wife has been on it for over a year. Has anyone had this experience before and is willing to share? Thanks.
If she went off Avastin, how long would it take before she could have the tooth removed? Is is safe for her to go off for a time? These might be questions to ask.
Good luck and take care, JC
Per the pharmaceutical company, Avastin will be out of the body in 16 weeks which is 5 treatments missed. You can see our quandry. We are just unsure how surgical is pulling a tooth and how much is the healing impaired. Yet is it chancy or is it not.
Avastin is indeed associated with wound dehiscence (the parting of the layers of a surgical wound, either the surface layers separate or the whole wound splits open) or impaired wound healing. Avastin can inhibit the growth of capillaries into newly forming normal tissue, as well as in tumor tissue. Scar tissue won't form because it can't make a blood supply. So this would may be a complication.
Is the wisdom tooth infected? If so I would think that getting it out would be very important, since chemo suppresses the immune system. Untreated head-area infections can lead to brain abcesses. The mouth heals very quickly from extractions due to good blood supply, and removing a tooth is nothing like having, say, an abdominal surgical procedure. They certainly wouldn't hesitate to remove her appendix if she had appendicitis!
I know that when I was doing chemo, My Oncologist said NO to having a tooth pulled. I was able to have it crowned so I had a choice.....I took antibiotics before that was done and anytime I went to the dentist. Be careful
I am receiving Avastin and Tarceva. I had to have oral surgery to remove pea-sized bone growths that were protruding out of my gum tissue. My oncologist's office checked with Genetech for their recommendations as far as timing for the surgery. We were told that the Avastin clears enough 14 days after the infusion but that there was just a 3 day window for surgery because you did not want it right before the next infusion at 21 days.
I had a total of 6 of these procedures (causes of growths unknown, jawbone was otherwise healthy) and healed with no complications. But I must add that rapid, complete healing was usual for me before I started chemo.
Many years ago I had a wisdom tooth taken out and it was a bigger deal than each of the oral surgeries I just had. A lot longer for the tissue to heal so I don't think that it is a breeze even under the best of circumstances.
A wisdom tooth can be pretty surgical. I'd go with the plan to stop the Avastin for a time to get both done. I have heard different number of sessions, so check with the doctor on that, but I'd hope 3 or 4 would be adequate. I don't think there's any other way without taking unnecessary chances. Even a couple sessions off would help more than none.
My husband has stage 4 nslc got his wisdom tooth out a week before his chemo..that was in April 2009-- and his mouth STILL hurts now from that pulled tooth...he is in so much mouth pain and it taking ibuprofen almost every day for the pain.. We think its from getting chemo while the gum was still sore and raw... it never healed.. he went ot the dentist and they took a xray and said that there was nothing left in his gums...but last week he pulled 2 small pieces of tooth out of his gum...we thought that would be the end of the pain... but it was not...I know the effects of ibuprofen and not good when taken over a long period of time...but he cant stand the pain...it radiates from his gum the side of his face .eyes,throat. and chest..
Gob bless everyone here!!
Pat
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