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Is There a Link Between Myeloma and Dental Health?

Is There a Link Between Myeloma and Dental Health? from Patient Empowerment Network on Vimeo.

Dr. Sikander Ailawadhi from Mayo Clinic explains that while multiple myeloma doesn’t commonly cause dental issues, there can be indirect connections via bone problems.

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Lisa Hatfield:

Another question from a patient since my diagnosis and bone marrow transplant, my teeth have been deteriorating, is there a connection between dental health and myeloma?

Dr. Sikander Ailawadhi:

Very important question because although this is not a very common finding, it is something that really affects quality of life, so myeloma itself does not always or frequently caused teeth problems or dentition problems, which you can imagine teeth are bones. Myeloma affects bones, Myeloma affects calcium deposition in bone so teeth can get damaged in two or three different ways in myeloma patients, first, if myeloma involves the job or you can imagine that the teeth in that particular area could become loose or they could become a little off because the structure is getting affected.

Sometimes if my novels present on the job, for example, and radiation is given, but that bone becomes weaker, so teeth can become weaker, another way myeloma and dental health can be connected is because we use certain bone-strengthening agents for myeloma. These drugs are called either bisphosphonates, for example, or zoledronic acid (Zometa) or pamidronate acid (Aredia), patients may know as Zometa or Aredia, or there’s a second category called RANK ligand inhibitors, one of the drugs there is denosumab or Xgeva, these are all drugs that are given for bone-strengthening for myeloma. Patients are recommended to take calcium and vitamin D, but a rare but definitive side effect that is known to happen or can happen with these drugs is what’s called osteonecrosis of the jaw, where basically the jaw bone is becoming necrosed or less viable.

And you can imagine if the jaw is less viable, the teeth that go into the jaw in that spot, they’ll become loose and hurt, painful…it’s not a good condition to have it very…it affects quality of life significantly. So while it is rare, this osteonecrosis of the jaw can occur maybe less than 10 percent of the cases, but it is a significant morbidity causing issue.

What I recommend to patients is that one, if that is happening, first of all, we’re not…we typically don’t continue that drug that is causing it, like a bisphosphonate or RANK ligand inhibitor. Secondly, the patient needs to see a good oral maxillofacial surgeon or a good dentist, preferably someone who has knowledge and experience in handling outreaches of the job. So different ways in which melodic treatment can affect the job, there is not a direct correlation, but in about 10 to 15 percent of cases, there may be care or death-related implications and monuments either from the disease or its treatment like radiation or bone-strengthening drugs. 

How Cancer Can Affect Your Dental Health

More than one-third of all cancer patients develop complications or side effects that can affect the mouth, according to the National Institute of Dental and Craniofacial Research. While it is probably one of the last things you want to think about when faced with a cancer diagnosis, assessing your dental health and developing an action plan for how you will care for and protect your teeth and gums is a great way to ensure you don’t experience complications that can affect your treatment and general health.

Assessing Your Dental Health

The American Dental Association recommends treating areas of concern before you engage in any cancer treatment as it may help reduce possible side effects associated with chemotherapy and radiation. If you are able to do this beforehand, you will be able to address any issues such as cavities, gum disease or other dental hygiene issues that have the possibility of getting worse as you get further into treatment. They also recommend stopping the use of all tobacco products, eating healthy foods to help make your immune system stronger and rinsing your mouth with hot water, baking soda and salt to ensure it’s clean and not a breeding ground for infection.

How to Care for Your Teeth with Cancer

If you experience issues such as dry mouth, mouth sores, jaw pain or sensitive gums, you will want to speak directly with your doctor as they can provide you with more accurate advice and medications. However, to ensure you’re following a great general oral hygiene routine, it’s recommended to brush twice a day with fluoride toothpaste and to floss every day as it helps remove plaque buildup and keep your mouth extra clean. If your mouth and gums are sore, there are alternatives to traditional flossing that might feel more comfortable. If you are still experiencing pain, try soaking your toothbrush in hot water before brushing to make it softer and look for a toothpaste with aloe vera and allantoin as they’ve been shown to help soothe pain in the mouth.

Common Oral Side Effects During Cancer Treatment

During treatment for cancer, your oral health and dental hygiene can be affected, among other things, due to the fact that your immune system is weakened and you are prone to various side effects. Dry mouth and painful sores are some of the most common side effects reported and can cause issues for the health of your teeth as saliva is generally used to wash away food particles and other bacteria. If you find that are experiencing dry mouth, whether in treatment or not, it is best to ask your doctor for artificial saliva and also fluoride gel. This gel will come with a tray that will slip into your mouth and, with the help of the fluoride gel, strengthens and protects your teeth.

Staying Positive About Your Health

Caring for your oral health is just one aspect of working through a cancer diagnosis and subsequent treatment. It is important to consult your doctor with any concerns you might have and gain a solid understanding of what your treatment will require and how it will affect your dental hygiene. Throughout all of it, however, it is most important to remain positive about your health and work to understand that it is a tough process, but with the right care and support, will only make you stronger.