Chemo and Teeth: Not a Pretty Picture
Last updated: February 2023
For many people, losing a chip off their tooth is at most an annoyance. But for me, it is a big deal. When it happened the other day, a feeling of dread crept over me.
I don’t have much dental real estate to spare. I have lost 12 teeth, one by one or two at a time. It’s possible that my dentist might be able to repair the tooth. But the teeth I lost were so fragile they could not be repaired when they became decayed and either cracked, chipped or even crumbled. When I felt that I was chewing on something that should not be there, and when I spit the tiny piece of tooth into my hand, I thought, “Oh no, not again.”
I wasn’t eating anything hard, like an almond or Tootsie Roll, the previous culprits. It was a soft Cliff Bar. The major culprit is chemotherapy. Without it, I wouldn’t be here. But I’m here with fewer teeth. Chemotherapy suppresses the immune response needed to fight the bacteria that causes tooth decay.
Four transplants are rare
If you or someone you know is a transplant prospect or patient, don’t worry about this happening to you. It is unusual to lose so many teeth. But I am an unusual case. Between 2003 and 2009, I had four transplants. Three and a half years after my first transplant, I relapsed; then I had transplant #2, and, six months later, graft failure. This is when the donor’s cells disappear. Then came transplant #3 and, six months later, relapse and transplant #4.
I have been in remission for nine years.
I've learned that while two transplants are not uncommon and three are given occasionally, four is extremely rare. I had chemotherapy before each one.
Chemotherapy and dental health
Another fun fact: Chemotherapy causes dry mouth, which is bad for dental health since saliva helps prevent tooth decay. It also feels yucky.
When after my last transplant, my immune system had recovered to the point that a dentist could poke around in my mouth, I got bad news. Four or five teeth would need to be extracted.
That was just the start of it.
Looking forward to an extraction
A surgeon said he would remove the teeth two at a time. He said I could go under general anesthesia, but most people just took Ativan. I took two 1-milligram tablets. They made me not care. Except for one outlier, it was obvious when a tooth had come to the end of its road.
A toothache from hell broke that pattern. To this day, I don’t know what caused it. Neither my dentist nor a specialist at Brigham and Women’s Hospital knew why an upper molar was KILLING me. I lay on the couch and cried. I got a root canal. It didn’t work. I cried some more. I took the oxycodone that the dentist prescribed.
The tooth would have to be pulled.
You wouldn’t think a person would look forward to an extraction, but I couldn’t wait to see it go.
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