In 2007, my daughter was having counts in the teens to thirties when she needed all remaining (stubborn) baby teeth extracted for braces at age 13. She had seven teeth removed by a specialist as an outpatient procedure in the OR of the teaching hospital where her hem/onc group practiced. That way, hemorrhage control measures were at hand, and the hem/oncs were right down the hallway. The hem/oncs and dentist together formed a plan. (This is what I treasured about our teaching hospital docs when we were enduring ITP.) She took pred for several days before and after, with the count reaching the nineties. (It fell later, of course.) She was also prescribed amicar (expensive, around $200US), but it was later realized she probably could not take it because she'd recently started on the bc pills to stop terrible periods. (Some can take amicar when bleeding is a problem, but there are some contraindications in folks at risk for clots, women on the pill, etc.) The pediatric dentist (you would likely have an oral surgeon) used dressings developed for the military (the substance is chitosan), and inserted them as packing in the sites. He'd never used them before, but was using this as a teaching opportunity in grand rounds, and was planning a journal article on the subject. I'm not sure that was ever published. (Goal for ITP patients: try not to be so interesting you become a journal piece. In medicine, "interesting" is to be avoided.) Our dentist was Rockman of the Medical College of Georgia, now known as Georgia Health Sciences University, if your guy wants to call him. Our regular dentist would not have done the extractions in his small rural clinic. It can be done, and sounds like your health would be better with dentures. Good luck. Let us know how you do.
Norma
