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ITP and dental procedure 2 months 3 weeks ago #72464

  • Lman
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  • We cannot change the cards we are dealt, just how we play the hand.
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Hi.
Does anyone have any idea about ITP and dental procedures? I need to have a couple of teeth filled, and I'm worried about ITP. I know for filling tooth counts should not be high (maybe 40k would be enough according to something I had seen years ago), but I discussed it with the doctor, and he suggested being +80k and told me I could have some extra Nplate for a week with some pred. The thing I'm worried about is dental anesthesia and its effect on platelet aggregation. I have not discussed it wthe dentist, yet but I'll surely let him know my condition.
Does anybody have any ideas?

P.S: I'm really afraid of tooth fillings. They are PAINFUL :) The pain is comparable to bone marrow biopsies I believe 

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ITP and dental procedure 2 months 3 weeks ago #72465

  • mrsb04
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  • ITP since 2014. Retired nurse. My belief is empower patients to be involved as much as possible in their care. Read, read, read & ALWAYS question medics about the evidence base they use.
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ashpublications.org/bloodadvances/article/3/22/3780/428877/Updated-international-consensus-report-on-the 

Lman:- The  latest ITP guidelines Link Above  See Table 6. My haemo isn't at all worried about dental treatment with low counts, neither is my dentist. I've just come back from a descaling  by the hygienist. My count is currently 6 and I have had no ill effects.  I would discuss the the dentist. I can't see a filling causing much bleeding other possibly than the injection site. Ask the dentist about topical TXA .

I can assure you that a bone marrow biopsy is not painful. 

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ITP and dental procedure 2 months 3 weeks ago #72468

  • MelA
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After a tooth broke off and the root removed I had an implant before the pandemic - I also had a descaling of 1 root as mrsb did only the specialist did it - then I had a crown totally break off at the gum line & had to have the root removed which came out in pieces, bone implanted to keep the space proper [ decided against an implant ] and all went well, don't even know what my count was.   I think it depends on the dentist or specialist - a few years back a specialist was to perform surgery going through the gum to the top of a root that had a broken off piece of instrument from a root canal, now he insisted on a platelet count with a letter from my hematologist that it was ok to perform the surgery.   [this makes my teeth sound terrible, but they are good really]

Lman I wish you could use my dentist because he is fantastic - I even fell asleep during a root canal he was doing :)     I know there are people who are terribly afraid of dental work being done - my dentist's wife is one and she insists on receiving whatever that gas is called before any work done.

And you should tell any doctor or dentist you have ITP, and tell them up front !!!  

(oh mrsb the bone marrow I had while in the hospital when 1st diagnosed in 1989 was something I hope never to have to repeat, it was quite painful - after being given a hematologist and I told her about it she told me that had she done the procedure it would not have hurt).
"Instead of wasting your time worrying about symptoms, just get it checked out" -Nieca Goldberg, MD

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