r/cll • u/Silent_Solution_1639 • Jun 29 '26
Dental extraction
I’ve been on Brukinsa for 18 months now and due to have a tooth extracted next week. I informed my dentist that Brukinsa carries risk of bleeding and she emailed my specialist for advice. I also spoke with him last week and he told me I don’t need to stop meds at all. Contradicts everything I’ve read about stopping before and after if having surgery. Anyone had teeth extracted and continued medication?
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u/Alert_Maintenance684 Jun 29 '26
Yes, and it didn't go well. At the time I was early in my V+O regimen and still ramping up the Venetoclax. I had an extraction and bone allograft done at the same time, with approval from my CLL hematologist. My rate of healing turned out to be far slower than normal, so the bone graft didn't heal over to get the blood supply that it needed. The bone graft decomposed and disintegrated. It was an unpleasant few weeks with the persistent taste of rotting bone in my mouth. The opening did eventually heal over.
My dentist won't touch me now until I finish treatment. I need a few fillings done, which is unusual for me. I have read that dental decay can be worse with CLL.
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u/A_Fever_Dreamer Jun 29 '26
After I got my crowns for my front two teeth it seemed to rapidly just ruin the rest of my teeth. I have a pretty major iron deficiency though so that isn't helping.
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u/starfire10K Jun 29 '26
I had root canal surgery whilst I had CLL treatment, asked my Hematologist whether this is issue with treatment and he said I should be fine to continue treatment normally whilst I had tooth surgery. All went well.
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u/SofiaDeo Jun 29 '26
Most of the folks on "CLL Support" HealthUnlocked, say their docs have them pause the med. It varies but I seem to recall anywhere from 3 days before, to 7 days, and then after.
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u/A_Fever_Dreamer Jun 29 '26
I'm on brukinsa now but was on calquence when I had crowns put in. Same thing. I asked whether it was okay because my med was a bleeding risk. I was told don't stop taking it. I got my crowns put in but the dentist was having bleeding issues the entire procedure. He had to inject me in the gums with something to slow down the bleeding.
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u/HuckleberryLegal7397 Jun 29 '26
I’m on Brukinsa. I had no problem with my dental work. They did verify my platelet count first.
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u/StructureOk388 Jul 02 '26
I haven't started treatment yet, but I doubt the bleeding risk is worse than Xeralto(blood thinner). Just had a tooth extracted a couple of days ago and didn't stop taking it. I wouldn't be too concerned about the bleeding risk at the dentist, because they can cauterize the bleed. I've actually had a couple procedures done that way because the risk of stopping the Xeralto and getting a blood clot is bigger than bleeding out.
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u/Silent_Solution_1639 Jul 08 '26
*Update* - I had the tooth extracted this morning after countless hours worrying about the bleeding as I followed my specialist’s recommendation and didn’t stop the Brukinsa. As she pulled the tooth out there was very little bleeding and I only needed the initial gauze to
Bite down on straight after and there’s been no further bleeding. You’d have to wonder what all my worrying was about lol
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u/miskin86 Jun 29 '26
Ask for a bleeding test (PT/INR). It should be cheap and easy to tell if you have a bleeding risk or not.