Two Weeks of Chemo: Day 6

This is part of an ongoing two-week series. For more info, see this introductory post.

Today, I'm at the dentist! Yay?! Ok, not my favorite place, but one I frequent regularly. I had bad teeth before I had cancer and strangely enough, they're still bad. As much as I am loath to devote an entire post to dentistry, I have learned too much from my dental exploits this year to ignore them.

For one, dentistry is not one of the things you think about when someone says they are undergoing chemo. If you're like me, you tend to think that a cancer patient's entire life revolves around the cancer and treatment therefor. And it sorta does. However life keeps interrupting. There are bills to pay and chores to do and yes, the dentist to visit.

Actually, the typical chemo patient doesn't deal with the dentist, because they are told not to. As I mentioned on Day 2, the cells on the surface of the GI tract, including the mouth, are inadvertently targeted by chemo because of their high turnover rate. This often leads to mouth sores and generally increased sensitivity of the surfaces of the mouth, so it's not surprising that your oncologist doesn't want someone poking around your mouth with pointy metal things. Also, the thrombocytopenia (low platelet count) caused by chemo can lead to excess bleeding during dental procedures. This also puts the patient at risk for infection, which they are at a high risk for anyways.

So the prevailing policy has become one of less is more. Odds are whatever you need done can wait and people are generally happy to oblige. Just to be difficult, I had to be the exception. Not two weeks into chemo, one of my teeth developed an abscess and needed a root canal. This required multiple trips to the dentist and an endodontist, much to my oncologist's dismay. To placate him, I had to time my dental appointments with my chemo cycle (no easy task, mind you) and go to his office for a blood test prior to each appointment to make sure I wouldn't bleed out or develop an infection.

All of this illustrated an interesting point about medicine: dentistry is an obstinately separate field. When you have an eye problem you go to Dr. Ophthalmologist MD; a heart problem leads you to Dr. Cardiologist MD; and bowel problems go to Dr. Gastroenterologist MD. But for purely historical reasons, a patient with tooth problems goes to Dr. Dentist DDS or DMD. You are not referred to your dentist by your general practitioner, nor do you expect your dentist to coordinate care with your other specialties.

This makes sense historically, as dentistry was far more effective then medicine as a health profession for the vast majority of human history. It just surprises me that dentistry wasn't absorbed by the greater medical community once medicine as a field began to gain credence. All of this leads to the situation where my oncologist and dentist don't communicate and leave me as the de facto manager of my own care. There are worse things, but you don't need another ball to juggle when your cancer is already up in the air.

Back to Day 5.
Ahead to Day 7.