Hepatitis C Survivor  

It's One Of Those Side-Effects From Treatment

Written By:  Teri Gottlieb

There is a side-effect from Interferon treatment that isn't talked about much... It's what Peg-Interferon can do to your teeth, and it's not good.

When I was a kid, my parents were really strict about me taking care of my teeth. I went to the dentist twice a year without fail, they spent $1,400 on braces for me (back in 1970 that was a boat load of money) and made sure I brushed regularly. Habits that I carried into adulthood. When I was in my teens and early 20's my teeth were cleaned 4 times a year... I went religiously every 3 months to get my teeth cleaned. I had beautiful teeth. Operative word here, HAD.

Until I started HCV treatment in 2005, the only tooth issues I had were with wisdom teeth, like most people have, and those were pulled. Cue treatment... Six months into my treatment I had a tooth start giving me problems. It started hurting and tooth pain wasn't something I was used to. I called the dentist but because I was on treatment and my immune system was compromised, the dentist wouldn't touch me. She said I had to wait until treatment was over and my system had time to bounce back. My system never "bounced" but that's another blog entry!

A couple of months after I finished treatment, I found myself in the dentist chair complaining about that tooth. Very quickly, this tooth of mine went from having a cavity to being non-salvageable. That tooth was dead. Painful still but dead nonetheless. The tooth had to come out... and so it did. First casualty in my mouth from treatment. There were more to come. At the time, we had no idea there was a correlation between this tooth and my treatment.

So a few years go by and all is well with my teeth.. Or at least that's what I thought.  They weren't bothering me.  Then on a Saturday morning, we drive 5 hours South, into Indiana to take our daughter to college. We stop for breakfast on the way there and I broke one of my molars eating an omelette. This omelette did NOT have nuts and bolts in it, just cheese and spinach but it broke my tooth. In half! Strange thing was, there was absolutely no pain at all, just some rough edges. 

I made it thru the weekend and the next week, off I go to see my dentist. A person who, I might add, I have known since we were both 3 years old. We grew up together. She informed me that she no longer pulls teeth or does root canals (I had to stop myself from asking her exactly WHAT she did since she didn't do those things) but she did file the tooth so that the sharp edges wouldn't cut me any longer. Then she took some x-rays... MOST of my teeth were DEAD. Unsalvageable. Luckily for me, the dead teeth were all molars and not my smile teeth... they were however, the teeth I use to CHEW THINGS. Her next comment threw me for a loop. She said, and I quote "It's such a shame too because you had such nice teeth." I'm pretty sure if she hadn't known me for 40 some odd years, she wouldn't have said that. Or at least I hope not. In any case, the words stung. That was also the last time I would sit in her dental chair.

So over the next few years, 3 more of my molars broke. They didn't hurt, just those damn sharp edges, but they broke. When I went to see my Hepatologist for my 5 year post treatment check up, I asked him about my teeth. Yes, he said. Totally treatment related.

So my advice to anyone undergoing HCV treatment is to pay extra attention to your teeth. Mine rotted from the inside out. The tooth looked FINE but on the inside... dead. When you are going thru a rough treatment, it's pretty easy to not give a flip about your teeth. You might be lucky if you brush them once a day. Please take heed.. Your teeth need extra attention when you are on treatment. You don't want to have to go thru what has happened to me....

In the Fall of 2011 that tooth that broke on the omelette started hurting. That one and the broken one right next to it. I suffered for about 6 weeks with that pain while I was trying to find a dentist that actually DID pull teeth. Turns out, they are kind of hard to find. Almost non-existent. Finally, on the Tuesday before Thanksgiving, my "friend" the dentist got me a work in appointment with a colleague of hers who is an oral surgeon. After 6 weeks of pain, the painful teeth were removed. Did anyone catch that it was a few days before Thanksgiving? I cooked Thanksgiving dinner for the whole family but I couldn't eat.

Exactly 12 months later, when the tooth pain started again on the other side of my mouth, I was DETERMINED to not have anything pulled before Thanksgiving. You know what? It's just as hard to eat when your teeth are hurting as it is when they've just been pulled.  I was back in that same oral surgeons chair. He removed the offending two teeth. It was pretty quick and I was glad that the horrible pain I'd been in was going to stop. Did I mention I went thru 4 bottles of Anebesol, 2 bottles of clove oil and 30 pain pills? Well I did.  I still have 4 more molars that are affected but they haven't broken yet, they are on the top and they don't hurt. Let's see how long I can keep those.

So here is my final thought on this mess... I have heard many people talk about the side effects of Interferon treatment. About how hearing about those side effects have stopped them from treating. This is one of those side effects. Guess what? Had I not treated when I did, with what I did, I would not be here today to complain about it. So bad teeth or 6 feet under?  I'll take the bad teeth. Wouldn't you?