I am HIV+ and presently undergoing cheomotherapy for non-hodgkins lymphome. My first treatment landed me in the hospital neutropenic. Are there things I should/should not be doing while my immunity is low? Is flossing o.k? If I have had thrush should I be chanign my tootbrush?

Thanks for your help.

First of all it is very important that between bouts of chemotherapy, you should visit a dentist to address any existing dental disease. Ideally, any pre-existing dental disease should be managed prior to starting therapy. If your absolute granulocyte count (AGC) is below 500 you will need to be premedicated prior to any invasive dental work. Antibiotic premeditation for neutropenia is the same as recommended by the American Heart Association for mitral valve prolapse with regurgitation; your dentist will know what this means.

Oral hygiene is very important while you are undergoing systemic chemotherapy, therefore brushing with a soft toothbrush and flossing twice a day are important. If you had thrush (candidiasis) yes, you should change to a new toothbrush. While experiencing thrush, you should soak your toothbrush in a .12% chlorhexidine solution such as PerioGard between brushings.

I hope this information proves helpful. Please do not hesitate to contact me is you have any further questions.

Sincerely,

DR