Patients with MDS should contact their hematologist before scheduling dental procedures or surgeries. Because neutropenia or thrombocytopenia can develop during the course of MDS, you could be at risk for serious infection or excessive bleeding during or after dental procedures or surgery. Your hematologist should work with your dentist or surgeon to decide whether you need antibiotics to prevent infection, or whether one or more platelet transfusions or additional medications might help to reduce the risk of bleeding. In the case of a patient requiring a platelet transfusion, it may be prudent for the transfusion to be given the morning of the procedure, since platelets don’t survive long. Certain medications can be given as a swish and spit solution to help form blood clots if there is excessive bleeding in the mouth. If inpatient or outpatient surgery is required, ask your hematologist whether the risk of a procedure or surgery outweighs the potential benefits. If this is the case, your physician will tell you the concerns and discuss the alternatives. For example, if you were to undergo an elective dental procedure, such as routine teeth cleaning, with a very low platelet count, the potential risk of substantial bleeding would likely outweigh potential benefits.
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