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CC BY-NC-ND 4.0 · Eur J Dent 2018; 12(03): 443-445
DOI: 10.4103/ejd.ejd_412_17
Case Report
Dental Investigation Society

Toothache as the initial symptom of plasma cell myeloma

Tobias Wehrhahn
1   Department of Medical Oncology, Hematology and Transfusion Medicine, Cantonal Hospital Aarau, Aarau, Switzerland
,
Mario Bargetzi
1   Department of Medical Oncology, Hematology and Transfusion Medicine, Cantonal Hospital Aarau, Aarau, Switzerland
,
Carlos Buitrago-Tellez
2   Department of Radiology, Spital Zofingen, Zofingen, Switzerland
,
Gianni Cantelmi
3   Private Practice, Zofingen, Switzerland
› Author Affiliations
Further Information

Publication History

Publication Date:
16 September 2019 (online)

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ABSTRACT

Patients with plasma cell myeloma may initially present to their dentists or dental surgeons with toothache, loose teeth, or gingival masses. An X-ray of the jaw can reveal osteolyses. In addition, accumulation of monoclonal light chains in AL-amyloidosis can lead to macroglossia. It is prudent that the dentist or dental surgeon recognizes the underlying disease and refers the patient to the oncologist or hematologist for further workup to prevent the complications of plasma cell myeloma such as renal impairment, fractures, bone pain, infections, hypercalcemia, anemia, or heart failure. Another area where the dentist or dental surgeon is involved with patients suffering from plasma cell myeloma is prevention and therapy of osteonecrosis of the jaw, occurring after administration of bisphosphonates or denosumab for osteolytic bone disease. The case report presented here shows a patient complaining of toothache for whom recognition of a systemic disease by the dentist led to the diagnosis of plasma cell myeloma, highlighting the need for interdisciplinary cooperation. As recent years have seen many changes in the management of patients with plasma cell myeloma, an update for dentists and dental surgeons is warranted.

Key words:

AL-amyloidosis - bisphosphonates - denosumab - dental surgeon - dentist - macroglossia - osteolysis - osteonecrosis of the jaw - plasma cell myeloma - toothache
 

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