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
