Dental restoration post tx

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Comments

  • hrowe
    hrowe Member Posts: 57
    Loads of dentral problems post tx

    I'm 14 mo post tx. My teeth have shifted around by a few millimeters.

    Had 4 crowns redone (some less than 5 years old) and had 2 root canals. Total cost $7K. All done by my general dentist. No issue with healing. He uses a laser on the gums where the crowns would sit.

    My saliva is ~50% of normal.

    I was going to get an extraction - tooth near front lower right. My rad onc recommended getting hyperbaric treatments if that was going to happen. He ordered some HBO and I saw the hyperbaric specialist who is an MD/DDS. She recommended 20 before extraction, do the extraction within one week of finishing those 20, and then 10 more after. Each treatment is 90 min which allows for pressurizing, saturation and depressurizing. My regular dentist said leave sleeping dogs lie. The tooth was an old crown that broke off (post tx) at the gum line and has had a root canal years ago. No abcess. So, he smoothed it out and filled the top. Not very noticable. Could I get by without the HBO? Yes, but the HBO reduces the risk factor of improper healing.

    Implants are NOT recommended per the specialist. 50% chance of failure, that is the bone won't take and they could end up spinning. Problem is reduced blood flow into the bones due to the rads and if you need cadaver bone it, of course brings no blood flow to help heal everything.

  • donfoo
    donfoo Member Posts: 1,771 Member
    Crazy

    Seems like a number of survivors have dental issues that require abi-normal and costly fixes. It does seem implants post tx for those who were radiated in the mouth area is a high risk ill-advised way to get teeth back in the mouth. That pretty much leaves dentures or bridge type devices. For those with a fair number of extracted teeth, dentures seem to be more common. What about those who have a tooth missing here and there but most still intact?

    The whole hyperbaric chamber treatment seems pretty extreme and really costly if insurance does not pay which seems pretty iffy. For that matter seems many survivors shoulder the brunt of dental costs. Ironically, it seems getting the needed dental work done post tx can exceed the cost of the insurged cancer treatments.

    Guess I need get a consult with a dentist who is experienced working on oral cancer survivors. 

  • Crazymom
    Crazymom Member Posts: 339 Member
    teeth

    MD Anderson gave me a name of someone who would help with my dentistry.  He worked at MD Anderson for several years then mmoved out on his own.    I have spent over $20,000 on my teeth.  You need to get a name from your cancer center and go talk to someone.

     

    Ann

  • denistd
    denistd Member Posts: 597
    Paying for it

    Hi Deb. I had some dental work before rads, medicare paid. After rads when things started to go bad, my radiation Onc wrote a letter for Medicare's review. My oral surgeon also wrote that extractions and HBO were medical necessities to preserve my jaw bone. Medicare paid everything 100%, there was no wrangling. I was told before rads started that I should look after my teeth. used biofene toothpaste 3, 4 times a day and fluoride trays. It staved things off for 2 years then teeth started to break, never had any pain just breakage. had some removed  (went through HBO for that) 8 months later he decided to remove the remainder, more HBO, right thing to do, both cosmetically and jaw wise. have had no trouble since. There is, however, a major obstacle that will be standing in everybody's way from here on in, Obamacare. Cutbacks are already happening across the board in healthcare, the days of regular scans, especially pets, is over, cutting hundreds of billons out of medicare is gutting it. If you have insurance through your employer or such, shock is about to set in. Insurance companies, in trying to contain the premium increases it would have to make have opted for reducing the benefits in the plan, you will be seeing more PA's in the future and appointments will become limited. Example, I saw my gastro guy (PA) in May, had to have tests, was told follow up appontment would be in November, all tests were ok. My wife had an endoscopy done for her GERD, her co-pay was $300, it used to be $100. I suggest that if you need to get things done, do it now before it gets worse. I was an HR director for 20 years and intimately involved in health insurance and such. Denis

  • donfoo
    donfoo Member Posts: 1,771 Member
    20 grand?

    Ann,

    I may as well go buy lotto tickets. It is so fortunate you had resources to get your dental work completd but for many I suspect a missing tooth in the gumline is going to have to do. Mine are all in the back so cosmetics is not an issue, just being able to chomp down on stuff like the old days without having to navigate the food around to a place where my gum does not get jammed.

    Denis, 


    I think it is fair to say this next year will be one of the most difficult ever in navigating the business of health insurance. Personally, I m treading water trying to buy as much time as I can as I have several options to pick through. Current insurance has been great but need to reup in the fall. OCare options maybe. Wife has plans at new job to choose from. The most sobering thing of them all is the out of pocket costs for sick folks like us generally pretty high. For 5 decades plus, I never spent more than a couple hundred out of pocket. With cancer, I can blow through thousand dollar bills with hardly a sneeze. Even having treatment costs behind me, the ongoing medical needs are just so much higher than a healthy person that costs for all this is having a major impact on personal budget. Kids in college adds more strain to boot. All said, sure better to be alive and **** about it than the alternatives. lol

  • jim and i
    jim and i Member Posts: 1,788 Member
    denistd said:

    Paying for it

    Hi Deb. I had some dental work before rads, medicare paid. After rads when things started to go bad, my radiation Onc wrote a letter for Medicare's review. My oral surgeon also wrote that extractions and HBO were medical necessities to preserve my jaw bone. Medicare paid everything 100%, there was no wrangling. I was told before rads started that I should look after my teeth. used biofene toothpaste 3, 4 times a day and fluoride trays. It staved things off for 2 years then teeth started to break, never had any pain just breakage. had some removed  (went through HBO for that) 8 months later he decided to remove the remainder, more HBO, right thing to do, both cosmetically and jaw wise. have had no trouble since. There is, however, a major obstacle that will be standing in everybody's way from here on in, Obamacare. Cutbacks are already happening across the board in healthcare, the days of regular scans, especially pets, is over, cutting hundreds of billons out of medicare is gutting it. If you have insurance through your employer or such, shock is about to set in. Insurance companies, in trying to contain the premium increases it would have to make have opted for reducing the benefits in the plan, you will be seeing more PA's in the future and appointments will become limited. Example, I saw my gastro guy (PA) in May, had to have tests, was told follow up appontment would be in November, all tests were ok. My wife had an endoscopy done for her GERD, her co-pay was $300, it used to be $100. I suggest that if you need to get things done, do it now before it gets worse. I was an HR director for 20 years and intimately involved in health insurance and such. Denis

    Thanks Denis. I will get with

    Thanks Denis. I will get with Jim's oncologist for a recommendation to his medicare/insurance company.

    Debbie

  • denistd
    denistd Member Posts: 597
    future

    Yeah Don, looks like lots of thinking has to to start. October 1 the exchanges open, but in truth they won't be ready. The exchange will offer 3 plans bronze. silver and gold, if you are of limited income you can apply for subsidies. You will see that new people here on the forum are not getting scans after treatment, mostly scopes and x-rays, maybe one Ct or two. That will be the new protocol as insurance comapanies start to get squeezed out of business. Dental costs have become utterly ridiculous with no real dental insurance available. I know my dental costs were astronomical, lucky that Medicare paid for it, but I fear the money won't be there to cover much in the coming years, you cannot reduce funding $800,000,000,000 (that's eight hundred billon, hope there's enough 0's there) over ten years and maintain the level of care we are used to. Pretty grim looking for our kids and grandkids.

  • jackflash22
    jackflash22 Member Posts: 524 Member
    denistd said:

    future

    Yeah Don, looks like lots of thinking has to to start. October 1 the exchanges open, but in truth they won't be ready. The exchange will offer 3 plans bronze. silver and gold, if you are of limited income you can apply for subsidies. You will see that new people here on the forum are not getting scans after treatment, mostly scopes and x-rays, maybe one Ct or two. That will be the new protocol as insurance comapanies start to get squeezed out of business. Dental costs have become utterly ridiculous with no real dental insurance available. I know my dental costs were astronomical, lucky that Medicare paid for it, but I fear the money won't be there to cover much in the coming years, you cannot reduce funding $800,000,000,000 (that's eight hundred billon, hope there's enough 0's there) over ten years and maintain the level of care we are used to. Pretty grim looking for our kids and grandkids.

    teeth funding

    I have read so much about teeth as thats my biggest dread to lose my teeth. I've made sure they are in good nic before rad but still its not a guarantee I wont lose them. If the onc dentist removes them then he makes good after with dentures or whatever free of charge if I decide to not to have teeth removed before rad and at a later date my teeth rot I then have to go to my dentist. He's a private dentist but as I was a patient of his before he went private he kept me on for free. (NHS). I was a carer at the time looking after my mother full time and had to give up work so I'm glad he took pity on me. I,ve been with him many years and feel at ease with him he's never hurt me doing work on my teeth. I saw him today and the first thing he did was to pull up a chair and ask me about my op, said how he feels for his patients when something like this happens he then checked my teeth filed a pointed tooth a little because it caught the scarring in my mouth where the tongue flap was taken from. He then recommended Duraphat 5000ppm floride toothpaste to be used sparingly for the time I needed it. He even let me have it for half the cost and apologised for having to charge for it. I feel sorry that your costs are so high, I believe from what my sister tells me (shes now an American citizen) that medicare costs the earth if you can afford it otherwise you have to pay for doc and dentist in full. She has a good insurance plan as her husband was military and now she has medicare or something but because she has such a good insurance everytime she goes to the docs they find something wrong with her sell her drugs via insurance then a year down the line tell her she didn't have that wrong with her but now because of that she needs more drugs and so on. They put a pacemaker in her then two years later said she didn't need it. I'm not knocking your system as I expect not all docs are like that (yes, she has changed docs)  A lot of people knock our NHS but I find its great and has been for all my family. They got on my case as soon as I was diagnosed. Reading all the posts on this site everyone has a very good team of doctors.