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Radiation destroyed my teeth

Sheilarhc's picture
Sheilarhc
Posts: 46
Joined: Jan 2007

Finished radiation treatments in April 2007 after surgery to remove a tumor from my left cheek. Healing has been difficult and slow but I've over come many obstacles. I find myself facing a new dilemma....my teeth. I've been seeing the same dentist for many years. I've been going every three months like my oncologist suggested. I trusted my dentist and believed him when he told me he would care of my teeth. I'm 39 yrs old and I've never had a cavity in my life. I started having swelling in my face and then developed an infection from hell. I wound up going back to see the surgeon who removed my tumor. He sent me to a dentist at Loyola Medical Center. Seems my teeth have a lot of decay. They told me months. I’ve been using a fluoride rinse, and biotene products. I do no understand how he did not see all of this damage. When I complained of pain, he told me my teeth were sensitive due to radiation. Has anyone else had teeth issues post radiation? If I lose my teeth what are my options? Can I have implants? Will my gums be able to heal? I’m scared. Will this cancer rollercoaster ever end?I need to have 17 cavities filled and 5 root canals, totaling $15,000. I went to start the work today and was disappointed when they told me that as they drill my teeth, they are discovering they may not be salvageable. The three they worked on definitely need to be pulled and I will have to return next week to see how many more may need to be pulled. I guess to have teeth pulled I will need to have a total of 30 hyperbaric oxygen chamber treatments. I can not tell you how upsetting this is to me. I’ve been seeing a dentist every three

Hondo's picture
Hondo
Posts: 5717
Joined: Apr 2009

Sorry to hear about the bad news but I am not too far behind you. My teeth are in very bad condition because I can’t open my jaw more then ½ inch, my other problem is I can’t find a dentist to every work on me, when they hear Cancer and see my problems, they back off.

Take care and hope you do well God bless

train-nut
Posts: 101
Joined: Jun 2008

Sheilarhc,

Went 35 years without a cavity or even going to the dentist (dental phobia). So far, 2 1/2 years post-treatment, numerous cavities, two crowns ( a third this coming Monday) and several other teeth with cracks in them. You have my admiration for facing up to this. As I recall there are several Loyola's...the largest being in Chicago. I suggest calling or even visiting the radiation oncology departments in several of the larger cancer centers and asking which dentists they recommend. A second opinion on this much work might be well worthwhile. Regretably I don't know the answers to your questions regarding implants and gum healing. Perhaps others who do will post. I'm sorry you are having this much trouble. I wish you well. Rich P.S. Have you considered going into public service? You could begin by shooting your first dentist.

Sheilarhc's picture
Sheilarhc
Posts: 46
Joined: Jan 2007

Train nut,

Wow, all I can say is THANK YOU, thank you for making me laugh for the first time today. I've been sitting here crying for hours and I got to end my day with a smile. That was the gift I needed.

p.s. Loyola as in Chicago, that's where I go.

Sheila

Kent Cass's picture
Kent Cass
Posts: 1746
Joined: Nov 2009

Sheilarhc
17 cavities filled, and 5 root canals? I'm a 55 year-old male, and only have room for 30 teeth in my mouth,and began treatment with 5 crowns and a bridge already in place, as well as 3 voids where teeth were pulled. Did have to get a root canal done a couple months, post-treatment, and have noticed a couple of the teeth I have fillings in are major discolored- don't really look like teeth, anymore. Post-treatment options might be limited, as your mouth has gone thru the trauma of rads. I would just make sure your dental people think the cavity teeth can be saved with only fillings. Only getting fillings seems to be a better route, if those teeth are good enough to last with only fillings. Suspect that a number of those 22 teeth had underlying problems before you even began your ordeal. Best of luck.

Believe.

kcass

Sheilarhc's picture
Sheilarhc
Posts: 46
Joined: Jan 2007

Kent,
Oops, second time today I got to laugh. That was a typo on my part I meant 7 cavities. I had to have two emergency root canals due to an abscess that formed on the roof of my mouth. They had to drill both top eye teeth just to drain the infection then they drained the abscess directly. Today they attempted to due another root canal and fill cavities on two other teeth. As they begin to drill they tell me the decay is so much worse than what they see on the x-ray. All three teeth they worked on today will need to be pulled. I have a few others that are loose and they believe that 3 teeth on the other side will have the same outcome once they begin to drill. I guess the only way they know how bad the decay is, is to get in there. The bottom line is...I'm scared. I know that I'll have to do the hyperbaric and losing teeth isn’t the end of the world considering I’ve survived cancer but…none the less, I’m disappointed. Why is it doctors are always putting me in small spaces? I’m not looking forward to going into another small space for treatment.
I’m also so upset with my dentist…. How could he just not notice all decay going on in my mouth. Today is a bad day but tomorrow will be better…..

Take Care

soccerfreaks's picture
soccerfreaks
Posts: 2801
Joined: Sep 2006

You do not indicate the number of radiation treatments you received, sheila, so I will assume it is similar to the rather sizeable number that many of us have experienced (I received 33 of a planned 35 over a seven-week period).

A good radiation doctor would have strongly recommended that you seek quality dental care prior to your first treatment. And if your dentist was good at his job he would have (a) sent you elsewhere if he was not experienced in treatment for pre-rad cancer survivors, or (b) would have obtained xrays to determine the status of all of your teeth in terms of decay, would have acted as a result of the results of those xrays, and would have, at the very least, have done a most thorough cleaning prior to your first rad treatment.

That said, be advised that if he had found cavities prior to the treatment, the best he might have done would have been to remove those teeth: RadMan might have insisted on the removal of any fillings, in fact, rather than the creation of new ones.

Not to defend your dentist, sheila, but please realize, too, that radiation tends to remove, at least temporarily but for many on a permanent basis, one of the prime tools used by the human body to protect its teeth: saliva.

If your particular brand of head/neck cancer did not result in 'eating' through a tube for any length of time, it is likely that your teeth were back at their old job fairly quickly and even the best of personal oral hygiene, no longer in conjunction with the salivary glands, might result in some quick deterioration.

Even WITH a tube, and even WITH good oral hygiene, and even WITH the use of a drug during rads designed to save the salivary glands (ostensibly), I came away, ultimately, minus a couple of molars AND with a chipping away of teeth, due, I am sure, to the rads.

AND a later decaying tooth that was erroneously identified as a positive for new cancer.

It may very well be that your dentist did come up short. I have no idea. But please consider the above before selling him short. If you are not confident of him/her, take the advice of another respondent and seek out a dentist recommended by your cancer care team, even if it may be closing the barn after many of the horses have stampeded away.

Also consider, finally, that your doctors are not putting you into any 'small spaces': you choose to go into those 'small spaces', such as they are, to save yourself, to save pieces of yourself in this case. Your doctors are only pointing you to 'small spaces' that might help you to do so.

Good for them!

Good for you!

Take care,

Joe

ForFreedom
Posts: 3
Joined: Jan 2010

Hi Shiela,

My teeth also suffered from radiation/chemo for SCC at the base of the tongue with metastasis to lymph nodes. This is partly due to lack of saliva (damage to the glads from radiation). My Dr. told me that it would take 2 years for the blood vessels servicing the teeth/jaw to recover (and probably not 100%). My Dentist told me that my teeth were desicating and losing their minerals. My Dentist suggested putting some vaseline on my outer teeth prior to sleeping, and I think that's helped. I also use a flouride with a "tray" (which is like a tooth guard that holds the fluoride around the teeth for 5 minutes a day to help prevent decay. The flouride isn't available at the store but you can get it from a dentist. I also use some spray for dry mouth which also helps. Chewing gum also stimulates saliva production, so I've been using sugarless gum for that.

Best wishes and good luck.

Hondo's picture
Hondo
Posts: 5717
Joined: Apr 2009

Hi and welcome to CSN we are glad to have you here

Snotty Peed
Posts: 4
Joined: Jan 2010

Let me say I'm NOT a doctor of any kind! Just a patient who has been informed of your possible problems.

I had 33 radiation treatments in my forehead (frontal sinus), through my right eye and my right maxillary.

My radiologist told me from the jump, I had to have the majority of my teeth extracted. 29 at one time. There was some mention of retaining a couple of teeth, but when I was told the possibilities of an infection leading to removal of jaw bone, being ground zero and probable death, I elected to let them all go.

The radiation stops or severely limits your saliva producers. As a result, your teeth will develop cavities in short order and cannot be treated! My radiologist will not allow any post treatment work done to my gums or mouth. NONE! I can't recall the medical term of the infection, but I do know it's as long as my arm.

I had to have my extractions and wait until my gums somewhat healed before I could begin treatment and it was imperative to get started as my right eye was protruded almost out of it's socket. It was important reduce the tumor size ASAP. It also took 2 weeks to type my cancer, much to my radiologist chagrin.

I plead with you to talk to your RADIOLOGIST or get a consult or visit a dentist who specializes in radiation patients,for it very well may be dangerous for you to have any dental work at this point. It depends on the amount of radiation you received and what parts of your mouth / gums received it.

It is possible that you did not receive the needed amount of radiation to your gums, which would require no dental treatments, but just enough to cause your dental problems. Do you suffer from dry mouth or lack of saliva?

I've had a dentist offer free post / teeth, but my radiologist will not allow it. I do wear dentures when I simply have to. Otherwise, I Popeye sans teeth, less pipe!

Good Luck To You!

debbiejeanne's picture
debbiejeanne
Posts: 2357
Joined: Jan 2010

Please forgive my ignorance but is it just the tounge/tonsil/area cancer that ruins the teeth? I had vocal cord cancer and received 35 rad trmnts. My teeth seem to be a little more sensitive but that's it. I'm going to make a dentist appt and wondering if there are any specific questions I should ask.
Sheilarhr, I'm really sorry to hear of your troubles but hang it there, it will get better and if you need some encouragement, come here. The people on these sites are very kind and also knowledgeable. Good luck, I'll put you in my prayers.
God Bless You,
Debbie

Skiffin16's picture
Skiffin16
Posts: 8062
Joined: Sep 2009

Debbie, I believe it's just the main and primary area of concentration of the radiation for tongue & tonsil cancer. Yours being the vocal cords, perhaps yours was a little lower sparing your salivary glands, not sure on that just a guess. Then again, you might just be one of the lucky ones that for some unknown reason were spared.

I have regained a lot of my salivary function compared to where I was for the first several months post treatment. I use the flouride several times a week, brush and floss daily and haven't seen much damage as of yet.

I did not have any teeth pulled prior to radiation, though I did visit my dentist for an inital exam pre-radiation. I am a year out now from my last rads and just visited the dentist for the second time since finishing.

I did have three cavities filled and a crown. But I don't really know if this was accellerated by the radiation or not as my history has been like this prior from a lot of previous older filllings starting to deteriorate.

John

debbiejeanne's picture
debbiejeanne
Posts: 2357
Joined: Jan 2010

thanks John. My glads seem to be working normal again also, I;m 8 months post trmnt. My teeth also seem to be okay.
God Bless you friend,
debbie

Rick2924's picture
Rick2924
Posts: 22
Joined: Jan 2010

I finished 35 IMRT for Stage IV SCC base of tongue a year ago. I always had good teeth and experienced no problems until now. They have discovered one of my molars in the highest field of radiation (7000 Gy) is cracked down into the root and cannot be saved and that the only option is extraction. I am currently undergoing the MD Anderson protocal to help prevent osteoradionecrosis of 30 hyperbaric treatments before the extraction and 10 afterwards. I just completed no. 20. My oral surgeon is optomistic (he says no to implants), but my radiation ocncologist says there may be a 20% chance of ORN because of the high radiation dose. My extraction is scheduled for 2/16. I'll keep you up to date on my progress.

sweetblood22's picture
sweetblood22
Posts: 3230
Joined: Jan 2010

reading this thread with great interest as my dry mouth and radiation are causing many problems with my teeth despite tons of pre and post radiation care. my teeth are starting to discolor, and the bottom ones are shifting, and i too cannot open my mouth very wide at all. i had a cavity and a tooth filled a couple months ago. that was not easy.

the biotene products and floride burn my mouth so bad i cannot tolerate it. i am using children's bublegum flavored ACT floride, and kids floride tooth paste, but my teeth are still not doing too well.

Mike88
Posts: 1
Joined: Jun 2010

I myself had throat cancer. I have had one of two saliva glands removed. Saliva helps protect the teeth and since my production is low I have been authorized to use fluoride gel placed in mouth pieces every night before bed for about 5 minutes. This helps protect them at night. I get this from UCLA dental center. You need to be a patient and can become one by getting the tray molds made there. Any college university dental school should do this.

Teeth are allows a scary subject especially when they are your own. The dental industry has remarkable achievements and they are more about saving your teeth then replacing them. There are many techniques out there so find a place that makes you comfortable with technology you like. I think I would take technology over price when it comes to the drill. Some cavities are shallow. This doesn't mean wait till later because that means more drilling. That is my experience.

Nutrition. Vitamin D. I have just discovered this after 4 years. Apparently my kidneys have damage from my chemo type. This prevents my kidneys from producing their own. Vitamin D can be tough to absorb through the intestines. I take D3 for that instead of just D. I take 2,000 iu a day. You need Vitamin D for calcium uptake. I've also been told vitamin D deficiency will make you tired. When my thyroid medicine leveled off it turned out I was needing vitamin D and I feel much better.

My jaw became easier to open wider and seemed to stop clicking after I started taking vitamin D. I believe the bones were shrinking down and this was allowing the muscles to pull my jaw in more unbalanced. When the jaw bones got stronger it pulled the muscles back out to proper alignment.

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