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Dental Problems

sportsman
Posts: 98
Joined: Feb 2010

I am having major dental problems three years post treatment for throat cancer. Already had several crowns and several fillings. Is it true that you have to have hyperbaric oxygen treatment before having teeth removed. Any dental help I can get will be appreciated. My teeth were not very good at beginning of radiation, however I do not want to lose them.

denistd's picture
denistd
Posts: 484
Joined: Apr 2009

Yes, it is extremely important to have the hyperbaric treatments, it is to prevent necrosis of the bone and increase blood flow to the affected areas. I had 20 two hour sessions, then had 5 teeth removed (I still have all my others) and the ten follow up sessions and have not had any problems since, a year ago I started 35 rad treatments with 3 chemo rounds for laryngeal cancer. The hyperbarics are fine, you lay in a tube and watch tv for two hours then you come out. Denis

MarineE5
Posts: 744
Joined: Dec 2005

I'm not sure what your Cancer Team might have told you 3 years ago, but my Cancer Dentist told me that if I wasn't going to maintain my teeth, to have them pulled before radiation. I, like you wanted to keep what I had left. My mouth maintenance had been average at best. Didn't always brush after each meal or snacks.

I told the Dentist that I wanted to do what it took to keep them. He said that I would have to be almost perfect with brushing after each meal and snacks. I would also have to do Flouride Tray Treatments daily. I like you have had 2 caps put in. Mainly from my teeth cracking on two seperate occassions.

If you are like me and have no saliva, we can get cavities in 6 weeks verses the normal person that would take 6 months to get one. The saliva helps protect our teeth.

You are correct, we need to use the Hyperbaric chamber prior to any tooth extraction.

delnative's picture
delnative
Posts: 452
Joined: Aug 2009

It's my understanding that the hyperbaric treatments are necessary for pulling teeth, root canals and other serious stuff (but not for routine fillings or crowns).
FWIW, my dental specialist at Johns Hopkins told me to use fluoride tray treatments for 10 minutes every night until the day I die. After that I can discontinue treatments.
My saliva has come back almost 100 percent, but I still plan on using the fluoride trays. Heck, it can't hurt.
I also now have three dental checkups a year instead of two, brush a lot more frequently than I used to and floss after meals, something I never used to do before. I like my teeth, and hope to keep them.
Good luck.

--Jim in Delaware

Chefdaddy
Posts: 164
Joined: Dec 2009

I'm concerned, as I was never told anything about these hyperbaric treatments prior to the
Oral Surgeons removing my teeth or that it is to prevent necrosis of the bone.

Now what?

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

oral stooges, lol! don't panic. it is only after you have had radiation that you need the hyperbaric treatments, not before. you are okay. did they pull all your teeth, or just some?

they pulled my wisdom teeth, and the four next to them. my dentist has a picture of the three stooges pulling out teeth with these gigantic pliers. i find the picture very unsettling every time i am in that chair.

wifeforlife
Posts: 189
Joined: Feb 2010

my husband has just finished treatments, did not have any teeth pulled, and nothing has been said about this special dental proceedure....is this for a certain time period? forever? can someone please share???thanks

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

when i was with my tumor board one of them was the dentist, and he reccomended to have more teeth pulled then i let them. after radiation your jaw bone may have necrosis, decreased blood flow will not allow proper healing should you need a tooth pulled after radiation. also after radiation with no saliva, your teeth are not protected. i had flouride trays made. the flouride burns my mouth still, so i am using a children's bubble gum flouride rinse for now.

another problem that can happen is that you cannot open your mouth very wide after radiation, i have that problem. i need to use a children's toothbrush. if i did not get those teeth pulled, i would never have been able to brush the backs of them, and they would decay quickly.

so usuallly they recommend that you get any dental work taken care of before radiation because of the damage it can do and the problems it creates in dental care. i had to promise to go to my dentist every two to three months if i wanted to keep my teeth. i have already had a cavity filled.

here are some links:

http://www.oralcancerfoundation.org/dental/hyperbaric.htm

http://headneckmd.com/pages/article/YourTeeth.html

http://www.oralcancerfoundation.org/dental/pre-treatment-dental-issues.html

wifeforlife
Posts: 189
Joined: Feb 2010

Thanks so much...I will check out the links..

DonnaT123
Posts: 2
Joined: Mar 2010

I'm one of the unlucky folks diagnosed with Osteoradonecrosis after both CA and RAD for stage IV tongue cancer (SSC) almost 13 years ago. I really suffered through treatment of cancer and in fact, I really never believed I'd survive it. Burned inside out, sick from chemo, surgery removed more than two thirds of my tongue, had a free flap. I never thought the suffering would end. But it did. I did recover.

Now 13 years later I'm stuck with this crap. UGH! BUT I did have a pretty good run after recovery from CA and I'm thankful for that.

I can't believe the Oral surgeon didn't insist on HyberBaric chamber before removing your teeth and I would certainly bring this issue up with them. They know better. Are you from a small town? Would access to a chamber be difficult for you to get to. My understanding is that not many hospitals have the luxury of owning a chamber as they are quite expensive. I live in MPLS, MN so I'm fortunate to have a HB Chamber with 10 miles of my home. And trust me, I've used it A LOT. Now with this ONJ diagnoses I've already had 20 dives prior to surgery and have 10 more dives to deal with post surgery. I'm almost done. Thank god. ;-)

Anyway, the ONJ cost me my bottom teeth, a good bone scraping to remove the dead bone and then a painful recovery == AGAIN! BUT, I'm lucky. I dodged the big bullet in that I didn't have to have total mandible replacement surgery. I was scared to death of that because I wasn't sure how I could emotionally handle a long recovery time and another painful surgery. That's the thing with radiation -- it's a gift that just keeps on giving. I Kid. Radiation and the side effects have made my road to totally recovery impossible. I don't have a DROP of saliva and as you guys all know, that is a real curse. I have trouble eating, talking, and most of all swallowing. UGH! Plus, my mouth and lips burn non stop. I'm uncomfortable all the time. Does anybody out there have a saliva substitute that they like? I haven't found anything that really works and I sure would like to.

Anyway, I'm first time poster on this site and I'm glad I found it. Good luck to all those going through treatment for tongue cancer -- any cancer-- at this time. Try and remember there is a light at the end of the tunnel. You will get better and soon enough this whole experience will be nothing more than a distant memory. Good luck.

backachedp
Posts: 124
Joined: Oct 2009

Hi Donna..I see you are from Mpls..we live in a close suburb of Mpls...where did you have your treatments at? My Husband had his at the U of M...he has a Dental appt next Monday and he wants to cancel it..I do not think this is wise he say's his gum's are still too sore. He finished Radiation Jan 28 of this year..would like to talk to you about where you had treatment and how well it went for you...I added you as a friend hope you don't mind. There is talk of removing part of my Husbands tognue in May he has his first PET April 14. His tognue is still very hard near the back of his mouth. They said it is Scar Tissue. Hope to hear from you or anyone else...
Thanks...
Deb

DonnaT123
Posts: 2
Joined: Mar 2010

Hi Bachachedp...... would love to talk to you and hear your story!! I was treated at Abbott Northwestern -- Piper Cancer Center. Excellent treatment but I'm pretty sure it was the surgeon who made my life do able again after such an invasive surgery.

Make sure your husband takes very good care of his teeth and oral cavity -- you do not want to deal with what I'm going through right now.

Anyway, hope to hear from you again

donna

nicki74
Posts: 55
Joined: Feb 2010

hello everyone! my father just had 9 teeth pulled, including his wisdom and molars, and this is the first time i ever heard of hyberbaric treatments!

is this something i should bring up to the radiologist?

thank you so much for that information..

ljoy's picture
ljoy
Posts: 83
Joined: Dec 2007

See my post further down on Hyperbaric Treatments. I'm currently going through it in preparation to pull a right lower molar. Dental care is of utmost importance if you have had radiation to the head and neck. All of the posts are providing the valuable information regarding dental care pre and post radiation treatment.

Chefdaddy
Posts: 164
Joined: Dec 2009

Hi Sweets,

Thanks for clearing that up for me.

I had all my teeth pulled as they were all crumbling from a crazy doctor in California that had mass dosed me with corticosteroids and anabolic steroids after telling me that I had terminal lung cancer. The steroids brought on the blood disorder that had been dormant. I spent 4 years in an electric wheelchair from the severe neuropathy and paralysis. I didn't have lung cancer, I had a lung infection and the flu.

Your friend

Mike

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

holy cow, mike. that's insane. you and i really have the same kind of luck. we wouldn't want to stand together in a thunderstorm, that's for sure. sometimes doctors have no clue what they are doing.

delnative's picture
delnative
Posts: 452
Joined: Aug 2009

... that some docs don't provide people with information about proper dental care before treatment even begins. I don't know if it's out of ignorance, haste or possibly a fear of burdening patients with information overload, but dammit, this is stuff we have to know.
My regular dental hygienist once told me that she sees a number of patients come in, several years after rads, with their teeth in very bad shape simply because they weren't armed with the right information.
That shouldn't happen.

--Jim in Delaware

CajunEagle
Posts: 353
Joined: Oct 2009

My Dentist sells me this really good preventative toothpaste called Colgate PreviDent 5000. It is developed for those with Dry Mouth and has alot of Sodium Floride. I've been using it since the inception of treatment, and had no troubles except a slight burning sensation during it's usage. It costs around 12 bucks a container, but lasts a good while. Of course, I'm still using my trays every night (when I can remember...and this thread has helped) with the Cinnamon flavored Colgate Gel-Kam.

backachedp
Posts: 124
Joined: Oct 2009

My Husband Bob has a Dental Appt comming up nest Monday..he want's to canel cause he says his gums are too sore still....I really don't want him to cancel..he needs to go in and have them look..I really and not too impressed with our Dentist to begin with, but that's another story. He spoke to his Radiation Dr abbout the Hyperbaric treatments and she said it's not nessasary...makes me wonder when so many here have had them. I bought the Anti Cancer Book and it is wonderful info! Thanks again to all here for the advise...any input about Bob not going to the Dentist encouraged...I think he needs to..what are your opinions?? He ate some Oatmeal today which is a BIG FEAT for him! He finished treatment 1=2810...still coughing and mucous problems...

michels452
Posts: 1
Joined: Mar 2010

I'm 35 but have had tumors in my face since I was 11 yrs. I have had 17 tumors to date and currently tumor free. I have had 2 courses of radiation therapy and because of this I far exceeded the recommended doseage of radiation. It has been almost 5 yrs since my last radiation and a crown came out then the tooth next to it cracked. I always had good teeth and then it got infected. I have been sent to so many dentist, oral surgeons etc. but no one wanted to deal with me because of the radiaiton. I was told that my teeth have to come out but in order to do so I have to complete 40 dives in the hyperbaric oxygen chamber then they would do the surgery and then do 10 more dives. It is so hard to lay in this small container for 2 hrs a day knowing it all leads up to having my teeth pulled out. Knowing how I hate small spaces I don't want to do this again so I'm going to elect to have all the teeth pulled. While in treatment I have met some patients that did the oxygen treatment had the few effected teeth pulled and then a few years later had to do it all over again. The radiation kills the blood vessels that provide circulation to the jaw and also effects the parotid gland on the side of the face that controls the saliva. Without a good amount of saliva the teeth can't get rid of the bacteria from food even with brushing. There is a toothpaste called bioten and gum to help with this but if you had radiation and start having problems with your teeth it is time to see the oral surgeon. Do not let anyone remove or work on teeth without having them know the amount of radiation you had and getting a second opinion. If you have a tooth or teeth removed or a root canal gone wrong and did not have the hyperbaric oxygen treatment there can be major complications where the jaw bone is left exposed and can not heal. Tomorrow will be treatment #11. Now I know what zanex was made for. I hope this helps anyone that is having problems with their teeth after radiation. Good luck to all and God Bless

denistd's picture
denistd
Posts: 484
Joined: Apr 2009

I went through the oxygen treatments last year, had teeth removed after and then ten more post teeth removal. Was just eating a slice of pizza and my lower middle tooth broke off at the gumline, this probably means I will lose all of my lower teeth

delnative's picture
delnative
Posts: 452
Joined: Aug 2009

I'm sorry to hear that. Just tonight as my wife and I were eating dinner, she was eating a piece of Irish soda bread (left over from a St. Patrick's Day dinner the night before) and I heard a "pop!"
She'd bit down on something, maybe it was a piece of wheat kernel, and she was able to just shrug it off.
"Better you than me," I told her. I hate to think what would've happened if I'd bitten down on that thing. I suspect I would've broken a tooth.
I hope all works well for you. Please keep us informed.

--Jim in Delaware

ljoy's picture
ljoy
Posts: 83
Joined: Dec 2007

I'm currently taking treatments in Minneapolis. It has large chamber rooms with lounge chairs. There are up to ten patients in each session. We have a nurse with us at all times. There is also a doctor on site. We get two air breaks and are in the chamber for an hour and fifty minutes. I have completed 17 of the first 30. Then oral surgery then 10 final treatments. It is too bad you have to be in an individual chamber.

I like you and others hope this is my only time to do this. It is a grind. I commute a 150 miles round trip every day.

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

Over the past couple weeks I have noticed the tops of my biting/carnivourous teeth are kinda-like GONE. Lower-left has a single ridge running across it to show where the top of the whole tooth used to be. Been that way with the front teeth, upper and lower, for quite some time. So, it seems to me that the tops of my teeth are disintigrating. Is this typical? Use the Prevident once/day, and Colgate in the AM, but the teeth are all yellowed, and now the tops are disappearing. Don't have my next Dental check-up until May, and I'm wondering if I should make a visit this next week.

Would truly appreciate any advice, or word of a shared experience.

kcass

CajunEagle
Posts: 353
Joined: Oct 2009

Noticed just yesterday, while using my Water Pik for flossing purposes, that I have lost a filling in a front lower tooth. Doggonnit, I've been working hard to keep these teeth, so maybe I'm going at it too hard (?).....who knows. I've noticed that yellowing also, and that battery powered brush just doesn't seem to be getting the job done. Guess it's back to the dentist this coming week.

delnative's picture
delnative
Posts: 452
Joined: Aug 2009

I've been getting yellowing as well. My dental hygienist remarked on it at my last checkup/cleaning.
I told her I was doing Prevident each night and rinsing with ACT in the morning, but both she and the dentist said this isn't yellowing from fluoride. I too use a power brush, and the hygienist always says what a good job I do with my teeth.
I guess as long as my teeth are strong, I don't really care what color they are.

--Jim in Delaware

staceya's picture
staceya
Posts: 700
Joined: Jan 2010

While I was going through rads I notices my fillings were turning from silver (yes, they are that old) to black and they seem to be melting? and getting sticky. They don't feel as sticky now, has anyone experienced this? Did you have to replace the fillings?

Stacey

janymac
Posts: 31
Joined: Feb 2010

I had the same as you - NPC and blackening to the tops of my 6 front top and bottom teeth - I felt so self consious and couldn't wait to have them sorted. Went to dentists, NHS and private, and max fax - nobody really seemed to know what it was and one dentist even said I needed to have my teeth whitened, but I couldn't have that done as part of the NHS (from England) ANyway, finally got sent to a hosptial dentist, who said it was a certain sort of dental decay that is exceedingly slow, but it would take some years to completely rot my teeth away to a crumbling mass - can't remember the real name for it. He said whitening would be the worst thing to do as the black bits would not get brightened and would look worse against very white teeth (they are rasther yellowed.) So he suggested to my regular dentist that the teeth had the black bits scooped out and taken back to health enamal and refilled with white filling. This has worked well for a year and a half - only had one fall out in all this time, but see that it is spreading to other teeth. Check yours very carefully on the edges - it starts with just a small pin head sized hole.

Personally, the care I got for my teeth prior to, during and adfter my cancer treatment was non exisitent.Even when I was flat out for the last 4 weeks of my radio in hospital, and couldn't get out of bed, nobody saw to it that I was washed, or had teeth care. My regular dentist doesn't even see me having had head and neck radiotherpapy as a risk of any sort. The only person who has ever said anything to me was my GP 2 weeks ago when he examined my mouth to check I didn't have a tooth abcess - I didn't - but he said, I more than anyone should be regularly seeing my dentist! A bit late now 8 years on!! Just as well I look everything up on the internet.

thegirlfriend's picture
thegirlfriend
Posts: 147
Joined: Sep 2009

you mean you never ever saw a dental oncologist?

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

Thank you- bigtime. What I see in the center-tops of all the teeth is a darkish brown. It's the carnivour/ripping teeth that alarm me most, as they have lost a lot of mass to them. I called, and go to see my Dentist tomorrow at 8AM. Again- thank you, Janymac. Good to know I'm not alone in the specifics of my teeth.

Had been wondering how you're doing. Remember you and Hondo have close to the same tenure, he in Honduras, and you across the pond. And I got years to go to get there. NPC. Please stay in touch. This is the ACS, and they're in it with us.

And Jim- your posts have always been most helpful. Thank you.

kcass

sabriene
Posts: 27
Joined: Aug 2006

Yes, sounds like I am in the same boat as you are with the teeth. The rad. doctor was telling me yesterday usually you have to take 30 treatments in the chamber. In my situation the oral surgeon is saying if they need to extract one tooth, then all should be removed. I clearly understand rad. is death on teeth but I still question about taking them all out at one time. Then also oral surgeon is saying they may never be able to fit me for dentures. That does tend to upset one just a little.

sabriene
Posts: 27
Joined: Aug 2006

Yes, sounds like I am in the same boat as you are with the teeth. The rad. doctor was telling me yesterday usually you have to take 30 treatments in the chamber. In my situation the oral surgeon is saying if they need to extract one tooth, then all should be removed. I clearly understand rad. is death on teeth but I still question about taking them all out at one time. Then also oral surgeon is saying they may never be able to fit me for dentures. That does tend to upset one just a little.

delnative's picture
delnative
Posts: 452
Joined: Aug 2009

Lord knows I'm no expert, only a guy who's gone through this with the help of what is possibly the world's best medical institution, Johns Hopkins. FWIW, the oral surgeon who was assigned to my case at Hopkins told me that if any teeth were in iffy condition, those teeth would have to come out. But there wasn't even a mention that if I had one bum tooth, all of them would have to come out. That just doesn't sound right. As a matter of fact, it sounds like an unneeded trauma at a time when you're going to have plenty 'nuff to deal with already.
As it happens, I have always taken good care of my teeth, and I didn't have to have any teeth pulled. I didn't even need a filling prior to beginning treatment.
Your mileage may vary, but I would suggest you seek a second opinion -- and that you seek out someone who's experienced in the field of radiation oncology.

--Jim in Delaware

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