Question about teeth

Dentures
My husband had to have all of his teeth extracted prior to radiation in 2008. He got dentures immediately and actually wore them most of the time during treatment. There were times when the mouth sores got bad that he could not wear them, but he had them for the times he could. I guess it may depend on where you are being radiated. My husband was radiated for throat/neck cancer.

About 4 months after treatment my husband got implants to secure his dentures. He has not had any problems.

Good luck.

Myka

QUESTIONS
Why do I read about so many people having either a few or all of their teeth pulled prior to radiation? Dental problems and poor condition of teeth to begin with?

It was not even discussed with me, and my teeth so far seem to be holding up just fine. I do make a visit to my Dentist every 90 days and brush with the "prevadent" line from colgate. I get it from my dentist and it has a higher level of flouride, and is also for sensitive teeth. I do have a couple of sensitive spots, but other than that they are OK.

Now I am only 8 months post radiation, so who knows what the future will hold for me dental wise.

Best!!

Mike

zepfreak said:

pulled teeth
I had 3 cavaties and a bridge. By having all teeth pulled my post-radiation energy would go towards my throat and not mouth. Plus there is a risk to the jawbone during radiation if teeth are bad. My onc Dr told me and i also asked my ent to confirm it.

INTERESTING INFORMATION
Thanks for the answer. I must be pretty fortunate and or lucky to still have good dental health and a jaw that does hurt, but does function properly.

Best!!

Mike

luv4lacrosse said:

INTERESTING INFORMATION
Thanks for the answer. I must be pretty fortunate and or lucky to still have good dental health and a jaw that does hurt, but does function properly.

Best!!

Mike

Toothy too
My Onco team at UNC did a pre-rad dental screening. Found one small filling needed and took care of it. I am going to assume that there were some poor dental hygeine issues that would have resulted in someone's teeth all having to be removed. I am having no issues so far with rads.

Mike

sweetblood22 said:

It's not necessarily poor
It's not necessarily poor hygiene habits that teeth were removed. It has to also do with how much radiation you are getting and where it will be targeted. The condition of the teeth, and jaw, and other factors. Like any oral cancer surgeries, etc. When you look at X-rays from radiated patients, I've seen mine, you can clearly see the difference in the areas that got a lot of radiation. You can see the lack of blood flow or healthy jaw bone. The necrosis of the jawbone after radiation can happen to anyone, as far as I know. it's one of the side effects and risks of radiation.

When they pulled mine, they only pulled the 3 wisdom teeth I had, (1 never was there) then the four teeth next to the wisdom teeth. My jaw doesn't open very far at all now, and it's hard to get to those back teeth to brush.

I am having such a hard time with my teeth, and I brush five times a day, floss once, and use my trays once per day. My mouth is so dry that there is no saliva to protect my teeth from decay. I basically brush or floss or rinse every single time I go into that bathroom during the day.

Those of you with no teeth problems, I hope it stays that way for you. My mouth is so dry that when they are working on me they don't even really use that thing that sucks the saliva out of my mouth and every once in a while they take pity on me and wet down my tongue and 'tissues' as she kept saying on Thursday. My tongue is killing me by the time I get out of there. I hate going to the dentist.

Ditto Sweets!
I had very few problems the first 4-6 years and then they went bad. I brush my teeth each time this way and now seems to help. I use a waterpic with very warm water, floss, use Sonicare tooth brush with bioteen toothpaste, and then Sonicare tooth brush with flouride. I do this Three - four times daily. I go see dentist every 3 months and he continues to find new break downs and some repairs to repairs. Say that is the history of radiation... he has worked of head and neck cancer survivors for 20 years and tried everything. I added the waterpic with the warmest water one can stand 3 years ago and it has been a huge help. I have even gone a couple times without repair work needed, even he was surprised.

Mouth is extremely dry, must excrete something that breaks down the tooth protection.

Early on in survivorship was not bad at all, it maybe more long, long side effects that take there toll. BTW 15 years for me.

John

i had to have an impacted
i had to have an impacted wisdom tooth removed on the same side
that my tonsil cancer was on, and it had to heal before treatment
could begin. My dentist refered me to a oral surgeon who basically wasn't
going to have it any other way than to remove all my teeth proactively,
even though no one was even talking about such extreme measures.
i tried about 4 different times to get him to just remove the impacted
tooth and let it go but he wouldn't hear of it. So i told him he was fired
and walked out on him. I went back to the receptionist and asked for my copay back.
I also told them that i didn't want them to bill my insurance company, because the
doctor was refusing to administer the treatment that i was there to get.
Then the patient services rep showed up, and asked if the doctor only removed the tooth would i be satisfied? I told her no because i didn't trust him not to mess up my other teeth on purpose, because he had already refused to do that. so they set me up with an afiliated oral surgeon at a different location, the next day who did a good job.
And the most important part is that i still have my teeth, and my doctors have repeatedly commented on how well my teeth are doing.
I guess the moral of the story is.. don't sacrifice your teeth unless you absolutely have too. And sometimes oral surgeons are just a little too willing to sacrifice someone elses teeth. The sorry @#$%^ (it still burns me up when i think about it.)
Best wishes TONYB

tonyb said:

i had to have an impacted
i had to have an impacted wisdom tooth removed on the same side
that my tonsil cancer was on, and it had to heal before treatment
could begin. My dentist refered me to a oral surgeon who basically wasn't
going to have it any other way than to remove all my teeth proactively,
even though no one was even talking about such extreme measures.
i tried about 4 different times to get him to just remove the impacted
tooth and let it go but he wouldn't hear of it. So i told him he was fired
and walked out on him. I went back to the receptionist and asked for my copay back.
I also told them that i didn't want them to bill my insurance company, because the
doctor was refusing to administer the treatment that i was there to get.
Then the patient services rep showed up, and asked if the doctor only removed the tooth would i be satisfied? I told her no because i didn't trust him not to mess up my other teeth on purpose, because he had already refused to do that. so they set me up with an afiliated oral surgeon at a different location, the next day who did a good job.
And the most important part is that i still have my teeth, and my doctors have repeatedly commented on how well my teeth are doing.
I guess the moral of the story is.. don't sacrifice your teeth unless you absolutely have too. And sometimes oral surgeons are just a little too willing to sacrifice someone elses teeth. The sorry @#$%^ (it still burns me up when i think about it.)
Best wishes TONYB

Good Wishes.
Tony, I wish only the best for you. They told me I did not need them pulled. I went thru treatment and 4-5 years post treatment with only minor problems. Now many years later I wish I had them removed, all of them. I have spent approx. out of pocket 60,000 dollars trying to keep them as removing them is high risk for necrosis. 15,000 out of pocket for treatment and surgery only and 4 times that to keep teeth. Long Long term side effects suck.

I hope for continued good dental reports.

John

fisrpotpe said:

Good Wishes.
Tony, I wish only the best for you. They told me I did not need them pulled. I went thru treatment and 4-5 years post treatment with only minor problems. Now many years later I wish I had them removed, all of them. I have spent approx. out of pocket 60,000 dollars trying to keep them as removing them is high risk for necrosis. 15,000 out of pocket for treatment and surgery only and 4 times that to keep teeth. Long Long term side effects suck.

I hope for continued good dental reports.

John

Wisdom Teeth Extraction Post-Radiation?
I'm starting to find out the dental cost the past few months and it's definetly going to be more than my out of pocket medical expense for throat cancer. My teeth were in pretty good shape going in to surgery, chemo, radiation, and brachytherapy in 2007. PET scans are good, PTL. I have dry mouth and I floss after every meal, but 4 years later my dentist says decay is setting in and I'm going every week while he works on my teeth for 2 or 3 hours. I still have my wisdom teeth, but my dentist wants to pull them rather than repair them. Long-term it seems like a good idea, but I'm nervous due to mandibular Osteoradionecrosis (ORN) risk. I'm 54 years old and healthly and I'm not sure if I want to risk the wisdom teeth extraction after radiation. Anyone else had post radiation extractions out there?

BJammin said:

Wisdom Teeth Extraction Post-Radiation?
I'm starting to find out the dental cost the past few months and it's definetly going to be more than my out of pocket medical expense for throat cancer. My teeth were in pretty good shape going in to surgery, chemo, radiation, and brachytherapy in 2007. PET scans are good, PTL. I have dry mouth and I floss after every meal, but 4 years later my dentist says decay is setting in and I'm going every week while he works on my teeth for 2 or 3 hours. I still have my wisdom teeth, but my dentist wants to pull them rather than repair them. Long-term it seems like a good idea, but I'm nervous due to mandibular Osteoradionecrosis (ORN) risk. I'm 54 years old and healthly and I'm not sure if I want to risk the wisdom teeth extraction after radiation. Anyone else had post radiation extractions out there?

Extractions
BJ, my rule of thumb for extractions is... if it is not broken do not fix. So if your not having problems with a tooth do not do anything. If your dentist does not have a long history with dealing post radiation survivors I would find someone that does. I had two teeth extracted 18 months ago after they showed some slight infection. My Dentist and oral surgeon for removing them have 10 plus years dealing with and teaching others at the University of Indiana. I was put on antibiotic for 30 days and watched very close, they looked at me once a week for 6 weeks. Then once a month for 6 months and every 3 months. Just recently after two years they have released me as the healing is very slow due to radiation damage to blood vessels, it took 6-8 months just to get a light covering of gum over the extraction just to cover the jaw bone.

Nobody want necrosis of any kind and having the jaw bone infected leads to bone remove and reconstruction. They thought they found more cancer on my pharynx 3 years ago, while going in for biopsy they found it to be necrosis. They did IV antibiotics 3 times a day for 9 weeks and 40 hbo treatments. Good news we have that removed but watch it very closely as if it had become worse the only fix is removal of voice box.

9 years ago I was sent to these dentists as my dentist could not slow the decay or keep up. The first suggestion they had was get a Sonicare Toothbrush with only bioteen tooth paste only and put focus on the gum line when brushing. Second is to Floss several times a day, which i do after most every meal. Use my sonicare tooth brush to put on the fluoride paste with focus on gum line. The focus on gum line is the gap between the tooth and gum line is where the decay most likely begins. All this changed the amount of decay. I went from 3-4 repairs every 6 weeks to maybe 1-2 new decay repairs and 3-4 repairs of repairs past every year. 2 years ago I decided with help from my oral surgeon to use the waterpic. I tried it for a week and it was a challenge getting used to, however soon after it start to help the whole feeling of gums, teeth and skin. A month or two after starting with the waterpic I was thinking was my hands with warm water I wonder how very warm water would do with the waterpic. Wow what a great feeling, so now use as warm as I can stand. The results have lead to even my dentist and hygienist could see a huge difference.

My regiment is waterpic with warm water with focus on gum line, floss, brush with bioteen toothpaste with focus on gum line, rinse with waterpic again with focus on gum line ( I do this so the toothpaste is out) and finally I apply fluoride paste with tooth brush with focus on gum line (flouride 2-3 times per day) do not rinse for 30 min. I try to do this after every meal and most importantly 1 hour before bedtime.

Hope this helps just a bit
John