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Dental Impants post radiation

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

After completing radiation in early 2007 I started to have issues about a year later with facial swelling and random fevers. After many trips to the ER and Oncologist, I found out it was was due to my teeth. Before I started radiation I had never had a cavity. After treatment, I saw my dentist every three months like I was told. Anyway, at this point all of my top teeth have been crowned and I've lost 4 teeth on the bottom. I recently underwent unsuccessful gum graphing and at this point my dentist is recommending pulling the remaining bottom teeth and trying dental implants. I've already had 20 dives in the hyperbaric chamber but am very nervous at the thought of implants. I was wondering if anyone else has had issues with their teeth post radiation and has had implants. If so, did it work?

jim and i's picture
jim and i
Posts: 1627
Joined: May 2011

Yes, Jim's teeth are just crumbling away. We have no dental insurance so will probably go with dentures.

Debbie

hwt's picture
hwt
Posts: 1935
Joined: Jun 2012

I was scheduled for implant surgery but battling it out with the insurance company so implants are on hold. I already did 30 HBOT dives. Other than time consuming, 2 hours a day, hyper barics was not at all painful and tx was uneventful. The dental specialist is not comfortable with putting implants on one side lower jaw because of the amount of radiation I received. I think I am more anxious about these implants than I was about surgery, rads and chemo all put together, not sure why.

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

I agree, I'm very nervous about moving forward with impants.  I'm so worried about my jaw bone....I just don't know what to do.

I'm in the same boat, I'm trying to get my medical plan to cover the implants......I'm praying they will.

Duggie88's picture
Duggie88
Posts: 539
Joined: Feb 2010

I was told my jaw would never survive implants. I lost my four front bottom teeth just shy of three years after radiation. I would think twice about risking the jaw bone and the money.

      Jeff

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

Jeff,

The cost of the implants is overwhelming but the fear of moving forward with it is just as overwhelming.  The surgeon that wants to do the implants seems very confident it will work.

Lot's to think about.......I'm just so sick of being in pain.    It hurts to eat or drink anything and IF the implants work, it would take away all my pain. Again, lot's to think about

Thank you for your advice....I appriciate it. 

Duggie88's picture
Duggie88
Posts: 539
Joined: Feb 2010

I would definately get another opinion.

I don't understand how implants will take away the pain with drinking and eating. You may want to consider dentures which cost much less than the implants which is the way I went. If you choose implants and your jaw bone takes a dive the expensive implants will have to come out and from what I've heard jaw bone replacemnt surgery involves a lengthy stay in the hospital.

I'm sure others will have thoughts to help you make  your decision.

      Jeff

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

Since radiation my teeth are so sensitive to hot and cold.  Plus my gums are receding and my roots are exposed.  Actually, I have two teeth where the recession is so bad I’m shocked the tooth hasn’t just fallen out.  I recently underwent gum graphing for two teeth and it didn’t work.  Between dry mouth and painful teeth and gums, I feel like everything in my mouth is constantly killing me and it really makes eating difficult.  The thought of implants taking away the pain is what drew me to it BUT I’m afraid they will do more harm than good.  I was hoping I’d find successful story after story, of people that had the procedure, no such luck.   

 

 

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

Since radiation my teeth are so sensitive to hot and cold.  Plus my gums are receding and my roots are exposed.  Actually, I have two teeth where the recession is so bad I’m shocked the tooth hasn’t just fallen out.  I recently underwent gum graphing for two teeth and it didn’t work.  Between dry mouth and painful teeth and gums, I feel like everything in my mouth is constantly killing me and it really makes eating difficult.  The thought of implants taking away the pain is what drew me to it BUT I’m afraid they will do more harm than good.  I was hoping I’d find successful story after story, of people that had the procedure, no such luck.   

 

 

fisrpotpe's picture
fisrpotpe
Posts: 1338
Joined: Aug 2010

after 17 years i have had many, many issues with my teeth. i have had no implants, i was told by three different doctors it is a huge risk of infection setting in which would lead to have bone removed. the dentists at Indiana School of Dentistry agree, the risk is not worth it. so i will not even begin to entertain the option. i would rather walk around with no teeth than to have jaw bone removed. 

if and when needed, i will make dentures work for me. 

good luck with you choice. 

john 

lorig01
Posts: 69
Joined: Jul 2012

Hi.  I had my teeth removed prior to treatment for tonsil cancer and I had 7 implants put in to hold dentures.  Granted I had the implants done prior to radiation but I have seen implanted dentures on the internet that require only 4 implants.  I would definitely get another opinion but this may be a better option. The dentures stay in place with the implants and I am able to eat almost anything,  (with liquids).   I am sorry for your frustration and hope you can get some relief soon.

MarineE5
Posts: 754
Joined: Dec 2005

Luckily, I haven't had any major issues with my teeth. Had 2 capped early on due to me trying to eat something hard and cracked 2 teeth.

As mentioned above, the main issue is the change in the DNA in our tissue and jaw bone from the radiation. Healing of the gums to cover the exposed bone becomes an issue from what my Cancer Dentist told me years ago. He at the time recommended Dentures if I decided to have my teeth removed. My teeth were border-line as far as keeping or removing them, I decided to keep them. I do my Flouride treatments daily and haven't had any issues.

Implants are not on my list of options...just my 2 cents.....

My Best to You and Everyone Here

traceyd1
Posts: 29
Joined: Nov 2012

My husband is supposed to get the process of getting implants started in August or September.  His jawbone and gums were replaced with his fibula and skin grafting, so the tissue and bone being used for the implants were never radiated.  Our radiaiton oncologist said this is the only reason he's approving the procedure.

nonoandno
Posts: 1
Joined: May 2013

hi sorry about the teeth! my husband had stage 4 scc of the tonsil, and was told to have all his teeth pulled immediately when diagnosed, but his teeth were perfect, he was given double doses of both chemo and rad, with a survival chance of 20%. he refused to have his teeth pulled. he now must have them all pulled and dentures put in, but it is 7 years later, he is still cancer free, and i prefer keeping him  over his teeth:) p.ps. he has no saliva glands in the mouth and the dentist said he probably kept his teeth that long because he chewed alot of gum to bring up moisture!

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

Thank you all for your comments.  I can't express how much I've suffered from all my dental issues.  Sometimes I feel guilty for being upset or frustrated but the bigger picture is, I'm cancer free.  All the stress and expense over the last few years dealing with these issues has made me feel like, in some way, my cancer is sitting on my shoulder not allowing me to escape.  I did the work, I had the surgery and I endured radiation, endless bouts of thrush, weight loss, hair loss, and my sense of well being.  I struggled to get to the other side and I feel like I'm at another cross in the road.  I get it, it's only teeth.  Who cares about teeth when I survived cancer.  BUT, spending all my time at the dentist getting drilled and glued back together is weighing on me.  I've had many dentists’ tell me implants were out of the question.  My current dentist once told me that even if I was a good candidate, I'd be hard pressed to find a dentist that would even risk it.  BUT, he has since introduced me to an oral surgeon who feels differently and thinks it will work.  I'm almost wondering if permanent dentures is a better way to describe what they are suggesting.  They would put 4 implants on the bottom front jaw and then it’s one piece (of whatever it’s made of) that would hook onto the four implants but It would provide me with a full set of bottom teeth.  I don't know what to do but the prospect of being painfree is very tempting....very, very tempting.  Thank you all for your advice….I really appreciate it. 

God Bless…..

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

Thank you all for your comments.  I can't express how much I've suffered from all my dental issues.  Sometimes I feel guilty for being upset or frustrated but the bigger picture is, I'm cancer free.  All the stress and expense over the last few years dealing with these issues has made me feel like, in some way, my cancer is sitting on my shoulder not allowing me to escape.  I did the work, I had the surgery and I endured radiation, endless bouts of thrush, weight loss, hair loss, and my sense of well being.  I struggled to get to the other side and I feel like I'm at another cross in the road.  I get it, it's only teeth.  Who cares about teeth when I survived cancer.  BUT, spending all my time at the dentist getting drilled and glued back together is weighing on me.  I've had many dentists’ tell me implants were out of the question.  My current dentist once told me that even if I was a good candidate, I'd be hard pressed to find a dentist that would even risk it.  BUT, he has since introduced me to an oral surgeon who feels differently and thinks it will work.  I'm almost wondering if permanent dentures is a better way to describe what they are suggesting.  They would put 4 implants on the bottom front jaw and then it’s one piece (of whatever it’s made of) that would hook onto the four implants but It would provide me with a full set of bottom teeth.  I don't know what to do but the prospect of being painfree is very tempting....very, very tempting.  Thank you all for your advice….I really appreciate it. 

God Bless…..

hwt's picture
hwt
Posts: 1935
Joined: Jun 2012

Actually my specialist is planning similar but putting 5-6 implants in mandible now made of my fibula and titanium and attaching a denture to that. I have a temporary denture now with only 4 of my own lower teeth. It's difficult to get in and out because my mouth doesn't open as wide as it used to. This specialist is supposed to be one of the very best so I'm putting my trust in him. He did say he would not put any implants in the other side of lower jaw because of the amount of radiation that I had. The surgeon who spent 19 hours removing the cancer and reconstructing my jaw also has confidence in him.

Good luck in whatever you decide.

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

Hwt….thank you for sharing.   Sounds like you’ve been through a lot and I will keep you in my prayers. Please keep me posted on your progress…..I’m curious to hear how feel with the implants.

Good luck….

Duggie88's picture
Duggie88
Posts: 539
Joined: Feb 2010

Reading your latest post I have concerns that one out of many said he would do the implants. Keep in mind the majority isn't ruling here. I would even question the permanent dentures because they have to anchor something into the jaw bone that has been compromised by the radiation. I know all that have made suggestions are based on their individual circumastances but make sure you do what is best for you. Also, keep in mind these doctors have a practice which menas they are not perfect, they are only working towards it. I once asked a sugeon why do you wear a mask so I can't pick you out in a line-up? All kidding aside don't make any snap decisions although either road you choose you will have to have the bad ones pulled which should help with the pain. You can decide how to replace them later.

I never had a gum issue, my lower front four just started breaking off with no pain except for one that hurt off and on for a day or two but the pain stopped and it broke off at the gum line two months later. Three of the four broke off prior to the hyberbaric treatments

Keep us posted

      Jeff

metro22's picture
metro22
Posts: 16
Joined: Apr 2013

Sheilarhc

Perhaps you would feel better in consulting a specialist in Dental Oncology.  I had conflicting opinions about which teeth to extract before radiation begins so last week flew into Kansas City for a consultation -  I went to

Oncology Dental Support Clinic

  http://dentistry.umkc.edu/Patient_Information/oncology.shtml  

At the University of Missouri - Kansas City. There can of course be serious complication in tampering with the jaw bone after radiation and I wanted a specialist’s opinion. I will have 17 teeth removed this week. Many were nice new crowns done  in  the last 2 years but we want to look out many years and plan on the best outcome. I imagine there are several dental specialists in this field.

 

Good luck to you.

wrhbounds's picture
wrhbounds
Posts: 39
Joined: Jan 2013

After radiation treatment I was lucky I kept my teeth for 8 years until while traveling I developed a bad tooth ache I found a small town dentist who pulled my tooth it took weeks to get back home & by that time the jaw bone had started to die. After 3 operations to try and save my jaw I need a fibula flap. Now 5 years latter &12 more operations I have 6 implants. I am off tube feeding and now on soft food & pereed meat.

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

Thank you for sharing.  Sounds like you've experienced it all and I'm happy to hear you're starting to eat foods again.  If you don't mind me asking, how do the implants feel? 

 

lorig01
Posts: 69
Joined: Jul 2012

Hi.  I had all of my teeth removed during my neck dissection and treatment for tonsil cancer in July 2012. I totally understand about you feeling weird about complaining about your teeth because I felt the same way.  I told many friends that I seemed to handle the radiation and the surgery better than the loss of my teeth.  I could "eat" soft foods 2 or 3 months out from radiation but my lack of teeth was the real problem that kept me from eating.  I became very depressed.  I had to wait 6 months after the implants were inserted until they would start my "permanent" dentures.  So I had temporary dentures for 6 months. It took me awhile to adjust. I could wear the top denture all day but I never could wear the bottom. It "floated" and made me gag with all the "teeth" in my mouth.  So, I returned to work after 3 months post radiation with only the top denture. You could not see my bottom so no one could tell that I had only top teeth.  After 6 months I was fitted with the permanent denture. I wore just the top for a week and then slowly started with the bottom.  I adjusted right away and I was surprised how well I could eat with them.  Now I am wearing them all day but I do remove them to sleep.  I clean my mouth several times a day.  I cannot feel the implants at all. My dentures feel very comfortable as well. I was pleasantly surprised.  Please feel free to ask any questions about this as I was frustrated about the lack of info about dentures, etc. on the web.  Hope you are feeling better soon.

hwt's picture
hwt
Posts: 1935
Joined: Jun 2012

Thank you...you helped ease my mind and my anxiety a bit. It's nice to hear something positive from someone that had radiation and implants. 

Candi

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

Thank you so much.  I cannot tell you how nice it is to hear that someone understands how I feel about the whole teeth situation. (I’m crying as I write this)  The past two years have been so hard on me.  I think there is guilt attached to my emotions and I don’t want to seem like I’m ungrateful.  I survived cancer, I survived radiation,  and I survived all the ups and downs in between.  Now, I’m trying to survive all the craziness related to my teeth.  I don’t think people understand how emotionally difficult it is to deal with the pain (both physical and emotional) when it comes to not being able to eat.  After radiation I was so thin and just swallowing water was a chore.  I remember one night I was so desperate to eat or even just taste food again, I sat in my kitchen licking a Frito hoping I’d at least be able to taste the salt.  No luck, it was like licking paper and I was at my lowest point.  Even now, my taste buds aren’t perfect but manageable.  The lack of saliva has been a struggle but for the most part, I can eat to satisfy myself.  I really don’t eat meat because I just can’t break it down enough to swallow it.  I remember the days I lived for a Steak with some A1 sauce.  Those days are behind me and I’m finally at a point where I’m okay with it.  Now I’m dealing with all the teeth issues and the pain is hard on me.  I work a lot, I’m a single mother of two and there is very little time for me to deal with all of this.  Food, or lack thereof it, takes a toll on people.   When I hear people say “I’m starving” I think….they truly have no idea what it’s like to actually starve and I hope they never do.  I’ve lost 4 molars on my bottom jaw and wear a partial denture.  All of my top teeth have been crowned.  My gums have receded so badly on a few of the bottom teeth it hurts just to breath sometimes.  At first my dentist said that implants would not be an option but now that my first gum graphing failed, he feels like I should consider implants.  The periodontist that did my gum graphing told me that he would not recommend implants and told me that keeping my natural teeth would always be the better choice.  Last week when I went in to get fitted for new partial my dentist told me that the periodontist is now re thinking his opinion and may recommend implants.  Many have mad mention that they have a permanent denture but I’m not sure what that is.  What’s the difference between a permanent denture and implants?  What I do know is that the word implant refers to the anchor (I don’t know what to call it) that they put into the jaw bone to hold the teeth.  Because I have bone loss, they want to pull the remaining bottom teeth and only put 4 implants in the lower front jaw bone.  With those 4 implants they would make me teeth that would be anchored to those four implants.  These teeth would be one piece and I would never have to take them out.  I’m scheduled to see the periodontist in two weeks for my follow up from the gum graphing and discuss trying the gum graph one more time.  I’m just so scared to allow them to drill into my jaw.  I know it’s my decision if I want to try but I do not want them to destroy my jaw bone and make things worse.  I’ve tried to research implants post radiation and it doesn’t seem like there’s much information available.

So, now that I wrote a novel, again I thank so you so much for responding to my post and I’m happy that you are doing well. 

Duggie88's picture
Duggie88
Posts: 539
Joined: Feb 2010

I never had the gum line issue. You did bring back memories of getting my taste back. I wasn't ready to swallow potatoe chips but I did put them in my mouth until they were so soft I could wash them down with water. It was the salt that my taste buds recognized early on and those chips fried in lard sure tasted good.

I can certainly agree with you that you have a tough decision. I see the big factor being what will the implant spikes do to the jawbone. You do state that you have bone loss which throws up a red flag. I certainly wish you luck. Keep us posted so we all can celebrate with you.

      Jeff

lorig01
Posts: 69
Joined: Jul 2012

Hi.  I don't have the kind of implants that I think you are getting.  I have implanted dentures.  These are permanent dentures that snap into implants in your gum. I have to remove them after I eat to clean and I don't sleep with them.  The implants allow you to have more adhesive strength so that you can chew better than regular dentures.  Permanent dentures are what you would think of as dentures.  When I had dentures made they gave me a temporary pair that I used to get used to and then after my gums adjusted they made a permanent pair. They are harder and adhere to your gums better and you can eat with them. I could not eat with the temporary and used them only for looks, (actually I only wore the upper).  With implanted dentures they take your permanent and put snaps in them. These dentures snal into implants that are in your gums. I snap them in and remove them to clean and to sleep, (you can sleep with them but I don't). I asked my dentist about sleeping with them and she said I could but I don't.

I have been thinking about your dilemma.  I know you are concerned about implants and jaw issues.  What if you asked your dentist about dentures? Dentures may work for you.  You can ask them if you have problems with dentures then can I go ahead and have implants put in at a later time and have my denture anchored? If yes then you can slowly move toward a solution and reduce your worry about jaw issues.  They could only put 3 anchors in my lower jaw and I can eat pretty much anything. There is a learning curve though. 

I know it is such a hard decision.  Having to decide in less than a week to have all of my teeth removed was the hardest decision that I ever had to make. I know that it seems overwhelming and it is a big decision.  It sounds to me that the worst thing for you is the pain that you are experiencing so I would press the doctors to see what the best option is to eliminate the pain and discomfort. After that then the next decision might be what options would be best for going forward taking into account safety and functionality. 

Here is a website detailing differnet types of denture options.

http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-at-Any-Age/Seniors/Dentures-and-Dental-Implants/article/Implant-Supported-Denture.cvsp

Also,  what part of the country are you in? I am in Houston Texas and can recommend my dentist who trained at MD Anderson and worked with radiation patients. She was so careful and cautious about everything that it drove me crazy. But I felt totally safe with her. I hope you are working witha dentist that has experience with radiation patients.  Also, she gave me a discount because my work was medical and not cosmetic. Anyway have to get to work.  Hope you have a great day!

 

 

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

Lorig01….I live in Chicago and have been to many large hospitals in my area (Rush and Loyola University)  I’m currently working with a dentist that is wonderful and determined to help me.  I’ve also been to many dentists that basically told me to see a pain specialist because I didn’t have many options.

Thank you for the link….very informative.  You’ve been great and very helpful.  Means a lot to me…….

wrhbounds's picture
wrhbounds
Posts: 39
Joined: Jan 2013

I enjoy the freedom they give me & They make me feel better because I look closer to normal

hwt's picture
hwt
Posts: 1935
Joined: Jun 2012

that makes me feel twice as good!

I consulted two Maxillofacial Surgeons about implants, both work with cancer patients and radiated patients. It is my suggestion to seek an opinion from a specialist.

 

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