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Pre-Radiation Dental Issues

LCSister
Posts: 13
Joined: May 2013

Bunch of Questions...

Brother slated to started radiation in 1.5 weeks to right and left side of head post left parotidectomy and neck dissection.  Dental screening yesterday:  2 cracked teeth (they will work on and crown later)...and 3 impacted (no infection) widom teeth and one that erupted.  He will be contacting rad onc doc today, but I wanted to get the forums opinion/experiences.

1.  Should he have wisdom teeth removed?

2.  How long will he have to wait for radiation/chemo then?

3.  Is it OK to corwn later?

 

Thnaks for your help!

Skiffin16's picture
Skiffin16
Posts: 8104
Joined: Sep 2009

Get them pulled now....., even if it delays treatment a few weeks. I'm sure it wouldn't be much longer as a few people have had all of their teeth pulled pre-treatment.

As for crowns, that shouldn't be a problem after the fact...

I was STGIII Tonsils, sixteen weeks total of four types of chemo, seven of which were concurrent with 35 daily rads sessions...

I've had two crowns post treatment...

Welcome....

John

ratface's picture
ratface
Posts: 1254
Joined: Aug 2009

Finding any dentist to even consider one extraction let alone 4 extractions will prove impossible.  No one will touch him without expensive and extensive hyperbaric treatments. Get the wisdom teeth out now. They can form the crown now, put in temporaries, and finish up impressions after radiation. I'm only guessing that he can start radiation quite soon if the extractions don't get complicated. You are a true blood sibling! My best to you and your brother.

D Lewis's picture
D Lewis
Posts: 1547
Joined: Jan 2010

Your brother needs to get this done as soon as possible, preferably before treatment, because they won't easily be able to do it afterwards, at least until his mouth heals up.  If he needs extractions, do them now, because post-radiation extractions will likely require hyperbaric treatments to help with healing and that is expensive and time consuming.  I've had two crowns subsequent to radiation, and both went fine.  Not sure about how long to wait for radiation after an extraction. His oncologist should be able to tell him that. I had a crown put in, just days before radiation started, and I was fine to start treatment.

He may need to call around to find a dentist willing to do a rush job on the teeth. Fortunately, my dentist was able to do this for me after she heard my diagnosis.

Deb

MarineE5
Posts: 762
Joined: Dec 2005

LCSister,

1. Yes, he should have any questionable teeth pulled now before the radiation. He may have to reschedule the radiation a week or two.

2. Roughly 2 weeks give or take. I had some jaw work done prior to my radiation, I was healed in 2 weeks and able to receive the radiation.

3. Yes, I cracked 2 teeth after my radiation and had Crowns put on with no problems. The issues araise when teeth need to be pulled after radiation. The radiation changes the DNA in our mouth and neck area and healing becomes an issue. That is why it is recommended that we do the Hyperbaric chamber for 20 days prior to tooth removal and another 10 days afterwards. So, many Doctors suggest to get any mouth work done prior to the Radiation.

My Best to You, Your Brother and Everyone Here

fishmanpa's picture
fishmanpa
Posts: 1134
Joined: Jan 2013

LCSis,

As the others have said, get the work done PRIOR to rads. He'll need about two weeks to heal so re-scheduling rads will be in order. 

I had to give my team (Johns Hopkins) a letter from the dentist stating that all work was done and I was clear for treatment. 

Positive thoughts and prayers

"T"

Billie67's picture
Billie67
Posts: 834
Joined: Jul 2012

Get extractions done now and crowns will be ok to wait on. I'm surprised they didn't tell you that was a must!?
Anything where major healing might be an issue should be taken care of now. Healing will be much more difficult after rads and could cause irreversible damage and changes. The crown however involves very little tissue changes.
Billie

CivilMatt's picture
CivilMatt
Posts: 3093
Joined: May 2012

LCSister,

My rad onc actually talked to my dentist to confirm the condition of my teeth.

If there are issues with his teeth, they will need to be addressed to the rad onc satisfaction.

Smile, the start is crazy fun. He will be OK.

Matt

jim and i's picture
jim and i
Posts: 1686
Joined: May 2011

Recommend Before Treatment. Jim had to wait two weeks for gums to heal before rads but that was safer than having left them for later. Any tooth problems prior leads to bad infection and dangerous complications. Temp crown work can be done prior.

jim and i's picture
jim and i
Posts: 1686
Joined: May 2011

 

LCSister
Posts: 13
Joined: May 2013

Great advice from all.

I wanted to hear what you guys all had to say before I heard what rad onc doc said.  The doc is off today so he is going to call them tm to give them the report.

Knowledge is power!

phrannie51's picture
phrannie51
Posts: 3852
Joined: Mar 2012

than my vote for getting all extractions done ahead of treatment....doing them afterwards is expensive and risky in the healing department. 

p

HobbsDoggy
Posts: 165
Joined: Feb 2013

I had one crown after readiation and another scheudled.  That went OK.  I did go to a dentist who was familiar with neck radiation issues.  He did not find any teeth to pull, but said he would do that before radiation if pulling was needed.  I go every three months post for a year or more just to keepon top of dential issues. Best of luck.

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