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Teeth problems after radiation treatment

miklosk's picture
miklosk
Posts: 2
Joined: May 2013

I have been reading on line about teeth pulling after radiation treatments and am scared to death about what I am reading!.  I am 40 months out of radiation treatments. One of my teeth is now at the point of needing to be extracted. Prior to the radiation treatments I requested that I have my teeth pulled  knowing that there would be issues later on as I have had trouble with my teeth all my life. The Dr's informed me that it would be better to have my own teeth. 

My issue is that other people I know who have the same problem informed me that medicare and the suppliment I have will not cover HBO or Hyperbaric Oxygen Therapy. I am on a fixed income and cannot afford this treatment but need it to get my tooth pulled. Does anyone have any information that will help me.

I will be contacting my oncologist in the morning to find out what can be done and what my radiation levels were. Any information would be greatly appreciated.

CivilMatt's picture
CivilMatt
Posts: 2803
Joined: May 2012

miklosk,

Welcome to the H&N forum, you skipped over all the side effects and gone straight to teeth.

I don’t have any information about teeth, from what I’ve been reading I am just waiting for them to fall out, but so far so good at 14 months post.

I do have information about one thing; you look like a real cool cat. I am glad to see you have your sun protection.

Good luck on the teeth (or tooth) it is defiantly the most popular subject going.

Matt

miklosk's picture
miklosk
Posts: 2
Joined: May 2013

Thanks so much for getting back to me so fast. I skipped over the other side effects as they are just not as life threatening as the teeth problem for me. I am still suffering from fatique, thyroid issues and dry mouth all which are being addressed through medication and dietary changes. 

I am a solar person and need the sun to keep me warm and energized. I do however wear 100 on my neck when in the sun and wear something to protect my head. I am also an avid motorcyclist and now wear the dreaded full face helmet which I hate but safety first. 

Thanks again

Miklos

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

Miklos

I have had two teeth extracted on separate occaisions after my radiation treatment. One due to a cracked root and the other because it was in the way after a buccal flap was used to close exposed bone after a surgery. In both cases my doctors at MD Anderson orderd HBO treatments. 35 before the extraction and 10 after. I had 70 Gy to the mandible involved. Other than being bored out of my mind during 2 different sessions of 45 HBO treatments, I had no major problems and healed well. My insurance was through United Healthcare and there was no issue regarding coverage. Best of luck and don't neglect your teeth. Keep up with the flouride.

Rick

D Lewis's picture
D Lewis
Posts: 1518
Joined: Jan 2010

Welcome to the group. Hopefully someone here will have an answer for you.  I am shocked that medicare and your supplement will not pay for hyperbaric treatments. It is my understanding that if your cancer-treating physician places the order for hyperbaric treatments, then your insurance should cover it.  As your oncologist what he can do for you.  Good luck. Insurance sucks.

Oh, and my radiation oncologist told me that I would not need hyperbaric treatments if I ever needed an extraction - I received 68.4 GY both sides of jaw.  My ENT strenuously disagrees with her, and has stated that if I ever do need an extraction, HE will prescribe it for me. Radiation oncologist said all I should need would be a lengthy course of antibiotics to prevent infection while slow healing takes place.

So far, just two crowns since end of treatment, and had no trouble with them.

 

Deb

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

I had gone to a Cancer specialist in dental care to consult - but the surgeon who pulled  15 of my teeth  last week had told me that in his experience after 2-3 years the upper jaw often can have enough blood flow that has returned to not caue a problem while the lower jaw is slower to add blood supply. Maybe you can find a university in your are that has such a cancer dental support - I went here  UMKC

dellarose
Posts: 4
Joined: Mar 2010

After reading your post it gives me a little hope. My husband had his radiation treatments 12yrs ago and now his lower wisdom tooth is decaying. The million dollar question is do we or don't we get HBO treatments for one tooth. He did have all his upper teeth removed about 5-6 yrs ago with no HBO treaments and no problems. Not sure what to do:((

Skiffin16's picture
Skiffin16
Posts: 8052
Joined: Sep 2009

Welcome...

Like mentioned, a lot depends upon if the tooth you mention is upper or lower...

Lower being more prone to problems due to possible infection, healing and recovery.. But even that is not a given...

I seem to remember more than a few here that have lower teeth extracted with no issues, and without HBO, etc...

I'd first approach it with a dentist very familiar with H&N Cancer Treatment involving radiation. I would presume they can determine if the added procedures are warranted...

Best,

John

hlrowe
Posts: 23
Joined: Oct 2012

I don't believe hyperbaric treatments are necessary for an extraction per my periodontist and rad onc. If you want an implant then you would need to get the O2 treatments before and after.

Skiffin16's picture
Skiffin16
Posts: 8052
Joined: Sep 2009

An extraction can warrant going through HBO, but not always...

It's not a given you will, nor won't need HBO for healing with an extraction..

JG

dellarose
Posts: 4
Joined: Mar 2010

Hi I read your post and wondering did you have a tooth extracted without hbo treatments, if so what was the out come. My husband is going through this now trying to decide if he needs these treaments?? any feed back would be helpful, I am new to this board

thanks

dellarose
Posts: 4
Joined: Mar 2010

Hi new to this board. Did you or some one you know have a tooth extracted with HBO treatments and what was the out come? My husband has  to have a lower tooth pulled and is a 12 yr survivor and does not want to go to HBO treatments we are torn on what to do:((

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

Why does the tooth need to be pulled? In my case, four years after treatment my right lower jaw tooth became loose. So I went to the dentist and the x-ray showed dead bone under the tooth. That is osteoradionucrosis from radiation treatment. In this case you must have HBO to restore capillary circulation or it won't heal after  the extraction. Also the dead bone needs to be removed down to bleeding bone. I had Medicare as a supplement to my wifes insurance  and all my HBO treatments were paid as a medical expense not dental.

It is important that your doctors are famiiar with post radiation treatment problems. I was fortlunate to have an oral surgeon who was very knowleglable in head and neck treatment for cancer.

denistd's picture
denistd
Posts: 483
Joined: Apr 2009

I had 17 teeth taken out 30 months out from treatment. Medicare paid for the whole kit and kaboodle including the HBO treatments. I would strongly recommend the HBO, if nothing ever happens after how do you know if the HBO was worth it. If you vave non0-healing issues and the jaw starts to go bad, was that bexause you did not have the HBO, kind of like was paying for car insurance all your life and not having to use it worth it? Denis

Duggie88's picture
Duggie88
Posts: 515
Joined: Feb 2010

I had to have four teeth yanked (bottom front) due to radiation. Three of them broke off before I finished HBO post extractions. Two Dentists and the Oral Surgeon all said keep the rest and definitely sit through the boring HBO. I stressed that in the event one or more teeth went bad in the future I didn’t want to go through HBO again and both dentists felt the rest of my teeth will be fine. Like others have said your insurance needs to know that it is medically necessary in order for them to cover the HBO. I healed really well after having them pulled on the day Hurricane Sandy hit the east coast.

Now I gots me some new toofers and I look normal again. However I will never ever act normal.

      Jeff

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

 Did 20 dives of HBO prior to extraction and 10 dives after.  A few doctors have told me I will never have to have HBO again and others that have said if I need more extractions or implants I would only have to do 10 dives after surgery.  I’m not sure I’m buyin what they’re selling but I’m glad I did it.  Better to be safe than sorry…..even if it’s them most boring two hours of your life. 

George_Baltimore's picture
George_Baltimore
Posts: 303
Joined: Jun 2009

I've had a total of 124 dives since 2009 and have never received a bill.  Medicare and BCBS paid the whole thing.

dennis318's picture
dennis318
Posts: 349
Joined: Feb 2010

I had 30 HBO and was lucky that Blue Cross Shield of Michigan just started paying it that year....they cam after me for 68,000 from a credit agency after they told me it was approved, cancer and creditors don't mix......they finally paid it after a yearglad you fellow cancers people got it so quickly..take care Dennis

dennis318's picture
dennis318
Posts: 349
Joined: Feb 2010

I have 5 teeth rotting from the tom of the gum lines and I have no  dentistry insurance, will Medicaid pay for the repairs to have them filled? Thanks Dennis, where do i check?

George_Baltimore's picture
George_Baltimore
Posts: 303
Joined: Jun 2009

they will pay to have them "filled".  They may pay to have them pulled if the oral surgeon says it was due to radiation.  Go to an oral surgeon if you are thinking about having them yanked out.  He or she should be able to tell you whether it will be covered.

dellarose
Posts: 4
Joined: Mar 2010

Please I am in need of some info. My husband had his radiation therapy 12 years ago and had all of his upper teeth pulled about 6-7years ago without any problems and no HBO treatments (didn't even know about this:((. But now he has a lower wisdom tooth that is not impacted but is starting to decay and the oral surgeon refuses to pull it unless he gets thes HBO treatments?? My husband is in perfect health otherwise. any feed back would be greatly appreciated

God Bless all survivors and never give up hope.

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

DellaRose,  this can sometimes be a difficult question to answer. i did 20 dives in the HBO prior to my extractions and 10 more after. I had some doctors tell me they wouldn't' touch me unless I had these treatments and a few doctors that said I didn't need it. I made the descoin to have the treatments.  They were time consuming but not painful.  I didn't want to endure all of the complications that "might" occure if I didn't do it. I can't tell you if it helped or not but I had four teeth extracted without any issues. I healed nicely and didn't have any inflections. I have been told buy one oral surgeon that since I did the dives, I will never have to do them again Then I have other doctors tell me that if I had more extraction or even implants I would only have to do the two weeks of dives after the procedure. I wish I could give you the exact answer you're looking for but like me, you may just have to go with what you think is best. 

Goodluck and God bless

 

hwt's picture
hwt
Posts: 1819
Joined: Jun 2012

If insurance covers it, I say why take the additional risk. Had 30 HBOT, boring, time consuming but otherwise uneventful. Insurance paid.

hawk711's picture
hawk711
Posts: 525
Joined: Jan 2010

My doctor said he'd like to see 2 teeth out, but Dentist is holding back due to potential ORN problems.  i have no outward ORN issues, but they are just saying it can happen. 

Did anyone have severe Trismus, prior to the tooth extractions????  I went from 26mm to 18 mm overnight on mouth opening ability and am on hold at that margin.   I have pain in gum as I have an impacted wisdom tooth, but other than that feel great.  Go figure.  

I wanted to move this back to the top as I have a dental appt tomorrow and wanted to be able to read the posts again.

Enjoy the day,

Steve

Skiffin16's picture
Skiffin16
Posts: 8052
Joined: Sep 2009

That comment by your dentist reminds me of giving blood up for routine labs...

They always ask which arm..., my standard answer is usually, "That guy's over there"..., LOL.

Steve, Trismus has been brought up a few times... Not long ago there was a thread and I posted a link to exercises to help retain mouth flexibility... I know that Billie had a lot to say on the subject also...

John

hawk711's picture
hawk711
Posts: 525
Joined: Jan 2010

I'll keep you posted on my dental visit.   I'll check out your thread if I can find it and now starts the search for more and better information and advice.  I'll check with Billie after my visit too.  Talking to Greg53 and mikemetzler now and they are giving very good advice and information.

catch up with you soon,

Steve

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