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Hyperbaric treatment and dental extractions looming on the horizon

D Lewis's picture
D Lewis
Posts: 1545
Joined: Jan 2010
Hello everyone, long time no see!
I have a question for you all regarding hyperbaric treatments relating to dental extractions - given the time involved, loss of hours at work, cost, potential for short-term and long-term visual adverse effects, especially in my own case...  (It will "ripen" my radiation-induced cataracts, and exacerbate issues I have with retinal hemorrhage, which has already taken the central vision of one eye)
if it turns out that I need hyperbaric treatment for the extraction of a single tooth, should I have them all removed? Or, perhaps, just remove all from my lower jaw, where the blood flow is most intensely compromised and the need greatest? I have concerns about coming successfully through the process for a single tooth, and then six months or a year down the road, having another tooth fail, and needing to do it all again. Anyone with relevant experience? Ideas? Thanks.
Deb
KTeacher
Posts: 982
Joined: Jan 2011

I've had 2 teeth removed without HBO treatments.  I did ok.  The second one took a little longer to heal but I was watched and had some med.  They were uppers.  Have you been sent to a specialist?

phrannie51's picture
phrannie51
Posts: 3819
Joined: Mar 2012

I put myself in your shoes because that is something I'd truly want to know....if I'm going to do the Hyperbarics, and it takes so much money and time, should I get them all yanked at once, or do this money/time consumer over and over.  I sure don't have an answer, but wonder if your dentist could give you some idea how well other teeth are doing.  Thinking also, that you'd probably have to have 2 or 4  pegs put into the bone to hold a denture or a bunch of pegs if they're doing implants....the jaw bone would have to hold up to those, too.

p

 

Mikemetz's picture
Mikemetz
Posts: 353
Joined: Nov 2011

I've had two series of HBO treatments and have serious doubts about their effectiveness, even before you factor in cost, lost time, lost productivity, and mind-numbing boredom.

When I've asked my doctors' opinions, the best I get is that "It can't hurt, so do it."  Well, if they had to take nearly 3 hours a day off of work each time, they might have a different answer for me.

All of the research I've read gives no more than weak support for HBO's effectiveness, and no one seems to know under what circumstances it can be an effective treatment.  The HBO docs say that you have to complete the full series of "dives" to get any effect--if any is there to be had, so they convince you to ride out them out and not stop in the middle.

mikr

 

longtermsurvivor's picture
longtermsurvivor
Posts: 1830
Joined: Mar 2010

Certainly in terms of experience.  Hey you have to post on your blogsite too.  It doesn't do me any good to have you have this nice site, be in New Zealand, then not blog.  So stop sightseeing, and type away!

donfoo's picture
donfoo
Posts: 1316
Joined: Dec 2012

When I've asked my doctors' opinions, the best I get is that "It can't hurt, so do it."

This is sort of lame response from medical professionalS. Just what is HBO supposed to accomplish anyway? Just something to keep the cancer survivor alumni worrying? Is it supposed to lower the chance of infection or slow tissue repair after an extraction? How is the decision influenced by signs of ORN or not?  I follow this topic a lot and find I have more questions than solid answers as time goes on. Don

D Lewis's picture
D Lewis
Posts: 1545
Joined: Jan 2010

Heading out to see a specialist early next week.  Sent an email in to my favorite expert at Stanford to get their opinion. My ENT is heavily in favor of hyperbaric, owing to the fact that he is treating 3 patients right now who have serious ORN issues and he doesn't want to see me go there.  Looking foward to a response from my ophthalmologist with regard to the potential for adverse events.   My dentist has a lot of experience with Head/Neck survivors, and she's been thrilled by my hygiene, and very happy with the state of my teeth.  This one snuck up on her though; a crown came off to reveal extensive decay and a shattered tooth beneath.  It wasn't even painful.  What happened to the nerve? I have a mouth full of crowns already, and no idea which of them, if any, might be incubating more decay underneath.  So far, everything else seems solid, but so did this tooth, up until about three weeks ago. Ick.  My dentist wants first to try a root canal to salvage what is left of the tooth. 

I have read elsewhere that the main issue with ORN is with the lower jaw, as it takes a harder hit from the radiation and is served by fewer blood vessels.  Anyone else hear this one?

Deb - dining on yogurt today. bleh.   

KTeacher
Posts: 982
Joined: Jan 2011

Always good to ask the main man at Stanford where you should go.  Did he send you to the Bay Area or someone in the valley?  The specialist will probably do a panorama x-ray and that should show if you have any other problems to be looked at.  I will be interested to hear how that appointment goes.

hawk711's picture
hawk711
Posts: 527
Joined: Jan 2010

Hey Deb

Sorry to hear about the teeth issues.  I am about 6 months ahead of you with your description of your situation.  I had 30 HBO dives with the intent of removing an imbedded wisdom tooth and maybe one more tooth.  My issue is ORN and they wanted to do this to try and stop it in it's tracks, but I found out my jawbone is cracked and the Oral Surgeon thought he may break my jaw if he tried to remove the tooth.  The good news was the HBO improved my swelling, pain, and actually gave me more saliva (who'd a thought).  The effects lasted about 4-6 months and now I have swelling again with pain.  The ORN is a Bi*ch.  The tooth extraction was to help the ORN, but my dentist thought better to leave the teeth in than to risk the bone not healing.  Why don't you PM me and we can discuss.  I go to Stanford also and I can share with you what takes too long to write here.  For me the HBO was a good experience. My eyesight changed as you said, but it came back in about 8 weeks to normal.  I have some serious eye issues too and it didn't bother me any more that other abi-normal people.  

Hope you find this helpful.

Steve 

D Lewis's picture
D Lewis
Posts: 1545
Joined: Jan 2010

Thanks, Steve.  Will do.

Duggie88's picture
Duggie88
Posts: 556
Joined: Feb 2010

I asked the same question when I had to have 4 pulled on the bottom and the dentist didn't like the idea of having more than needed pulled. Maybe it was money in the bank for his kids college fund who knows. But I chose to agree that it is best to keep your natural teeth as long as possible.Yes it was a boring 2.5 hours but I never healed faster in my life after having them yanked.

     Jeff

D Lewis's picture
D Lewis
Posts: 1545
Joined: Jan 2010

Thanks, Jeff.  That's a good way to look at it.

Deb

donfoo's picture
donfoo
Posts: 1316
Joined: Dec 2012

the dentist didn't like the idea of having more than needed pulled. Maybe it was money in the bank for his kids college fund who knows

You bust me up. That is truely a unique spin on why a dentist choses to pull less teeth now. I would hate to be the folks coming in the month when his new Ferrari is rolling off the boat!

PatDarago
Posts: 13
Joined: Sep 2012

Deb,

I have some (alot)of expierence with HBO. Little back ground. BOT SCC in 2010 with 36 radiation treatments and chemo. In 2011 ,I had a tooth prepare for a crown and the area around the tooth was damaged and I developed ORN. In Jan 2012, I went thru 20 treaments of HBO before the tooth was extracted and 10 more after . The wound did not heal and in March of 2013 ,I had a debrevement done to remove the dead bone ,and had 10 more HBO treatment ,a total of 40, which the doctors tell me is the limit.

As for the amount of money , It was all covered thru my insurance and I was very fortunite to have a hospital near me that has a HBO chambar that was only 10 minutes away. the hospital worked with me so I would not miss any work and did my tratments after I got off work daily. It was hard to lay flat on my back in that glass chambar for 2 1/2 hours at a time, But my wife bought me all 6 seasons of the Saprano's ,which I watched 2 episodes a night to pass the time.

In the end ,I think it helped , but I am still looking at a total Jaw replacement in the future due to ORN .

 

Hope you well and make the right choice that fits you.

 

Pat

Kent Cass's picture
Kent Cass
Posts: 1747
Joined: Nov 2009

Deb

   With 10 Crowns and a Bridge, our boats aren't too far apart. Less than a year ago I had a problem under a Crown, which lead to two Root Canals on the same tooth, then a new Crown to replace the old. Way it was explained to me was that keeping the teeth is by far the best option once we've been thru the C tx. The Hyperbaric was discussed, pending how the RC went and condition of tooth after it, but they thought it was good enough to re-Crown. 

   Lot I don't understand, but the issue is bloodflow and pockets developing in the jawbone that compromise it's physical integrity, and leads to problems. Those pockets are difficult to find. Did some reading and You Tubing on seminars, and it seems there's still only a combination of two tests that can best assess the condition of the jaw- one is the regular Panaramic X-ray, and the other has a name that escapes me, but which I know your people at Stanford will know of. I would suggest you throw that past the Stanford team to get a good focus on the big picture, and take their advice on what's best, long term, for you.

   The costs are major, girl, but no way around that unless you can get Aflac (can't join until 5-years C-free), or some such  to help. My Dentist insists that pulling teeth only leads to complications in the ORN field, or so he says. FYI.

    kcass 

hawk711's picture
hawk711
Posts: 527
Joined: Jan 2010

Great to hear from you Kent.  Hope you are doing well in QC.

 

deb, my HBO Dr's sain he thinks HBO works for 66% of people, 2/3rds is what he says shows improvement.  I was one of the 66%, so I am a believer, but you and others could be in the 1/3rd that it doesn't help.  As we say, everyone is different.

 

good luck

steve

thennies61's picture
thennies61
Posts: 213
Joined: Jan 2014

I had a team of surgens and the one that did graphing sugested removing the teeth I had mainly because he said when I start raditation will most likely destory what is left.Will find out shortly

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